Shoulder blade pain can be a sign of a Pancoast tumor, a type of lung cancer. It’s important to note that there are several other signs and symptoms that usually coincide with this pain if it truly is cancer.
Pancoast tumors are a rare form of lung cancer, affecting only 3-5% of people who develop it.
According to this scientific article, these are the associated cluster of findings with a Pancoast Tumor:
“This is characterized by ipsilateral shoulder and arm pain, paresthesias, paresis and atrophy of the thenar muscles of the hand, and Horner’s syndrome (ptosis, miosis, and anhidrosis).”
Pubmed Link to Scientific Article
Key Points
- While shoulder blade pain can be a sign of cancer, this diagnosis would only be made after a careful evaluation by your doctor including a detailed health history and physical exam.
- Physical therapists are trained to differentiate between musculoskeletal and non-musculoskeletal diagnoses.
- A Pancoast tumor is very rare and comes with a specific set of symptoms that your healthcare provider should be able to pick out
- If it is not cancer and is musculoskeletal there are many types of exercises that can help make your symptoms go away and prevent it from getting worse
How are Pancoast Tumors Evaluated?
- Shoulder or arm pain with associated paresthesias along the medial half of the fourth, fifth fingers and medial side of the hand, arm, and forearm due to C8 through T1 radiculopathy are usually primary symptoms associated – SOURCE
- There is usually no shortness of breath at the early stages of the disease
- Laboratory measurements are not taken (blood) as no abnormalities show up
- A chest x-ray will likely be done first to see if there are any abnormalities on or around the lung
- CT scan may be taken for a more comprehensive view
- MRI of the neck, chest and upper abdomen may be done to further evaluate the soft tissue and it may give a better view of the tumor (if there is one)
- Additionally, a CT-guided core biopsy may be made to further aid diagnosis.
How Should I Think About This?
If you’re like me and the rest of the population, you probably jump to the worst possible conclusions and assume that any random pain is probably cancer.
The good news is that this type of cancer is very rare and chances are, it’s not that.
You should go through a full history of your condition and physical exam with your physical therapist and doctor and then they will be able to properly guide you through to the next step.
This history will include all medical history including your work, hobbies, and other important aspects of your life to create a full picture of your health.
This physical exam will include observing and measuring range of motion and strength. It will test if certain movements hurt more than others, and whether or not certain motions or a certain amount of weight aggravate symptoms further, or not.
As a Doctor of Physical Therapy, I’ve been extensively trained in differential diagnosis and recognizing when something isn’t musculoskeletal. I’ve had several patients come in with symptoms that didn’t quite add up and I’ve had to refer them out to their physician as it was something more dangerous going on.
But, out of the over 1,000 patients I’ve worked with in the past 6 years, I can count on two hands how many people I’ve had to refer out, only maybe a few were cancer.
So, chances are in your favor that it’s likely something that is musculoskeletal. In any case, you won’t hurt yourself further by trying different shoulder blade exercises as I’ve shared in this article that I wrote that is very popular.
You can try out those different exercises and see how you feel. If it starts feeling better, it’s likely musculoskeletal and I just saved you a doctor’s visit!
