Shoulder pain when taking a deep breath can be a concerning symptom. While this sensation can sometimes indicate a minor issue, it can also signal significant underlying conditions. Understanding the various potential causes helps clarify why this discomfort arises, from common muscle strains to issues affecting the lungs or other body systems.
Common Musculoskeletal Reasons
Pain in the shoulder when breathing deeply often originates from the musculoskeletal system, including the chest wall and shoulder. A common cause is intercostal muscle strain, affecting the muscles between the ribs. This strain results in sharp, localized pain in the chest or ribs that can radiate to the shoulder or back, intensifying with deep breathing or coughing. Such strains occur from sudden movements, overuse, or direct trauma.
Injuries to the ribs, such as fractures or bruising, also cause pain exacerbated by deep inhalation. Chest expansion during breathing puts pressure on injured ribs, causing discomfort that may extend to the shoulder. Another musculoskeletal cause is costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone. This condition presents as sharp, aching, or pressure-like pain, worsening with deep breaths or coughing, potentially radiating to the arms and shoulders.
Muscles involved in respiration can also contribute to this pain. The diaphragm, the primary breathing muscle, can experience strain, leading to discomfort. Issues with the serratus anterior muscle, located along the ribcage, can cause pain more noticeable with deep breathing or coughing. Its irritation or strain can manifest as aching discomfort along the ribcage, sometimes extending to the shoulder blade.
Lung and Pleural Conditions
Conditions affecting the lungs or pleura, the protective membranes surrounding them, can manifest as shoulder pain during deep breathing. Pleurisy, an inflammation of the pleura, causes sharp chest pain that worsens significantly with deep breaths, coughing, or sneezing. This pain frequently radiates to the shoulder, as the inflamed lining rubs together with each breath.
Pneumonia, a lung infection with fluid buildup in the air sacs, can also cause sharp or stabbing chest pain. This pain is often aggravated by deep breathing or coughing and may spread to the shoulder, upper chest, or neck. Similarly, a pneumothorax, or collapsed lung, where air escapes into the space between the lung and chest wall, can result in sharp pain that intensifies with deep breaths.
A pulmonary embolism, a blood clot blocking an artery in the lung, is a serious cause. This condition can cause sudden shortness of breath and sharp chest pain that often worsens with deep breathing and may radiate to the shoulder, arm, or jaw. Pain from these lung-related issues is tied to breathing mechanics, as chest expansion irritates inflamed or compromised structures.
Nerve Compression and Referred Pain
Shoulder pain experienced with deep breathing can be referred from another body part, often due to nerve pathways. The phrenic nerve, which controls the diaphragm, plays a significant role in this referred pain. Irritation or damage to this nerve can cause pain to be felt in the shoulder because of shared nerve connections.
Irritation of the diaphragm, such as from issues in the abdominal cavity, can also lead to referred shoulder pain. For instance, gallbladder problems, including inflammation or gallstones, may cause pain in the upper right abdomen that radiates to the right shoulder blade, often worsening with deep breaths. This phenomenon, where pain is perceived in a location distant from its source, is a characteristic of diaphragmatic irritation.
A pinched nerve in the neck, known as cervical radiculopathy, can cause pain to radiate into the shoulder and arm. While not always directly linked to deep breathing, certain respiratory movements can sometimes aggravate such nerve compression. Cardiac events can also present as referred pain in the shoulder or arm.
Knowing When to See a Doctor
While shoulder pain with deep breathing can stem from minor causes, certain accompanying symptoms warrant immediate medical attention. Consult a healthcare professional if the pain is severe, sudden, or progressively worsens. Any pain following trauma to the chest or shoulder should also be evaluated promptly.
Symptoms suggesting a more serious underlying condition include shortness of breath, fever, persistent coughing, or chest tightness. Dizziness, lightheadedness, or fainting alongside the pain are serious indicators. If the pain radiates into an arm, the neck, or is accompanied by numbness, tingling, or weakness, medical advice is necessary. Delaying evaluation can be detrimental, so consulting a doctor for proper diagnosis and treatment is important.