What Causes Burning Shoulder Pain?

• Nerves & neck problems
• Vertebral disc diseases
• Shoulder problems
• Other causes

Burning shoulder pain is one of the most dis-comfortable experience one can have. You either experience it constantly or in some cases, it may come & go. It can affect the shoulder or small part of it.

In some cases, it may travel from shoulder to the arm, back, and neck region. It can distract your sleep and keeps you awake.

Usually, this pain is caused by various shoulder problems. However, in many patients with burning shoulder pain; the actual problem lies in the neck region, even though there are no apparent symptoms that relate to the neck. ^[01]

In this article, we will discuss the different causes that lead to the burning pain in the shoulder. We will also discuss their respective symptoms & the targeted age group that suffers from these causes.

This article will guide you to find out the most probable cause of your pain and will also help you to decide whether your problem is related to the shoulder or is it related to the neck, which is one of the most common causes of burning shoulder pain.

Nerves and Neck Problems

Often, these burning pain is a result of underlying problems within a neck region or nerves that arise from the neck.

In many cases, it seems like that there is no issue with the neck, as the patient does not show any neck-related complaints like neck stiffness or neck pain.

But the burning pain in the shoulder can be a “referred pain”, which means the pain is felt at a different location than the exact area where problem present.

Seven vertebrae, which sit on top of each other forms the vertebral column of the neck. Between the two cervical vertebrae lies the thick, ring-shaped vertebral disc which provides the cushion to the vertebrae. It is made up of the cartilage on the outer side while filled with gel-like material on the inner side.

The cervical vertebral column does have a slightly curved shape and helps to hold the skull in the right position as well as provide space for various nerves that arise from the cervical spinal cord. ^[02]

The spinal cord, which looks like a tree trunk, arise from the bottom part of the brain and run through a hole shaped space between these vertebrae. This space is known as the spinal canal.

After each vertebra, the nerve pair arises from the spinal cord and extend into the surrounding tissues. In case of neck, they run down the arm and other parts of hands.

Together these nerves are termed as the peripheral nervous system. And they play an important role to carry the various signal to & from the brain. The brain is the center of the nervous system, so known as the central nervous system. ^[03]

The central nervous system works as headquarter to interpret the signal that came via peripheral nerves and control our body movements by sending out the instructions via the peripheral nervous system.

Most common causes of nerve irritation that leads to the burning shoulder pain:

Diseases of Vertebral Disc

Degeneration of disc leads to an abnormal pressure on the root of nerves which results in the burning pain in the shoulder. ^[05]

This is caused by bulging or herniated disc. Both terms are often used interchangeably, but there are few differences between these two conditions.

1. Bulging Disc

Central gel-like portion of vertebral disc protrudes into the spinal canal and puts pressure on the root of the nerve. Bulging disc is not ruptured or do not show any tear or nucleus leak.

2. Herniated Disc

A herniated disc is a type protruding disc that has tears on the outer part of disc and often shows the nucleus leak. In short herniated disc is a non-contained bulging disc.

Both conditions are referred to as a ruptured or slipped disc and often leads to the pain in the neck, shoulder and arm region.

No matter by what name you describe these condition, they always end up irritating the nerve roots and leads to the burning, tingling, numbness, muscle weakness or traveling pain.

3. Degenerative Diseases of Disc

Aging is the leading cause of tissue degeneration. With growing age disc tends to dehydrate and lose its plump, flexibility and become weak. Weaker discs are not able to provide sufficient space and cushion to the adjacent vertebrae. This reduced pressure along with less flexibility within the disc can damage the vertebrae.

