Yes, atherosclerosis can cause shoulder pain when it affects the arteries that supply blood to the heart. Fatty deposits can narrow these arteries, reducing blood flow and causing pain that spreads from the chest to the shoulder or arm. Shoulder pain can also come from muscles or joints. However, sudden shoulder pain with chest discomfort or breathlessness may signal a heart attack and needs emergency care.
How can atherosclerosis lead to shoulder pain?
Atherosclerosis occurs when fatty deposits, cholesterol, and other substances build up inside the arteries. These deposits, called plaque, can narrow the blood vessels and restrict blood flow. When this happens in the coronary arteries, which supply blood to the heart muscle, it can lead to coronary artery disease.
According to MedlinePlus, coronary artery disease can cause chest discomfort that spreads to the shoulder, neck, or arm. This pain is not necessarily caused by a problem in the shoulder itself. It can be a referred sensation linked to reduced blood flow to the heart muscle.
What does shoulder pain related to atherosclerosis feel like?
When atherosclerosis affects the coronary arteries, the resulting discomfort may be felt in the chest, one or both shoulders, an arm, the neck, the jaw, or the upper back. Some people experience pressure, tightness, heaviness, aching, or discomfort rather than sharp pain. Chest pain does not always occur alongside shoulder pain.
The American Heart Association explains that angina is discomfort caused by insufficient oxygen-rich blood reaching the heart muscle. It may spread to the shoulders and other parts of the upper body. The sensation and location can differ between people, so shoulder pain alone cannot establish its cause.
When might the pain occur?
Heart-related shoulder discomfort may appear during physical activity or emotional stress, when the heart needs more oxygen. In some cases, it improves with rest. However, symptoms that are new, occur at rest, last longer than usual, or become more frequent may indicate a more urgent heart problem. A heart attack can also cause shoulder pain without obvious chest pain.
What other symptoms may occur with heart-related shoulder pain?
Shoulder pain caused by reduced blood flow to the heart may occur with other symptoms. Examples include:
- Pressure, tightness, or discomfort in the chest.
- Pain spreading to an arm, the neck, jaw, or upper back.
- Shortness of breath.
- Unusual tiredness or weakness.
- Nausea or an upset stomach.
- Cold sweating, lightheadedness, or dizziness.
These symptoms can occur in different combinations. Some people, including women and older adults, may have less typical symptoms or little noticeable chest discomfort. The Mayo Clinic's guidance on heart attack symptoms describes shoulder and arm discomfort among the possible warning signs.
When is shoulder pain an emergency?
Seek emergency medical help if shoulder pain occurs with chest pressure, difficulty breathing, cold sweating, faintness, nausea, or discomfort spreading to the jaw, back, or arm. Sudden unexplained shoulder or upper-body discomfort can sometimes be a heart attack symptom, even when chest pain is absent.
Do not wait for symptoms to become severe or assume that rest will make them harmless. Call your local emergency number immediately if a heart attack is possible. In India, call 112 for emergency assistance. Do not drive yourself to the hospital if emergency services are available.
The American Heart Association's heart attack warning signs emphasize that discomfort in the shoulder or arm, shortness of breath, sweating, and other symptoms can require urgent attention. Prompt assessment is important because treatment delays can increase heart damage.
Can atherosclerosis cause shoulder pain without chest pain?
Yes. Coronary artery disease can sometimes cause discomfort in the shoulder or arm without noticeable chest pain. Other symptoms, such as breathlessness, unusual fatigue, nausea, or lightheadedness, may occur instead. Some people also have few or no warning symptoms until a serious heart problem develops.
Shoulder pain without chest discomfort can also have non-cardiac causes, so the absence of chest pain does not confirm or rule out a heart problem. New or unexplained shoulder pain deserves prompt assessment when it occurs during activity, repeatedly returns, or is accompanied by other concerning symptoms.
How is the cause of shoulder pain evaluated?
A healthcare professional considers the location and nature of the pain, when it began, what brings it on, whether it spreads, and whether other symptoms occur. Medical history and cardiovascular risk factors also help guide the evaluation. A physical examination may help identify shoulder or muscle problems, but it cannot always exclude a heart-related cause.
If a heart problem is suspected, assessment may include an electrocardiogram (ECG), blood tests for signs of heart muscle injury, and other tests based on the circumstances. Depending on the findings, a clinician may recommend further evaluation of the coronary arteries. The tests chosen depend on the symptoms, examination, medical history, and urgency of the situation.
What if the shoulder pain is caused by something else?
Many cases of shoulder pain are related to muscles, tendons, joints, or nearby nerves rather than atherosclerosis. Common causes include muscle strain, rotator cuff problems, arthritis, and neck conditions that cause pain to travel into the shoulder. Pain that changes with arm movement or follows an injury may suggest a musculoskeletal cause, but these features do not reliably rule out heart disease.
Persistent, worsening, recurring, or unexplained shoulder pain should be assessed by a healthcare professional. If the pain begins suddenly or occurs with possible heart attack symptoms, seek emergency care rather than trying to determine the cause at home.
Does treating atherosclerosis help shoulder pain?
If shoulder discomfort is caused by reduced blood flow from coronary artery disease, treatment focuses on improving heart health and reducing the risk of complications. Depending on the findings, care may include medicines, changes to cardiovascular risk factors, and procedures to improve blood flow when appropriate. The treatment plan depends on the underlying heart condition and the person's overall health.
Shoulder pain from a muscle, joint, or nerve problem requires a different approach. Identifying the cause matters because treating the shoulder alone would not address reduced blood flow to the heart if that were responsible for the symptoms.