From killer cancer to a 999 emergency – the signs your shoulder pain could be more serious revealed

IF shoulder pain wakes you up in the night, makes simple tasks like brushing your hair challenging, or stops you from reaching up for that item on the top shelf, you're not alone.

Shoulder pain is one of the most common musculoskeletal disorders -and that's because shoulders are one of the most mobile joints in the body.

The shoulder's complex anatomy, including multiple bones, muscles, tendons, and ligaments, makes it prone to instability, injury, and overuse, and can lead to a variety of painful conditions.

And shoulder pain can feel very different depending on what's causing it.

For some, it's a dull ache deep in the joint, while others describe feeling a sharp, catching pain when making certain movements.

It can also spread down to the arm and be associated with other symptoms like stiffness or weakness.

According to Dr Donald Grant, GP and senior clinical advisor at The Independent Pharmacy, injuries stemming from overuse or age are the most common causes of shoulder pain.

He tells Sun Health: "Typically, the rotator cuff can experience issues, including muscle tears or tendonitis.

"Other common causes of shoulder pain include dislocations, frozen shoulder, damaged nerves and sprains."

Frozen shoulder is a condition where the lining of the shoulder joint becomes thickened, tight, and inflamed, causing pain and stiffness that can last for months, sometimes years.

The two main symptoms of frozen shoulder, according to the NHS, are:

• Pain in your shoulder which can be worse at night and disturb sleep
• Stiffness in your shoulder which makes it difficult to move

The condition can be treated with shoulder exercises and painkillers.

But in some cases, shoulder pain could be caused by something more serious.

Dr Lewis Raiman, a Sport & Exercise Medicine Doctor, warns: "Most shoulder pain is not serious, but in some cases, it can be a sign of an underlying problem.

"Rare causes include nerve issues, inflammatory arthritis, or pain referred from the neck or chest.

"If it comes on suddenly, is severe, or happens with chest pain, breathlessness, fever or swelling and redness around the joint, seek urgent medical help."

Dr Grant adds: "A lot of people are unaware, but intense shoulder pain can be a sign of an oncoming heart attack.

"Sudden pain in the left shoulder often signifies a major heart event - and knowing this can ensure people receive essential care.

“Additionally, shoulder pain may also be a sign of a broken collarbone or lung cancer - as Pancoast tumours growing on the lungs apply pressure onto the shoulder, causing pain and discomfort."

IF shoulder pain is caused by something more serious, other symptoms may offer clues, says Dr Raiman.

Shoulder pain caused by nerve issue often comes with symptoms like tingling, numbness, burning, or weakness in the arm or hand, he explains.

"The pain may shoot down the arm or get worse when you move your neck, and you might notice your grip is weaker or you're dropping things," he says.

"These are clues the issue could be coming from a nerve in the neck.

"While these signs can be helpful, symptoms don't always follow the textbook. If you're unsure or concerned, it's best to get checked by a healthcare professional."

Inflammatory arthritis pain in both shoulders tends to feel worse in the morning, often with stiffness, he adds.

There may be swelling, warmth, or other joints affected and sometimes general fatigue or feeling unwell.

But symptoms can be mild or develop gradually, he says, so even if it's not a classic presentation, persistent or worsening pain should be reviewed.

Shoulder pain linked to a heart attack is usually felt on the left side, and may be accompanied by chest pressure, pain radiating to the arm, neck or jaw, shortness of breath, sweating, or nausea, he said.

He warns: "This is a medical emergency, call 999 if these symptoms appear.

"Some heart-related symptoms can be vague or come on gradually, so if there's any doubt, it's safer to seek urgent medical advice."

Shoulder pain linked to lung cancer is complex, and there are different types of lung cancer with a wide range of symptoms, he said.

In many cases, the first sign of a Pancoast tumour - a type of lung cancer that grows at the top of the lung - is a sharp pain in the shoulder or arm, which can be persistent and may worsen at night.

Other symptoms of Pancoast tumours include Horner's syndrome, which includes a drooping eyelid, small pupil, and loss of sweating on one side of the face.

WHILE it depends on the underlying cause, a mild muscular strain from over-exercise could improve in a matter of days, says Dr Gordon.

With conditions like frozen shoulder, it can last for months or even years.

Dr Daniel Gordon of Olive Health advised: "Most muscle or tendon issues tend to improve within a few weeks with the right combination of rest and rehabilitation.

"But they can of course come back if you don't address the underlying problem."

DR Gordon's general rule is any pain that lasts over two weeks should be checked out by a health professional.

But with shoulder pain, it's important to be mindful of those rarer and more serious causes.

He adds: "If your pain is severe, associated with chest pain, shortness of breath or any other unusual symptoms you should seek help immediately.

"If your pain is caused by a musculoskeletal problem, remember that early intervention and rehabilitation can make a big difference in your recovery, so if your symptoms aren't settling as you expect, it's best to be safe and see your GP or a physiotherapist sooner rather than later."