An ache in the left shoulder can range from a minor annoyance to a symptom of a more serious underlying issue. This discomfort can arise from various sources, making it important to understand its potential origins. While often benign, left shoulder pain sometimes signals conditions that warrant careful attention, particularly due to the proximity of vital organs.
Common Musculoskeletal Causes
Many left shoulder aches stem from issues within the shoulder joint or its surrounding muscles, tendons, and ligaments. Muscle strain or sprain, often from overuse or sudden movements, is a frequent culprit. This pain is typically localized and worsens with specific activities.
Rotator cuff injuries are another common source of shoulder pain, involving the muscles and tendons that stabilize the shoulder joint. These injuries can manifest as tendinitis (tendon inflammation) or tears. Symptoms often include recurring pain, especially when lifting the arm overhead or sleeping on the affected side, and sometimes a grinding sound with movement.
Bursitis, inflammation of the fluid-filled sacs (bursae) that cushion joints, can also cause shoulder pain. Bursae reduce friction between bones, tendons, and muscles. Their inflammation leads to pain, swelling, and stiffness, often a dull ache that sharpens with arm movement.
Frozen shoulder (adhesive capsulitis) develops gradually, causing increasing pain and stiffness that limits shoulder movement. It progresses through “freezing,” “frozen,” and “thawing” stages, with stiffness becoming the dominant symptom.
Osteoarthritis, characterized by wear and tear of joint cartilage, can also affect the shoulder, leading to pain and stiffness. These musculoskeletal conditions often present with pain related to movement or positioning.
Pain Originating Elsewhere
Pain felt in the left shoulder does not always originate there; it can be “referred” from other body parts. This phenomenon occurs when pain is perceived in a location different from its source due to shared nerve pathways. This is particularly relevant for left-sided pain, as it can indicate internal organ issues.
One concerning cause of referred left shoulder pain involves cardiac issues, such as angina or a heart attack. Insufficient blood flow to the heart muscle can cause pain to radiate from the chest to the left shoulder, arm, neck, or jaw. This pain may accompany symptoms like chest pressure, shortness of breath, sweating, or nausea, and may worsen with physical activity.
Nerve impingement can also cause referred pain to the shoulder. This occurs when a neck nerve is pinched, leading to pain, numbness, or tingling that travels down the arm and into the shoulder. The sensation may extend along the nerve’s path.
Diaphragm irritation can also refer pain to the shoulder, especially the left side. This is known as Kehr’s sign, often from conditions like a ruptured spleen, due to shared nerve connections. Certain lung conditions, like tumors or pleurisy, may also cause referred shoulder pain. Referred pain often does not change with shoulder movement, unlike pain originating directly from the joint.
When to Seek Professional Medical Advice
Knowing when to consult a healthcare professional for left shoulder pain is important. Immediate medical attention is necessary if the pain is sudden and severe, especially after injury. Crushing chest pain combined with shoulder pain, shortness of breath, dizziness, or sweating warrant emergency care, as these can signal a cardiac event.
Seek evaluation if there is an obvious shoulder deformity, inability to move the arm, or numbness, tingling, or weakness in the arm or hand. These can indicate a fracture, dislocation, or nerve damage.
For less urgent situations, see a doctor if the pain persists for more than a few days without improvement from rest or over-the-counter pain relievers. Pain that worsens over time, disrupts sleep, or is accompanied by swelling or redness around the joint also warrants assessment. Clicking or grinding noises with movement, especially if painful, also warrant advice.
How Healthcare Professionals Diagnose
When evaluating left shoulder ache, healthcare professionals begin with a medical history and physical examination. They inquire about the pain’s nature, onset, and factors that worsen or alleviate it, alongside overall health. During the physical exam, they assess the shoulder’s range of motion, evaluate tenderness, and test muscle strength. They may also perform maneuvers to identify issues like rotator cuff tears or impingement.
Imaging tests are used to visualize underlying structures. X-rays identify bone problems like fractures, arthritis, or bone spurs, but do not show soft tissues. Magnetic Resonance Imaging (MRI) is a powerful tool for visualizing soft tissues like tendons, ligaments, and cartilage, useful for diagnosing rotator cuff tears, bursitis, and other soft tissue injuries. Sometimes, a CT scan, providing detailed cross-sectional images, is used for intricate bone imaging.
If referred pain is suspected, further tests may be ordered. Blood tests can rule out inflammatory conditions or infections. If cardiac causes are possible, an electrocardiogram (ECG or EKG) may assess heart activity. Depending on initial findings, a patient might be referred to specialists such as orthopedists, cardiologists, or neurologists for evaluation and management.