Is Shoulder Blade Pain a Sign of Lung Cancer?

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Shoulder blade pain is a sign of lung cancer in some people. Lung cancer may be especially be suspected if you also have other symptoms of lung cancer or your shoulder pain worsens at night.

With that said, shoulder pain is not a definite sign of lung cancer. Other diseases such as arthritis can cause pain in that area, too.

This article explains why lung cancer sometimes causes shoulder pain and how this pain differs from other causes of shoulder pain.

lung cancer-related shoulder pain

Verywell / Emily Roberts

How Lung Cancer Causes Shoulder Pain

Lung cancer-related shoulder pain can be caused by a number of different mechanisms.

Pancoast Tumors

Pancoast tumors, a form of lung cancer, grow near the upper part of the lungs and can invade tissues near the shoulder. Pancoast tumors often cause pain in the shoulder that radiates down the arm.

Due to their location, these tumors are less likely to cause typical symptoms of lung cancer such as a persistent cough, coughing up blood, and shortness of breath. These tumors are also sometimes difficult to diagnose, as they can "hide" on a normal chest X-ray.

Referred Pain

Pain in your shoulder could be referred pain (meaning that the pain is felt in the shoulder but originates somewhere else in the body). In some cases, this referred pain is caused by a lung cancer tumor.

An example of referred pain from lung cancer is when a lung tumor causes pressure on a nerve that travels near the lungs. In this case, the brain interprets pain as coming from the shoulder, when in fact, the nerve is being irritated within the lungs.

Bone Metastases

Shoulder pain in lung cancer can also be related to the spread of lung cancer to bones in and near the shoulder. Roughly 30% to 40% of people with lung cancer develop bone metastases (the spread of cancer to bones) at some time during the course of their disease. In about half of all cases, it's the spine that is affected.

Malignant Pleural Mesothelioma

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% of patients developed shoulder pain as the 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 healthcare provider know.

Shoulder Pain as a Symptom

Unfortunately, shoulder pain related to lung cancer or mesothelioma can be very similar or identical to that of conditions such as arthritis. If you have any question at all about shoulder pain, it's better to be safe and talk to your healthcare provider. Yet, there are a few symptoms that make lung cancer more likely.

Symptoms that may be more concerning for lung cancer include shoulder pain that's worse at night, pain that occurs at rest, and pain that's 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:

Many people dismiss the early symptoms of lung cancer as being due to age-related changes in exercise tolerance, weight gain, or being too sedentary.

Keep in mind that the symptoms of lung cancer in people assigned female at birth and symptoms of lung cancer in non-smokers are often less typical than those in smokers and people assigned male at birth. They are sometimes vague, such as the gradual onset of shortness of breath with activity and fatigue.

How Lung Cancer is Diagnosed

If there is any chance that your shoulder pain is due to lung cancer, it's important for it to be thoroughly evaluated. After all, lung cancer is the leading cause of cancer-related deaths in the United States in both males and females.

If you've never smoked, you're still at risk. Lung cancer in never-smokers is thought to be the sixth leading cause of cancer-related deaths, and lung cancer in never-smokers is actually increasing, especially for young females who have never smoked.

Many people feel reassured if they have a normal chest X-ray, but a chest X-ray isn't sufficient to rule out the disease. Overall, up to 25% of lung cancers are missed on a chest X-ray, and Pancoast tumors are commonly missed. If there is any question at all, a chest CT scan is needed.

Treatment Options

Treatment of shoulder pain related to lung cancer will depend on the underlying cause for 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. Options could include surgery or radiation locally, or systemic treatment with chemotherapy targeted therapy drugs, or immunotherapy drugs.

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 and/or bone-modifying medications may reduce symptoms significantly.


Lung cancer can sometimes be a cause of shoulder pain, but other causes are more likely. Shoulder pain that occurs along with typical symptoms of lung cancer like fatigue, coughing up blood, and unexplained weight loss, suggests the greater possibility of lung cancer.

Certain types of lung cancer, including pancoast tumors, may be more likely to cause shoulder pain. That's also true if cancer has metastasized (spread) to the shoulder bone. A thorough diagnosis may require tests beyond chest X-rays, which can miss up to 25% of lung cancers.

If you do not have an explanation for your pain, it's important to see your healthcare provider to ensure that any necessary treatment begins as soon as possible. Recent guidelines for evaluating shoulder pain may increase the likelihood that less common causes of shoulder pain (such as lung cancer) will be accurately diagnosed.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."