Left shoulder pain is a common concern for men, presenting a range of sensations from a dull ache to sharp discomfort. This pain can arise from various sources, including the musculoskeletal system, internal organs, or the heart. Understanding these potential causes can help individuals determine appropriate next steps for evaluation.
Musculoskeletal Causes
Many instances of left shoulder pain stem from issues within the musculoskeletal system, which includes muscles, bones, joints, and connective tissues. Rotator cuff injuries are a frequent cause, involving the group of four tendons and muscles that stabilize the shoulder joint. These can manifest as tendinitis, an inflammation of the tendons, or tears, which are disruptions of the tendon fibers. Such injuries often result in a dull ache, pain that worsens with overhead movements, and discomfort that might intensify at night.
Bursitis is another common musculoskeletal culprit, characterized by inflammation of a bursa, a small fluid-filled sac that cushions joints. When a bursa in the shoulder becomes inflamed, it can lead to pain, tenderness, and restricted movement. Arthritis, which involves inflammation of the joints, can also contribute to left shoulder pain. Osteoarthritis, a “wear-and-tear” type, occurs when cartilage deteriorates, leading to pain, stiffness, and reduced flexibility. Rheumatoid arthritis, an autoimmune condition, causes the immune system to attack the joint lining, resulting in chronic inflammation and pain.
Frozen shoulder, medically known as adhesive capsulitis, is a condition where the shoulder joint progressively loses its range of motion and becomes stiff and painful. This stiffness can make even simple movements challenging. Strains and sprains also frequently cause shoulder discomfort; a strain involves the overstretching or tearing of a muscle or tendon, while a sprain affects ligaments. Both can cause pain, swelling, and limited ability to move the shoulder.
Nerve impingement, particularly cervical radiculopathy, can cause pain that originates in the neck but radiates to the left shoulder and arm due to a pinched nerve. This referred pain might also include tingling or numbness. Fractures of the shoulder bones—the humerus, clavicle, or scapula—can result from trauma and cause severe pain, swelling, bruising, deformity, and an inability to move the arm.
Cardiac Related Pain
Pain in the left shoulder can sometimes signal a heart condition, a phenomenon known as referred pain where discomfort from an internal organ is perceived in a different body part. Angina, a type of chest pain, occurs when the heart muscle does not receive sufficient oxygen-rich blood, often due to narrowed coronary arteries. Angina pain can radiate from the chest to the left shoulder, arm, jaw, neck, or back. This discomfort can feel like pressure, squeezing, or tightness and is frequently triggered by physical exertion or emotional stress, typically subsiding with rest or medication.
A heart attack, or myocardial infarction, is a medical emergency where blood flow to a part of the heart is severely reduced or blocked, leading to heart muscle damage. Left shoulder and arm pain are well-known symptoms, often described as heavy or squeezing. This pain may spread to the jaw, neck, or back.
Accompanying symptoms can include chest pressure or tightness, shortness of breath, sweating, nausea, lightheadedness, or anxiety. Heart attack symptoms can vary and may sometimes be subtle. The nerves from the heart and the left shoulder share pathways in the spinal cord, which is why heart problems can manifest as shoulder pain.
Other Internal Organ Considerations
While musculoskeletal and cardiac issues are more common, pain in the left shoulder can also be referred from other internal organs. Irritation of the diaphragm, the muscle that separates the chest and abdominal cavities, is a notable example. Conditions affecting the diaphragm can transmit pain signals along the phrenic nerve to the supraclavicular region, leading to referred pain in the left shoulder.
A classic instance is Kehr’s sign, where left shoulder pain results from irritation of the diaphragm, often due to bleeding from a splenic rupture. An enlarged spleen, or splenomegaly, can also cause pain in the upper left abdomen that radiates to the left shoulder. Pneumonia, an infection of the lungs, can sometimes lead to referred pain in the shoulder area.
Pancreatitis, which is inflammation of the pancreas, can sometimes cause pain that radiates to the left shoulder blade or back. While the primary pain from pancreatitis is felt in the upper abdomen, especially after eating fatty foods, referred pain to the shoulder is possible. This referred pain can sometimes be more prominent than the abdominal discomfort.
When to Consult a Doctor
Immediate medical attention is necessary if left shoulder pain is sudden and severe, or if it is accompanied by symptoms that may indicate a heart attack. These urgent symptoms include chest pressure or tightness, difficulty breathing or shortness of breath, sweating, nausea, lightheadedness, or pain radiating to the jaw or arm. Any loss of consciousness or confusion also warrants emergency care. If the pain results from a significant injury or trauma, such as a fall, and there is a visible deformity of the shoulder or an inability to move the arm, prompt evaluation is advised.
For less immediate but persistent concerns, consulting a healthcare provider is recommended. This includes pain that lasts for more than several weeks, worsens over time, or interferes with daily activities like lifting or sleeping. Swelling, redness, or tenderness around the shoulder joint, or a sensation of instability, should also prompt a medical visit. Seeking professional medical advice is important for an accurate diagnosis and appropriate treatment.