Damaged vertebrae cause inflammation, pain and put pressure on adjoining nerve roots, resulting in the burning pain. ^[06]

Burning shoulder pain around the neck and shoulder region may show the following characteristics:

1. Usually, it affects only one arm and pain travel down to the arm. (In some severe cases it may affect both side shoulder and arms)
2. Pain is aggravated by sneezing, coughing and with some other movements of the neck as the vertebral disc pressure increases.
3. Apart from burning pain, patients may complain about the abnormal sensations like pins, needles or ant-like crawling along the path of the nerve.
4. Often the pain is more in the morning because vertebral disc plumps up in the night because of reduced pressure on the disc during the night as patient lie down and rest.
5. Unless and until arm motions put extra pressure over the nerve, burning pain in the shoulder is not affected due to arm movements.
6. Pain can either start gradually or come suddenly due to an injury. (Work like lifting heavy object can cause disc bulge or herniation and trigger sudden pain)
7. Shoulder pain can be accompanied by neck pain while in many patient neck pain are absent.
8. People in the age group of 30 to 50 are commonly affected by the disc herniation, while disc degeneration is typically found in those over the age of 60.

Spinal Stenosis

Burning shoulder pain can also be caused by the stenosis of the spine. It is defined as abnormal narrowing of the spinal canal which increases pressure on spinal cord and nerve roots.

In an early stage of spinal stenosis, the patient does not show any symptoms. But once the pressure starts to increase because of the narrowing spinal canal more than 25 to 30%, symptoms start to appear.

Reduced space around the nerve root leads to an inflammation of nerves while the central narrowing of canal damages the spinal cord.

Burning shoulder pain caused by stenosis of the spinal canal has the following characteristics:

1. They appear slowly as the pressure develops.
2. May travel down to the arms as well as legs and often affects both sides.
3. Aggravates while looking down or while standing.
4. Usually affects the functions of hand and limits the performance of activities that involve hands like chopping veggies or writing.
5. The patient may complaint other sensations like numbness, heaviness, needles & pin along with burning in the arms.
6. Advanced cases of spinal stenosis may affect the function of bowel & bladder.
7. This condition is commonly seen in the people over the age of 50.

Brachial Neuritis

Brachial neuritis also known as Parsonage-Turner syndrome can cause the burning pain in the shoulder blade, shoulder weakness. An inflammation of brachial plexus leads to this condition.

Brachial plexus is the bunch of nerves originate from the lower cervical region and travels across the armpit and front area of the chest.

Often, it is caused by gene mutation or weak immunity. Vaccination, surgery or following ill can also trigger this syndrome.

Burning shoulder pain due to brachial neuritis shows the following characteristics:

1. Stabbing and burning pain often felt in the night and comes suddenly.
2. Pain is constant in nature and may travel down to the corresponding arm & hand.
3. Often involve one arm and aggravates with movements of the arm.
4. As condition progress, arm weakness sets in and make it difficult to move the arm.
5. Patient may complain of numbness, tingling along the nerve path and shortness of breath.
6. young and middle-aged men are affected more than the women. Can also be found in children, as it is a hereditary condition.

Brachial neuritis usually treated with the medications that include the painkillers along with the physical therapy rehab. To understand this condition in detail, please visit our brachial neuritis section.

Cervical Spondylosis (Arthritis of Neck)

Cervical is a medical term used for everything related to the neck. So, the neck arthritis is named as cervical spondylosis and it can be a cause of burning pain in the shoulder.

Cervical spondylosis is characterized by the wear & tear of cervical vertebrae and discs. Discs between the cervical vertebrae become dry, weak and lose their height leading to increased friction between two vertebrae. This friction wears away the bone and spurs start to form.

These bone spurs reduce the space available to the nerves and put the pressure on them causing neuritis and inflammation. Neck arthritis is a common condition and almost affects the 80% population with the age over 60. Most people have mild, non-noticeable symptoms, while few people show severe symptoms.

Cervical spondylosis is characterized by the following sign & symptoms:

1. Neck Pain – Pain caused by this condition usually radiates towards the shoulder and shoulder blade. If the pressure builds upon the cervical nerves, the patient may experience the burning shoulder pain along with tingling, numbness, and weakness in the arms & hands.
2. Neck Stiffness – Neck become stiff and movements become painful. Often, the patient is not able to move the head.
3. Symptoms aggravate in the morning and at the end of the day.
4. Pain, stiffness and other complaints caused by neck arthritis, tend to improve with the proper rest.
5. Movements of the neck can worsen the pain and other complaints.
6. Grinding noise while moving the neck.
7. This condition is common in the people over the age of 60 and may be accompanied by a headache.

