Before talking about symptoms, it helps to describe exactly what location we are talking about when describing the shoulder blades.
The shoulder blades—medically known as the scapulae—are the triangular-shaped bones of your upper back that stick out and become more visible when you extend your elbows towards your back. The shoulder blades have many functions, one of which is to support pivotal movements of the shoulder.
Pain in the region of the shoulder blade can be due to multiple causes. It may be due to inflammation in the scapula itself or referred pain from other areas of the body. Which shoulder blade is affected is an important question, as some conditions are more likely to affect the left shoulder blade, and others more likely to affect the right.
Pain in the shoulder blades can be related to inflammation or trauma to the shoulder area itself, or may instead be due to referred pain from other regions in the chest and abdomen.
These tumors are also sometimes difficult to diagnose, as they can "hide" on a normal chest x-ray.
Malignant pleural mesothelioma is a cancer of the pleura—the membranes lining the lungs—and is most commonly caused by exposure to asbestos on the job. In one study it was found that 14 percent of patients developed shoulder pain as their first symptom of mesothelioma.
If you have worked in construction or done a home remodeling project on an older home, make sure to let your doctor know.
How Is This Pain Different From Other Shoulder Pain?
Unfortunately, shoulder pain related to lung cancer can be very similar or identical to that of conditions such as arthritis.
Symptoms that may be more concerning, however, include shoulder pain that is worse at night, pain that occurs at rest, and pain that is not associated with any loss of motion with activity. Shoulder pain is also more likely to be something non-skeletal if you do not recall any injury or activities in which you may have overused your shoulder.
Shoulder pain is also more likely to be a symptom of lung cancer if you have other symptoms of lung cancer, such as shortness of breath (this can be mild and only with activity,) a persistent cough, or if you are losing weight for no reason.
Keep in mind that the symptoms of lung cancer in women and symptoms of lung cancer in non-smokers are often less typical than those in men—and sometimes very vague, such as the gradual onset shortness of breath with activity and fatigue.
Treatment Options for Shoulder Blade Pain
Treatment of shoulder pain related to lung cancer will depend on the underlying cause of your pain.
If the pain is referred pain from pressure on a nerve in the lung, treatment that decreases the tumor within the lungs is the primary goal. If a tumor is growing near the top of the lungs, surgery to remove the tumor or treating the tumor with radiation may relieve symptoms. If the pain is related to bone metastases, treatment with radiation therapy or bone-modifying agents may reduce symptoms significantly.
A Word From Healthcare Provider
If you are experiencing shoulder pain, don't panic. The chance that shoulder pain is related to lung cancer is usually small. If you do not have an explanation for your pain, however, it's important to see your doctor.
Pain is the way in which our bodies tell us something is wrong.
In addition to lung cancer, there are other serious medical conditions which may only have symptoms of shoulder pain at the onset. If you do not recall an injury and haven't used your arm excessively in the recent past, may sure to talk to your doctor even if your symptoms seem to be improving.
If you still do not have a clear explanation for your symptoms even after seeing your doctor, consider getting a second opinion. While shoulder pain is not a common symptom of lung cancer, some people have found their cancers early by listening to their bodies and having their symptoms evaluated. Be your own advocate for your health care. Nobody is more motivated than you are to make sure your symptoms are explained and treated as well as possible.
Lorkowski, J. et al. Shouder ring complaints as a rare first symptom of malignant pleural mesothelioma. Advances in Experimental Medicine and Biology. 2015. 852:5-10.
Marulli, G., Battistella, L., Mammana, M., Calabresse, F., and F. Rea. Superior Sulcus Tumors (Pancoast Tumors). Annals of Translational Medicine. 2016. 4(12):239.
Panagopoulos, N. et al. Pancoast tumors: characteristics and preoperative assessment. Journal of Thoracic Disease. 2014. Suppl 1:S108-15.
Sayeed, A., Alshamrani, F., Amrayn, A., and A. Alharbi. Should Pain in Smokers Could be a Life Changer. BMJ Case Reports. 2017 June 13:2017.pii: bcr-2017-220969.