Everything You Need to Know About Referred Shoulder Pain

What is Referred Shoulder Pain?

Referred shoulder pain is when you feel pain in the shoulder, but the actual cause of the pain comes from another area of the body, not the shoulder joint or muscles themselves. The pain is “referred” from somewhere else, often due to shared nerve pathways. This means the shoulder may hurt even though there’s nothing directly wrong with the shoulder itself.

An analogy…

Think of your nerves like power lines. If there’s a fault at the power station (another part of the body), the lights (your shoulder) might flicker or shut off, even though there’s nothing wrong with the lights themselves. That’s how referred pain works, the problem is coming from somewhere else, but the shoulder is where you feel it.

What causes referred shoulder pain?

The shoulder shares nerve connections with other parts of the body, including the neck (cervical spine), upper back (thoracic spine), diaphragm, and internal organs. If there’s a problem in these areas, like a pinched nerve, disc bulge, tight muscles, or organ irritation, the brain may interpret the signal as coming from the shoulder. Common sources include neck joints (facet or disc issues), gallbladder irritation, diaphragm tension, or even heart problems.

What are the signs and symptoms of referred shoulder pain?

Shoulder pain without a clear injury or movement-related cause
Pain that doesn’t change much with shoulder movement
Pain that comes with neck movement, breathing, or posture changes
Aching, burning, or deep dull pain rather than sharp or localised pain
Pain that occurs alongside symptoms in the neck, upper back, or even chest or abdomen
No swelling or weakness directly in the shoulder

What tests are used to diagnose referred shoulder pain?

Thorough history and physical examination to identify whether the shoulder is the source of the pain or not

Spinal motion testing to see if moving the neck or upper back reproduces shoulder symptoms

Neurological screening (reflexes, sensation, muscle strength) to assess nerve involvement

How long does referred shoulder pain take to heal?

Recovery depends on the underlying cause of the referred pain. If it’s from a mechanical source like a stiff neck joint or pinched nerve, symptoms can often improve in 2–6 weeks with treatment. If the cause is more complex (such as internal organ involvement or nerve irritation), recovery may take longer and involve input from other healthcare professionals.

How does referred shoulder pain happen?