A lump on the shoulder can be a source of concern, prompting questions about its origin and implications. These masses are a common occurrence, and while many are benign and harmless, some may require medical attention. Understanding the characteristics of different shoulder lumps can help individuals discern when to seek professional evaluation and appropriate care.
Common Benign Causes
Many shoulder lumps stem from non-cancerous conditions, often presenting as soft, movable masses. A frequent type is a lipoma, a benign fatty tumor that grows just beneath the skin. Lipomas feel rubbery or doughy to the touch and are generally painless, though they can cause discomfort if they press on nerves or blood vessels. These slow-growing lumps can range in size and are most common in adults between 40 and 60.
Cysts are another common benign cause, forming as fluid-filled sacs. Sebaceous cysts, also called epidermoid cysts, are flesh-colored sacs beneath the skin filled with keratin, sometimes exhibiting a tiny hole in the center. They are usually painless unless inflamed or infected. Ganglion cysts, fluid-filled masses near joints or tendons, can also appear on the shoulder. These cysts may fluctuate in size and are often asymptomatic, though they can cause pain if they compress surrounding nerves.
Muscle knots, or myofascial trigger points, are tense areas within muscle fibers that feel like hard, painful lumps. These knots often result from overuse, poor posture, stress, or injury, causing localized pain and tenderness that can sometimes radiate to other areas. Bursitis, an inflammation of the fluid-filled sacs (bursae) that cushion joints, can also present as a shoulder lump. This condition typically causes pain, swelling, and warmth, often aggravated by movement.
Benign bone growths, such as osteochondromas, are non-cancerous tumors composed of bone and cartilage. These growths develop during childhood or adolescence near the ends of long bones. While usually painless, an osteochondroma can cause discomfort if it presses on nerves, blood vessels, or tendons, or if its associated bursa becomes inflamed.
Potential Serious Causes
While most shoulder lumps are benign, some less common causes warrant closer attention. Malignant tumors, such as sarcomas or metastatic cancer, can manifest as lumps. Sarcomas are cancers forming in connective tissues like muscle, fat, or bone. Metastatic cancer indicates cancer from another body part has spread to the shoulder.
Infections can also lead to concerning shoulder lumps. An abscess, a pus-filled lump deep under the skin, often results from bacterial infection. Abscesses are typically round, firm, and painful, presenting with redness, warmth, and sometimes accompanied by fever or chills. These infections require prompt medical intervention to prevent further complications.
Certain inflammatory conditions might also present as a lump. For instance, rheumatoid nodules, associated with rheumatoid arthritis, are firm, flesh-colored lumps appearing on bony areas like the shoulders. Although generally not cancerous, they indicate an underlying systemic inflammatory disease.
Signs to Seek Medical Attention
Seek medical attention if a shoulder lump exhibits certain characteristics. Consult a healthcare professional if the lump grows rapidly or changes shape. Any new or increasing pain also warrants attention.
Other warning signs include redness or warmth over the lump, suggesting infection or inflammation. A lump that feels hard, fixed, or does not move easily should be examined. New lumps appearing in older adults, or any lump larger than 5 centimeters (approximately the size of a golf ball), also necessitate medical consultation. Seek medical advice if the lump is accompanied by systemic symptoms like unexplained fever, significant weight loss, or night sweats.
What to Expect at the Doctor
When evaluating a shoulder lump, a healthcare provider will typically begin with a thorough medical history. This involves asking about the lump’s appearance, changes in size or pain, and any other associated symptoms. A physical examination assesses the lump’s size, texture, mobility, tenderness, and location relative to surrounding structures.
To determine the lump’s nature, various diagnostic tests may be ordered. An ultrasound is often a first-line imaging technique, using sound waves to create images of soft tissues and differentiate between solid masses and fluid-filled cysts. X-rays help evaluate bone involvement if a bony growth is suspected.
For a detailed view of soft tissues, muscles, tendons, and nerves, a Magnetic Resonance Imaging (MRI) scan may be performed. If imaging results are inconclusive or malignancy is suspected, a biopsy may be necessary. This procedure involves taking a small tissue sample from the lump for microscopic examination to confirm a diagnosis. Treatment options, ranging from observation to medication or surgical removal, depend on the specific diagnosis.