Most cases respond to the conservative measures of treatment which includes rest, non-steroidal anti-inflammatory medications, wearing the cervical collar, physical therapy, chiropractic manipulation and in severe cases epidural steroid injections.

Burning Pain Caused by Shoulder Problems

As we have seen, the most common causes of burning shoulder pain are arising from the neck but in some cases, this pain can also indicate the problem within the shoulder joint.

Tendonitis and the bursitis of the shoulder can lead to the burning pain.

Shoulder Bursitis

Localized burning pain around the shoulder area can be due to bursitis. Our body has numerous bursae which are defined as small, fluid-filled sacs.

They provide a cushion to the bone and sit between the bone and surrounding soft tissues. This ensures the friction-free movements of bone.

Anything that leads to the irritation of these bursae can create inflammation and result in the burning shoulder pain. Increase pressure, repetitive friction and injury can trigger bursitis.

Shoulder joint host multiple bursae which are located around the shoulder blade. Bursitis can involve one or more bursa.

Burning shoulder pain caused by bursitis, shows the following characteristics:

1. In most cases, burning and aching pain comes gradually, except in the case of acute injury.
2. This pain becomes worse progressively.
3. This pain is typically localized in nature and the patient refers to the specific spot. As condition progress, pain may spread out to a certain extent but does not refer below the elbow joint.
4. Pain aggravates with the over the head movements of the shoulder joint.
5. Pain increases when you lie down on your side, as it increases the pressure on the bursa.
6. Pain during lying on your side results into the disturbed sleep.
7. As the condition progresses, stiffness & weakness of the arm sets in.
8. This condition may take weeks to months to get better.

Bursitis induced burning shoulder pain often responds well to the conservative treatment which includes the rest to shoulder, non-steroidal anti-inflammatory medications, physical therapy, exercises and in severe cases steroidal injections.

To understand the more about the various causes, sign & symptoms and treatment please visit our shoulder bursitis page.

Shoulder Tendonitis

Burning shoulder pain can be the result of an inflamed tendon of the muscles that are related to shoulder. Degeneration or inflammation of muscle-tendon is termed as the tendonitis.

Usually, biceps or rotator cuff tendon is involved in shoulder tendonitis. This inflammation can be a result of the constant friction on the tendon which is triggered by the repetitive movements of the shoulder like throwing, sports that involve shoulder movements and labor.

It can also be resulted due to the excessive pressure on the tendon caused by problems within the surrounding tissues like bone spurs, poor posture, etc.

Shoulder tendonitis is characterized by the following symptoms:

1. Burning and diffuse aching pain in the upper arm and shoulder region. Usually, they are localized and becomes sharp in nature with the arm movements.
2. Pain aggravates if you try to raise the arm, or when you move it against the resistance. (To check this, move your arm away from the body while stopping it by another hand, if you feel the pain then it might be caused by tendonitis)
3. In this condition, arm movements may be accompanied by noises like grating, crepitus, and clicking.
4. As discussed before, pain is localized in nature and the pain spot become tender to touch.
5. This condition can affect any age group.

Tendonitis induced burning shoulder pain often relieves with proper rest, medications, physical therapy and shoulder strengthening exercises. To understand the more details about how to perform these exercises, please visit our shoulder exercises guide.

Pain Induced by Other Reasons

Apart from the above-mentioned reasons, burning pain in the shoulder region can be triggered by various other reasons, such as:

Fibromyalgia

Also known as fibromyalgia syndrome (FMS), is characterized by widespread body pain that is chronic in nature. Pain is accompanied by tiredness and heightened pain response to pressure.

This condition predominantly affects woman between the age of 30 to 50. Burning shoulder pain caused by fibromyalgia is often associated with the pain in other body parts like elbow, hips, back, knees, chest, back & front of the neck.

