Causes of why both your shoulders hurt include strain and tension in the muscles from poor posture, overuse, or trauma from an injury that may also cause neck and shoulder pain. Read below for more information on causes and how to relieve shoulder pain on both arms.
7 most common cause(s)
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Pain in both shoulders symptoms
Shoulder pain is one of the most common reasons for a person to visit a doctor. The shoulder joints are very versatile, flexible, and mobile, but these traits also leave them vulnerable to injury. Due to the configuration of your nervous system, your shoulders may also register the pain coming from other parts of the body. This configuration means that you should not ignore the pain in one or both shoulders, especially if it seems to be happening for no apparent reason.
Common characteristics of pain in both shoulders
If you are experiencing pain in both shoulders, it can likely present with:
- Shoulder pain, heat, and redness over the joints
- Pain that is deep, aching, and/or burning
- Pressure or tightness in both shoulders and both arms: Especially when walking or otherwise exercising
- Pain with tingling in the arm and hand
Who is most often affected?
People who fit the following descriptions are likely to experience pain in both shoulders at some point.
- People who do hard labor: Strenuous physical work such as digging, cutting wood, or moving heavy objects can cause pain.
- Athletes: Such as people who play baseball, tennis, or other sports involving overhead throwing or hitting.
- Weightlifters
- Anyone with a disease of the heart, liver, or gallbladder
- Anyone who has suffered a heart attack
Is pain in both shoulders serious?
The severity of pain in both shoulders is ultimately dependent on the cause.
- Not serious: Shoulder pain that can be characterized as "sore" or "aching", comes on gradually, and improves with rest is probably not serious.
- Moderately serious: Shoulder pain caused by an acute injury can usually heal quite well if treated right away.
- Serious: Sudden, severe pain in both shoulders that seems to have no apparent cause can be very serious and should be treated as a medical emergency.
Pain in both shoulders causes
Many conditions can have pain in both shoulders as a symptom. The following details may help you better understand your symptoms and if and when you need to see a physician.
Most common causes
The most common causes of pain in both shoulders include the following.
- Inflammation of your muscles and/or tendons
- Tension in the muscles of your neck and shoulder: Tension is likely due to stress or poor posture. You're more likely to have poor posture if you spend long hours sitting at a desk or bending over a table or an assembly line.
- Chronic overuse injury: This type of injury occurs when you make the same motion with the shoulder over and over again. Swinging tennis rackets, hitting baseballs, or lifting weights are potential causes [3]. This injury can result in a sprain, strain, tear, or other damage to the joints, tendons, muscles, and bursa.
- Trauma: Examples of trauma include a fall, an automobile accident, or an acute sports injury.
Less common causes
The following are less common causes of pain in both shoulders.
- Autoimmune diseases: These diseases often cause repeated episodes of inflammation. Inflammation will eventually damage cartilage and bone and cause chronic pain.
- Neurologic diseases: These diseases damage the nerves and cause neuropathic pain.
- Severe infections of the bones or cartilage
Rare and unusual causes
The following are rare causes of pain in both shoulders.
- Aging: You may acquire degenerative diseases of the bone and cartilage of the neck and shoulders.
- Referred pain: Referred pain starts in another part of your body but is felt in your shoulders. In rare cases, pain in both shoulders can originate in tumors elsewhere in the body.
Examples of referred pain
The following are examples of pain that originates elsewhere in the body but may affect your shoulders.
- Tingling in the arm and hand: The neck may be the starting point.
- Tightness and discomfort in the arms: This tightness can indicate heart disease. If you continue to experience this discomfort, treat this as a medical emergency even if you don't have chest pain.
- Pain in the right upper abdomen: Pain in this area can be due to liver or gallbladder disease.
This list does not constitute medical advice and may not accurately represent what you have.
Shoulder arthritis
Shoulder arthritis means that there is inflammation and abnormal wear of one or both of the two joints in the shoulder.
Arthritis in any joint is most often be caused by long-term wear and tear, called osteoarthritis; by an autoimmune condition that attacks the joints, called rheumatoid arthritis; or by an injury, called post-traumatic arthritis.
Symptoms include pain, which becomes worse with use of the joint; limited range of motion, meaning the shoulder joint cannot move as far as it once did; and pain when resting or trying to sleep.
Shoulder arthritis cannot be cured, but symptoms can be managed to improve quality of life and ease pain and discomfort.
Diagnosis is made through patient history, physical examination, and x-rays. To confirm, an injection of anesthetic may be placed into the joint. If the pain is eased, arthritis is almost certainly the cause.
Treatment involves physical therapy; nonsteroidal anti-inflammatory drugs to ease discomfort and inflammation; and corticosteroid injections into the shoulder to relieve pain. Surgery and shoulder joint replacement can be done in some cases.
Rheumatoid arthritis
Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.
Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.
Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.
Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.
If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.
Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.
There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.
Repetitive strain injury of the shoulder ("swimmer's shoulder")
Repetitive strain injury of the upper arm is caused by consistent repetitive use.
You do not need treatment, just rest from your overuse. Wearing a brace and physical therapy might be helpful.
Rarity: Uncommon
Top Symptoms: shoulder pain from overuse, shoulder weakness, shoulder numbness
Symptoms that always occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): shoulder pain from overuse
Symptoms that never occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): severe shoulder pain, shoulder injury
Urgency: Self-treatment
Pinched nerve in the neck
A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.
It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.
Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.
Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.
A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.
Rarity: Common
Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain
Urgency: Primary care doctor
Non-specific shoulder pain
Non-specific shoulder pain, also called NSSP, means that the cause of pain in the shoulder is not immediately obvious.
