A burning sensation in the shoulder is a common complaint, often indicating a specific underlying physiological issue. This discomfort, which can range from a dull heat to an intense, searing pain, is distinct from a general ache. The burning feeling signals that sensory nerves are being irritated, either by mechanical compression or by inflammatory chemicals released from damaged tissues. Understanding this symptom helps narrow down the potential origins, which typically involve the nervous system or localized soft-tissue damage within the shoulder complex.
When the Burning Sensation Originates from Nerves
A true, electrical-feeling burn often points toward neuropathic pain, which originates from an irritated or damaged nerve. Since the shoulder is a complex junction for nerves traveling from the neck down the arm, it is susceptible to issues arising from the cervical spine. Cervical radiculopathy, or a pinched nerve in the neck, occurs when a nerve root is compressed or inflamed as it exits the spinal column. This frequently causes pain that radiates into the shoulder blade or down the arm.
This pain is frequently described as sharp, shooting, or burning because the nerve itself is generating the abnormal signal. Accompanying symptoms often include paresthesia, or a loss of sensation in the arm or hand, following the specific path of the affected nerve. Movements of the neck, such as turning the head or looking down, can sometimes aggravate the shoulder pain. This helps differentiate a neck problem from a strictly shoulder-based one.
Another common source of nerve-related burning is the brachial plexus, a complex network of nerves formed by spinal roots that pass through the shoulder region. Injuries to this bundle, often called “burners” or “stingers” in contact sports, result from sudden stretching or forceful compression. The resulting sensation is an acute, lightning-bolt pain that shoots down the arm due to direct trauma to the nerve fibers. Chronic compression of the brachial plexus and surrounding blood vessels, such as in Thoracic Outlet Syndrome, can also lead to persistent burning, tingling, and weakness in the shoulder and arm.
Localized Musculoskeletal and Inflammatory Triggers
While nerve irritation creates a distinctly electrical burn, intense localized inflammation from soft tissue injury can produce a sensation described as hot or burning. This type of pain, known as nociceptive pain, originates from structures within the shoulder joint itself, such as tendons and fluid-filled sacs. Overuse injuries and repetitive strain are the most common culprits, leading to conditions like bursitis and rotator cuff tendinopathy.
Bursitis involves the inflammation of a bursa, a small fluid-filled sac that cushions bones and soft tissues like the rotator cuff tendons. When the sac becomes irritated, often from friction or repeated pressure, the resulting inflammatory response generates localized heat and pain. Similarly, rotator cuff tendinopathy, which is irritation or degeneration of the shoulder tendons, triggers an acute inflammatory cascade. This response causes a painful burning sensation that is typically worse during or immediately after movement.
The mechanism behind this inflammatory burn is the release of specific chemical mediators at the site of tissue damage. Cells release substances like bradykinin, prostaglandins, and histamine, which directly activate and sensitize local pain receptors, known as nociceptors. This chemical sensitization lowers the tissue’s pain threshold, causing the nociceptors to fire more easily and intensely. This results in a hot, burning feeling distinct from the electrical shock of a compressed nerve, explaining why anti-inflammatory medications are often effective.
Identifying When to Seek Professional Diagnosis
For mild cases of burning shoulder pain, initial home care can often provide temporary relief, especially if the pain is related to a known overuse injury. The R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—is a common starting point, with ice application helping to reduce localized heat and swelling. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can also help manage the pain.
However, several red flag symptoms require immediate medical consultation. Seek urgent care if the pain is accompanied by severe, sudden weakness or the inability to lift or rotate the arm normally, as this may indicate a significant tendon tear or fracture. Signs of systemic infection, such as a high fever, chills, or spreading redness and warmth around the joint, also necessitate prompt medical attention. Furthermore, if the shoulder pain is accompanied by chest tightness, shortness of breath, or dizziness, it may be referred pain from a cardiac event, and emergency medical services should be contacted immediately.
When consulting a healthcare provider, the diagnostic process begins with a detailed physical examination to assess range of motion, strength, and any signs of nerve irritation. Imaging tests are frequently used to confirm the underlying cause and rule out serious damage. An X-ray is often the first step, providing a clear view of the bones to check for fractures, arthritis, or bone spurs that could be compressing soft tissues.
Imaging for Soft Tissue Damage
If soft tissue damage is suspected, a magnetic resonance imaging (MRI) scan or an ultrasound is used to visualize tendons, muscles, and bursae, identifying conditions like rotator cuff tears or bursitis.
Testing for Neuropathic Origin
If a neuropathic origin is a primary concern, a nerve conduction study (NCS) or electromyogram (EMG) may be ordered. These tests assess the electrical activity of the nerves and muscles, helping pinpoint the exact location and severity of the nerve compression.