From the Research
Yes, shoulder pain from bursitis or other inflammatory conditions can indeed cause chest pain and scapular pain. This occurs because pain can radiate from the shoulder joint to surrounding areas due to shared nerve pathways and muscular connections. Shoulder bursitis, which is inflammation of the fluid-filled sacs (bursae) that cushion the shoulder joint, commonly causes pain that extends beyond the immediate shoulder area. Similarly, conditions like rotator cuff tendinitis, frozen shoulder, or shoulder impingement syndrome can produce pain patterns that spread to the chest wall and scapular region. This referred pain happens because the shoulder complex is interconnected with muscles and fascia that extend across the chest and upper back.
Causes of Referred Pain
- Shoulder bursitis: inflammation of the fluid-filled sacs (bursae) that cushion the shoulder joint
- Rotator cuff tendinitis: inflammation of the tendons that surround the shoulder joint
- Frozen shoulder: stiffness and pain in the shoulder joint
- Shoulder impingement syndrome: compression of the tendons and bursae in the shoulder joint
Treatment Options
- Anti-inflammatory medications like ibuprofen (400-800mg three times daily with food) or naproxen (500mg twice daily)
- Rest, ice application for 15-20 minutes several times daily, and gentle stretching exercises
- Physical therapy focusing on proper shoulder mechanics and strengthening
- Corticosteroid injections for short-term pain relief and improvement in function, as seen in studies such as 1
Importance of Medical Evaluation
If pain persists beyond 2-3 weeks despite these measures, medical evaluation is recommended as persistent chest pain should never be ignored due to potential cardiac concerns. A study published in 2010 2 found that shoulder bursitis can be a significant cause of breast and chest wall pain, and can be successfully treated with a local injection at the site of maximum tenderness in the medial scapular border. Another study published in 2020 3 highlighted the importance of proper diagnosis and treatment of shoulder conditions, including rotator cuff injuries and bursitis.
Recent Studies
A more recent study published in 2021 4 found that image-guided retrocalcaneal bursa corticosteroid injection can be an effective treatment for retrocalcaneal bursitis, with significant short-term decrease in pain score in majority of patients. However, it is essential to carefully select patients using ultrasonography prior to injection, as seen in a study published in 2017 5.
Key Takeaway
Shoulder pain from bursitis or other inflammatory conditions should not be ignored, and medical evaluation is crucial to rule out potential cardiac concerns. With proper diagnosis and treatment, patients can experience significant improvement in pain and function, as seen in various studies 2, 5, 3, 4, 1.