There are several reasons that a person might experience pain in their right shoulder and arm. In many cases, the pain will occur as a result of muscle overuse or injury. Pain can also result from damage to the nerves in that area.
Shoulder pain is the third leading muscle and bone complaint in the United States. Researchers estimate that shoulder injuries account for 4.5 million doctor’s visits and $3 billion in healthcare costs in the U.S.
Sometimes, shoulder and arm pain have nothing to do with exercise or injury. Unexplained shoulder and arm pain can sometimes be a symptom of a heart attack.
Read on to discover the possible causes of right shoulder and arm pain, and their associated treatment options. We also offer advice on when to see a doctor.
1. Swimmer’s shoulder
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Swimmer’s shoulder is a possible cause of pain in the right arm and shoulder.
Swimmer’s shoulder describes a range of different shoulder injuries that may occur as a result of swimming. Swimmers are at increased risk of shoulder injuries due to the high number of swim stroke repetitions they perform during training.
Injuries associated with swimmer’s shoulder include:
Impingement syndrome: A tendon in the shoulder rubs and catches on surrounding tissues when a person lifts their arm.
Labral injuries: A tear in a piece of cartilage called the labrum, which sits inside the shoulder socket.
Shoulder instability: The structures around the shoulder joint are not effective in keeping the upper arm bone in the shoulder socket.
Peripheral neuropathy: Damage to one of the peripheral nerves, which generally causes numbness or weakness.
Appropriate treatment of swimmer’s shoulder can help to speed up recovery time. A sports doctor will recommend different treatments depending on the injury. These may include:
rest, ice, and compression
nonsteroidal anti-inflammatory drugs (NSAIDs)
cortisone injections into the shoulder
2. Rotator cuff tendonitis
The rotator cuff is a group of muscles and tendons that surround and support the shoulder joint. Together, they help to hold the upper arm bone firmly in the shoulder socket.
Rotator cuff tendonitis (RCT) refers to irritation or inflammation of the rotator cuff. This condition is particularly common among elite athletes and people who regularly play certain sports.
Some causes of RCT include:
poor overhead throwing technique in sports such as baseball and javelin
direct trauma to the rotator cuff
falling on a straight arm
To diagnose RCT, a doctor will take a full medical history. This will likely include questions about the following:
whether the person is right- or left-handed
current or previous participation in sports
history of injury to the shoulder
relevant surgical history
A doctor will also perform a physical examination of the shoulder, spine, and neck. Sometimes, a doctor may request medical imaging tests, such as:
magnetic resonance imaging (MRI)
A doctor will usually recommend that a person with RCT rests the shoulder to aid recovery. They may also suggest the following treatments:
cortisone injections into the rotator cuff
surgery to repair RCT
Overuse can cause damage and inflammation to the muscles in the arm and shoulder. This can result in muscle pain and fatigue, but a person may not experience these symptoms until hours after overexerting the muscles.
A 2018 review suggests that massage therapy may be the most effective treatment for fatigued muscles.
Other techniques that may relieve muscle inflammation and fatigue include compression garments and cold water immersion.
4. Disuse syndrome
Disuse syndrome is a general term for conditions that result from a period of immobility or physical inactivity. It typically involves muscle atrophy or wasting.
People who have recently undergone a period of bed rest are at particular risk of developing disuse syndrome.
A person may experience the following symptoms even after a short period of physical inactivity:
muscle shrinkage and wasting
muscles that are weak and susceptible to injury
The Physical Activity Guidelines for Americans recommend that adults perform at least 150 minutes a week of moderate intensity aerobic activity.
However, some people have chronic conditions that limit their mobility or physical activity levels. People who have these conditions should talk to a physical therapist. They will work with the person to devise an appropriate exercise program.
5. Brachial neuritis
Brachial neuritis is a type of peripheral neuropathy that affects the following parts of the body:
Peripheral neuropathy is a disease of the nerves which transmit signals between the central nervous system and other parts of the body. Nerve pain and a loss of function in affected body parts characterize the condition.
Usually, people with brachial neuritis experience pain and weakness in the shoulder and arm on one side of their body. Most of the time, this is their dominant side.
Most people will experience pain on the outside part of the shoulder. It generally comes on suddenly and may worsen at night.
After a few days, the pain may disappear. A person may then experience the following symptoms in their shoulder and arm:
changes in reflexes
loss of sensation
Infections are common causes of brachial neuritis. The infections may be bacterial, viral, or parasitic. Examples include:
Coxsackie B virus
variola major and minor
To make an accurate diagnosis, a doctor will take a full medical history. This will include questions about the following:
whether the person has received vaccines for influenza and tetanus
recently prescribed medications, such as antivirals, antiepileptics, and botulinum toxin
An electromyography test, which records electrical activity in muscles and nerves, is essential for diagnosing brachial neuritis. A doctor may also order medical imaging tests to rule out muscle and bone disorders.
Brachial neuritis usually resolves on its own. In the meantime, doctors may prescribe pain medications, such as:
nerve pain medications.
Once the pain subsides, some people may benefit from specific stretches and strength exercises.
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6. Heart problems
Many people associate a heart attack with pain in the left arm. However, some people may feel pain in the right shoulder and arm, or on both sides of the body.
Anyone who experiences unexplained arm and shoulder pain alongside any of the following symptoms should call 911 immediately.
chest pain or discomfort, which may feel like pressure, burning, tightness or sharpness
pain radiating to the jaw on one or both sides
shortness of breath
a rapid heartbeat
Some people have coronary heart disease, which may cause them to experience episodes of angina. Angina is chest pain caused by a temporary reduction in blood flow to the heart. The symptoms can be similar to those of a heart attack.
Aspirin and nitroglycerin sublingual spray can temporarily promote blood circulation and relieve angina. However, if symptoms persist, a person should seek emergency medical treatment. They could be having a heart attack.
When to see a doctor
A person who suspects they are having a heart attack should seek emergency medical attention.
People with angina may have difficulty differentiating a heart attack from an episode of angina. If symptoms persist after treatment with aspirin or nitroglycerin sublingual spray, emergency treatment is necessary.
Sports injuries, such as swimmer’s shoulder and RCT, may require medical attention if rest and ice do not alleviate symptoms. A doctor may prescribe pain relief and may refer the person to a physiotherapist for further treatment.
People with brachial neuritis may consult their doctor for a diagnosis and pain relief. However, there are few other treatment options available. The condition generally resolves on its own.
Pain in the right shoulder and arm is often due to muscle or tendon damage. It can also occur as a result of damage to the peripheral nerves in those areas.
Unexplained shoulder and arm pain can sometimes be a warning sign of a heart attack. A heart attack is a medical emergency.
People should see a doctor if they are concerned about pain in the right shoulder and arm. The doctor will work to diagnose the underlying issue and provide appropriate treatment.