Restless Arm Syndrome

In this condition sufferer complaint about an abnormal sensation beneath the skin of the arm, like tingling, burning and crawling. This often experienced during the resting mode of body and may progress to the leg leading to the restless leg syndrome.

These strange sensations are accompanied by the spontaneous jerking movements of the arm and legs. As these movements are experienced during the rest and the patient eventually suffer from insomnia. To know more about this condition, please visit our restless arm syndrome page.

Gall Bladder Conditions

The function of the gall bladder is to store the bile secreted by liver cells and then make it flow in the small intestine to aids the fat digestion.

Abnormal conditions of gall bladder like gallstones or inflammation of bladder wall may lead to the burning pain in the shoulder joint.

Prominent symptoms of gall bladder problems are a pain in the abdomen, nausea, heartburn, belching and feeling of fullness. Pain often increases after eating and may refer to the shoulder region and around the shoulder blade.

Herpes Zoster

Commonly referred to as shingles. This is a condition caused by the reactivation of the chickenpox virus in the body due to reduced immunity and accompanied by the painful rashes.

Burning shoulder pain caused by shingles is intense in nature and accompanied by the rash. It affects only one side of the body.

Heart Attack

Heart attack may cause the refereed pain at the shoulder region. If your shoulder pain comes with the crushing pain and tightness feeling in the chest, nausea, shortness of breath and sweating then it may indicate that you are having a heart attack and immediate medical intervention is necessary.

Please note that chest pain can be caused by various other reasons, but a proper diagnosis is necessary, so always seek medical help whenever you get the chest pain.

Muscle Soreness

Pain in the shoulder region can be caused by the soreness of shoulder muscles. DOMS – delayed onset muscle soreness can result in the burning pain in the shoulder.

DOMS is a condition of muscles resulted after un-accustomed, strenuous exercises in which sufferer experiences the pain and stiffness in the muscles.

Wrong Sleeping Positions

Early morning neck stiffness and burning shoulder pain may be induced by the wrong sleeping position. Sleeping awkwardly puts pressure on the muscles and nerves in the neck and causes the pain.

This pain slowly gets better as time passes and you start to move your neck and shoulder. Gentle exercises of the shoulder and neck can help to relieve the pain. To learn how to perform these stretching exercises, please visit our arm stretches guide.

No matter what the reason for burning pain in the shoulder might be, you should consult with a doctor to rule out the grievous causes and get the proper diagnosis. The physician will guide you to get the proper treatment and exercises.

In most cases, this burning pain is caused by some neck problem and often respond well to the medications, physical therapy that includes muscle stretching & strengthening exercises. Also, improving the neck & upper back posture can help.

If your pain is caused by some underlying issues of the shoulder, then you need to practice the exercises of shoulder muscles. To learn how to do stretch the shoulder muscles please visit our shoulder exercises section.

Burning pain in shoulder – FAQs

Can heartburn cause shoulder pain?

References:
[01]Mitchell, C., Adebajo, A., Hay, E., & Carr, A. (2005). Shoulder pain: diagnosis and management in primary care. BMJ (Clinical research ed.), 331(7525), 1124–1128. doi: 10.1136/bmj.331.7525.1124
[02]Cervical Spine Anatomy. University of Maryland Clinical Center. http://www.umm.edu/programs/spine/health/guides/cervical-spine-anatomy accessed on 02 Sep. 2019
[03]Neuroscience For Kids – Explore the nervous system. University of Washingtonhttps://faculty.washington.edu/chudler/nsdivide.html. Accessed on 02 Sep. 2019
[04]Eubanks, JD.Cervical Radiculopathy:Nonoperative Management of Neck Pain and Radicular Symptoms.American Family Physician 2010;81,33-40
[05]Peng, B., & DePalma, M. J. (2018). Cervical disc degeneration and neck pain. Journal of pain research, 11, 2853–2857. doi: 10.2147/JPR.S180018
[06]Conditions treated – degenerative disc disease. (n.d.). Retrieved from http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=111&action=detail