A burning sensation in the shoulder is a distinct symptom that often signals more than a simple ache or muscle fatigue. This fiery feeling, sometimes accompanied by tingling or numbness, suggests irritation or inflammation within the complex structures of the shoulder joint or, more commonly, the nerves that supply it. Understanding the origin of this specific type of pain is the first step toward effective treatment. The sensation frequently points toward a neurological or inflammatory process requiring targeted care. The shoulder’s broad range of motion and its proximity to the neck and chest make it vulnerable to a variety of conditions that can manifest with this uncomfortable symptom.
Nerve-Related Causes Originating in the Neck
The true burning sensation is frequently neuropathic, meaning it originates from an irritated or compressed nerve. The shoulder receives its primary nerve supply from the brachial plexus, a complex network of nerves stemming directly from the lower cervical spine (neck). When a nerve root is compressed as it exits the spinal column, a condition known as cervical radiculopathy occurs, often manifesting as sharp or burning pain that radiates into the shoulder and arm.
This compression most commonly affects the C5 or C6 nerve roots due to age-related degeneration, such as a herniated disc or the formation of bone spurs. The pain pattern follows the path of the irritated nerve, which is why a problem in the neck can be felt intensely in the shoulder region. Movements like extending or straining the neck can often intensify this radiating, electric-like pain, sometimes accompanied by weakness in the deltoid or biceps muscles.
A more sudden neurological cause is a brachial plexus injury, often colloquially termed a “burner” or “stinger.” This injury involves a forceful stretch or compression of the nerve bundle, typically resulting from trauma like a blow to the head and shoulder simultaneously, common in contact sports. The pain is immediate and severe, described as a lightning bolt or intense burning that shoots down the arm, frequently causing temporary arm weakness.
A less common neurological cause is Thoracic Outlet Syndrome (TOS). This occurs when the nerves and blood vessels are compressed in the narrow space between the collarbone and the first rib. This mechanical compression can lead to chronic burning, tingling, and numbness, particularly in the hand and arm, with the discomfort often beginning in the neck and shoulder. Neurogenic TOS, involving the compression of the brachial plexus nerves, is the most frequent type.
Localized Inflammation and Soft Tissue Injuries
While nerve issues typically cause the most intense burning, severe inflammation within the shoulder joint itself can also create a localized, fiery sensation. One of the most common causes is subacromial bursitis, which involves the inflammation of the bursa, a small fluid-filled sac that cushions the tendons. When this sac becomes irritated, often from repetitive overhead motions or trauma, it swells and creates intense, localized burning pain directly under the top of the shoulder. The pain from bursitis is often exacerbated by pressure, such as lying on the affected side, and by lifting the arm above shoulder height.
Another frequent culprit is rotator cuff tendinitis, where the tendons of the four muscles responsible for shoulder stability become inflamed. Chronic irritation or degeneration of these tendons, particularly the supraspinatus, can lead to a burning or aching pain that worsens with movement and may radiate down the side of the arm. In cases of partial or full-thickness rotator cuff tears, the accompanying acute inflammation can be severe enough to present with a sharp, burning quality upon attempting movement against resistance.
Even severe muscle strains, such as in the deltoid or trapezius muscles, can occasionally present with acute burning upon injury. The inflammatory response to a significant tear can release chemicals that sensitize local nerve endings, temporarily mimicking the distinct pain of nerve irritation. However, this type of burning is typically more diffuse and less associated with tingling or numbness in the hand than radiculopathy.
Specific Medical Conditions Causing Burning Pain
Some cases of shoulder burning are not mechanical or spinal in origin but stem from systemic or infectious conditions. A unique cause of unilateral, intense burning is Herpes Zoster, commonly known as Shingles. This viral infection involves the reactivation of the varicella-zoster virus in a spinal nerve root, causing a painful burning or deep ache that follows a specific dermatome, such as the C5 or C6 nerve distribution. The pain can be so severe that it is initially mistaken for a rotator cuff problem or other musculoskeletal injury before the blistering rash appears days later.
Burning pain can also be a form of referred pain, meaning the source is an internal organ sharing the same nerve pathway to the brain as the shoulder. For example, issues with the gallbladder, such as gallstones, frequently cause referred pain to the right shoulder or shoulder blade area, sometimes described as a deep burning or ache. Conversely, burning or pressure in the left shoulder can, in rare cases, be a symptom of a cardiac event like angina or a heart attack.
Chronic pain conditions, such as fibromyalgia or other generalized neuropathic pain syndromes, can also include a persistent burning component in the shoulder. These conditions involve changes in how the central nervous system processes pain signals, resulting in widespread pain and hypersensitivity. These systemic causes are often considered when mechanical and neurological tests of the shoulder and neck are inconclusive.
Knowing When to Contact a Doctor
While many causes of burning shoulder pain, like mild tendinitis, resolve with rest and self-care, certain symptoms require prompt medical evaluation. You should seek immediate medical attention if the burning pain is accompanied by signs of a possible cardiac event. These signs include chest tightness, shortness of breath, nausea, or sweating, especially if the pain is on the left side. Sudden inability to move the arm, or a rapid loss of strength or sensation, are also red flags that require urgent assessment for a severe nerve injury or rotator cuff tear.
A non-urgent medical visit is warranted if the burning sensation persists consistently for more than a few days, even with rest and over-the-counter anti-inflammatory medications. Pain that is severe enough to consistently interfere with sleep, or if a rash begins to appear in the painful area, should prompt you to schedule an appointment with a healthcare provider. Initial self-care steps, such as applying ice and avoiding activities that aggravate the pain, can provide temporary relief while determining the need for professional diagnosis.