Gallstones are small, hardened deposits that form within the gallbladder, a pear-shaped organ beneath the liver. This organ stores and concentrates bile, a digestive fluid that aids in fat digestion. While many people with gallstones experience no symptoms, some develop pain, sometimes in unexpected areas like the shoulder. This is known as referred pain, occurring due to the body’s complex nerve network.
The Connection: Gallstones and Referred Shoulder Pain
Pain from gallstones can manifest in the right shoulder or shoulder blade due to referred pain. This occurs when irritation in one body area is perceived as pain in a different location. The mechanism involves the phrenic nerve, which supplies the diaphragm, a muscle near the gallbladder. When the gallbladder becomes inflamed or irritated, it can stimulate the diaphragm.
The phrenic nerve shares nerve pathways in the spinal cord (C3-C5) with nerves supplying the shoulder. The brain then interprets signals from the irritated diaphragm and gallbladder as pain from the shoulder, not its actual source. This referred pain often intensifies after eating fatty meals, which trigger gallbladder contraction and potential irritation.
Identifying Other Gallstone Symptoms
While shoulder pain can be a symptom, gallstones typically present with other indicators. The most common is a sudden, rapidly intensifying pain in the upper right abdomen or center abdomen, below the breastbone. This pain, often called biliary colic, can last from minutes to hours. Nausea and vomiting may also occur. Some people report pain radiating to the back, between the shoulder blades.
If complications arise, more severe symptoms like fever, chills, or jaundice (yellowing of skin and eyes) may develop, sometimes with dark urine or clay-colored stools.
When to Seek Medical Attention and Diagnosis
Consult a healthcare professional if you experience persistent, severe, or worsening abdominal pain, especially with fever, chills, or jaundice. These signs could indicate a serious complication. A medical assessment begins with a symptom review and physical examination.
To confirm gallstones, providers use diagnostic tests. An abdominal ultrasound is often the first choice, effectively identifying most gallstones. Blood tests check for inflammation, infection, or liver function issues. Other imaging, like CT scans, MRIs, or HIDA scans, may provide more detailed information, particularly if bile duct stones are suspected.
Treatment Options for Gallstones
For individuals with asymptomatic gallstones, medical treatment is often unnecessary. A healthcare provider may recommend watchful waiting or dietary modifications, such as limiting fatty foods. Oral medications with bile acids can sometimes dissolve small cholesterol gallstones, though this takes months or years, and stones may reappear if treatment stops.
The most common and effective treatment for symptomatic gallstones is surgical removal of the gallbladder (cholecystectomy). This is often performed using laparoscopic techniques, involving small incisions for less pain and quicker recovery. The gallbladder is not essential for life, and after removal, bile flows directly from the liver to the small intestine, allowing continued digestion.