Discovering a shoulder lump can be concerning. Most are not serious, but understanding causes helps guide next steps.
Common Benign Causes
Many hard shoulder lumps are harmless, involving soft tissues or bone, posing no health risk.
Lipomas are non-cancerous, soft, movable fatty tissue growths. They grow slowly and are usually painless, though large ones can cause discomfort.
Cysts are sac-like structures filled with fluid or other material. Sebaceous cysts, common epidermoid cysts, arise from blocked oil glands, feeling firm, smooth, and movable, sometimes with a small pore.
Muscle knots form when muscle fibers or fascia tighten due to stress, poor posture, or overuse. They are tender or painful when pressed, restricting movement.
Bone spurs are bony projections forming along joint edges, often due to aging or osteoarthritis. In the shoulder, they can be felt as a hard, immobile lump.
Fibromas are slow-growing, painless fibrous tissue growths, appearing as firm, raised lumps on or under the skin.
Less Common and Concerning Causes
Some hard shoulder lumps require medical attention, ranging from inflammatory processes to rare, more serious conditions.
Ganglion cysts are fluid-filled sacs forming near joints or tendons. They can develop around the shoulder, feeling firm and sometimes changing size.
Bursitis is inflammation of a bursa, a fluid-filled sac cushioning joints. In the shoulder, an inflamed bursa can swell into a tender, hard lump, causing pain and limited motion.
Calcific tendinitis involves calcium deposits in tendons. These can feel like a hard lump, causing intense pain during arm movement. They can be debilitating, though the body may reabsorb them.
Trauma to the shoulder can cause a hard lump. A hematoma (clotted blood) can form after injury. Severe trauma might also result in a displaced bone fragment or dislocation, presenting as a hard lump with pain and loss of function.
Abscesses are localized infections with pus. On the shoulder, they feel firm, warm, red, and tender, accompanied by pain, fever, or chills, indicating systemic infection.
Benign bone or soft tissue tumors can manifest as hard lumps. Osteochondromas are non-cancerous bone growths near growth plates, usually painless but can cause pain if pressing on nerves. Desmoid tumors are rare fibrous tissue growths that can occur in the shoulder.
In rare instances, a hard lump could indicate a malignant tumor, such as a sarcoma. Any persistent or rapidly changing lump warrants medical evaluation.
Red Flags for Medical Consultation
Certain shoulder lump characteristics should prompt a healthcare visit. These signs help determine when medical evaluation is appropriate.
Rapid growth or changes in size/shape, or increasing pain/tenderness, are indicators for concern.
Signs of infection (fever, chills, redness, warmth) or skin changes (ulceration, discoloration, unusual texture) around the lump require prompt medical attention.
Impaired shoulder or arm movement, or a lump that feels fixed rather than movable, requires professional examination.
Lumps persisting after trauma, or accompanied by unexplained systemic symptoms like weight loss or fatigue, should be reviewed. Any new lump causing persistent concern warrants discussion with a doctor.
What to Expect at the Doctor’s Office
Consulting a doctor for a shoulder lump begins with a medical history and physical exam. The doctor will ask about its appearance, growth, symptoms, and general health, then assess its size, consistency, mobility, and tenderness.
Based on initial findings, diagnostic imaging tests may be recommended. Ultrasound uses sound waves for soft tissue imaging, determining if a lump is solid or fluid-filled. X-rays visualize bone abnormalities. MRI or CT scans provide detailed views of soft tissues and bone structures.
If imaging is inconclusive, a biopsy may be necessary. This involves taking a tissue sample for laboratory analysis, providing a definitive diagnosis by identifying cell types.
Once diagnosed, treatment options vary by cause. These range from observation for benign lumps, to medication, physical therapy, or surgical removal for cysts, tumors, or painful bone spurs. Proper diagnosis is important for effective management.