There are many structures in and around the shoulder. The pain may be from a condition or injury in the joint itself, or in any of the bones, muscles, tendons, and ligaments surrounding it. Anything from a broken arm to arthritis can cause shoulder pain.
Symptoms include pain that worsens with movement of the arm and shoulder, especially following overuse, or injury. Swelling, redness, joint deformity, inability to move the arm, or severe pain should be seen right away by a medical provider.
Shoulder pain with shortness of breath and/or pain or tightness in the chest can be signs of a heart attack. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and through x-ray or CT scan.
Treatment usually begins with rest and over-the-counter, nonsteroidal anti-inflammatory pain relievers. Further care will be determined by medical providers once the exact cause of the pain has been determined.
Rarity: Common
Top Symptoms: shoulder pain
Symptoms that always occur with non-specific shoulder pain: shoulder pain
Urgency: Self-treatment
Frozen shoulder (adhesive capsulitis of the shoulder)
Frozen shoulder is also called adhesive capsulitis of the shoulder. The "shoulder capsule" is the strong web of connective tissue which holds the ball joint of the upper arm inside the socket of the shoulder blade. If this connective tissue is damaged, scar tissue – or adhesions – may form and cause the shoulder capsule to become tight, painful, and inflexible.
The condition can happen if an injury to the shoulder forces it to stay immobilized while healing. Additional risk factors may be diabetes, thyroid abnormalities, and heart disease.
Symptoms include gradual worsening of the ability to move the shoulder, due to increasing pain and stiffness in the outer shoulder and upper arm.
Diagnosis is made through physical examination, with simple tests to measure how far the shoulder can move, as well as imaging such as x-ray or MRI.
Treatment involves physical therapy to help restore range of motion; over-the-counter, nonsteroidal anti-inflammatory drugs to ease pain; and sometimes cortisone injections to the shoulder joint. Surgery may be needed in some cases.
Rarity: Common
Top Symptoms: spontaneous shoulder pain, stiff shoulder, dull, achy shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder
Symptoms that always occur with frozen shoulder (adhesive capsulitis of the shoulder): stiff shoulder
Urgency: Primary care doctor
Fibromyalgia
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Rarity: Common
Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache
Symptoms that always occur with fibromyalgia: arthralgias or myalgias
Urgency: Primary care doctor
Brachial plexopathy (shoulder nerve issue)
A shoulder nerve injury, also called brachial plexopathy, is when damage occurs to a network of nerves in the front of the shoulder known as the brachial plexus. This damage can occur from injury, inflammation, radiation therapy, or other medical conditions. Symptoms include sharp pain in the shoulder, arm, or hand. Numbness or weakness in the shoulder or arm may also occur.
You should consider visiting a medical professional to discuss your symptoms. A doctor can evaluate shoulder nerve issues with a review of your symptoms and medical history. You might also be asked to do an EMG, a test that checks the connection between muscles and nerves. Once diagnosed, some options for treatment include pain or nerve block medication, physical therapy, and braces or splints. Some cases may require surgery. Depending on the severity, recovery times can range from weeks to years.
Rarity: Uncommon
Top Symptoms: pain in one arm, shoulder pain that shoots to the arm, arm weakness, numbness in one arm, shoulder pain
Symptoms that never occur with brachial plexopathy (shoulder nerve issue): pain in the front middle part of the neck
Urgency: Primary care doctor
Pain in both shoulders treatments and relief
At-home treatments
You can try the following treatments for pain in both shoulders at home.
- Apply heat or ice to the painful joints
- Pain medication: Take over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin to ease the pain.
- Improve posture when you're sitting and standing
- Move thoughtfully: Exercise appropriately and listen to your physician or physical therapist.
- Address weight and overall health: Change your diet and exercise habits to lose any excess weight. Losing weight will allow more freedom of movement and ease the stress on your joints.
When to see a doctor
You should consult your physician to address the following.
- If the pain worsens with rest: See a physician for severe pain and stiffness in both shoulders that is worse with rest and better with activity, especially if you also have flu-like symptoms.
- Pain that does not improve within two weeks
When it is an emergency
Seek immediate treatment in the emergency room or call 911 if:
- You have pain, pressure, tightness, or other discomforts in both shoulders and both arms, even if you do not have chest pain
- You have severe, constant, intractable pain in both shoulders, for no apparent reason
- You suffer an injury that results in pain in both shoulders, even with no outer sign of trauma
Prevention
Pain in both shoulders is preventable if you keep your posture in mind, especially if you must remain still throughout the day for long periods. Take breaks for a few minutes every hour to stretch, change positions, and to release tense muscles. Maintain a regular exercise regimen with proper techniques to improve your overall health.
Questions your doctor may ask about pain in both shoulders
- How would you explain the cause of your shoulder pain?
- Can you fully move your shoulders around?
- Have you ever been diagnosed with diabetes?
- Where exactly is your shoulder pain?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
References
- Mitchell C, Adebajo A, Hay E, Carr A. Shoulder pain: Diagnosis and management in primary care. BMJ. 2005;331(7525):1124-1128. NCBI Link
- Blahd WH Jr, Husney A, Romito K, Messenger D, eds. Referred shoulder pain. University of Michigan: Michigan Medicine. Updated September 20, 2018. U of M Health Link
- Yang J, Tibbetts AS, Covassin T, Cheng G, Nayar S, Heiden E. Epidemiology of overuse and acute injuries among competitive collegiate athletes. J Athl Train. 2012;47(2):198-204. NCBI Link
- Colloca L, Ludman T, Bouhassira D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002. NCBI Link
- Warning signs of a heart attack. American Heart Association. Updated June 30, 2016. AHA Link