What organs can cause neck and shoulder pain?

Vasculitis

Inflammation is your immune system’s natural response to injury or infection. It causes swelling and can help the body deal with invading germs.

But in vasculitis, for some reason the immune system attacks healthy blood vessels, causing them to become swollen and narrow.

This may be triggered by an infection, another underlying condition, or a medicine, although often the cause is unknown.

Vasculitis can range from a minor problem that just affects the skin, to a more serious illness that causes problems with organs like the heart or kidneys.

There are many types of vasculitis. The rest of this page discusses a range of potential causes.

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Eosinophilic granulomatosis with polyangiitis, also called Churg-Strauss syndrome, is a type of vasculitis that mainly affects adults around 38 to 54.

asthma
cold-like symptoms caused by allergies (allergic rhinitis)
a high temperature
muscle and joint pain
tiredness
loss of appetite and weight loss

It can also affect the nerves, causing weakness, pins and needles or numbness, and sometimes damages the kidneys or heart muscle.

It’s usually treated with steroid medicine.

Temporal arteritis (giant cell arteritis)

Temporal arteritis, also known as giant cell arteritis, is a type of vasculitis where the arteries at the side of the head (the temples) become inflamed.

It mostly affects adults over the age of 50 and can cause:

aching and soreness around the temples
jaw muscle pain while eating
headaches
double vision or vision loss

Some people with temporal arteritis also get polymyalgia rheumatica (muscle pain and stiffness in the shoulders, neck and hips).

The main treatment for temporal arteritis is steroid medicine.

When to get medical help

Get advice from 111 now if you think you might have temporal arteritis.

It can lead to serious problems like stroke and blindness if not treated quickly.

111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.

Go to 111 online or call 111.

Granulomatosis with polyangiitis (Wegener’s granulomatosis)

Granulomatosis with polyangiitis, also called Wegener’s granulomatosis, is a type of vasculitis that affects blood vessels in the nose, sinuses, ears, lungs and kidneys.

It mainly affects middle-aged or older people and can cause:

a high temperature
night sweats
inflammation of the sinuses (sinusitis)
nosebleeds and crusting of the nose
shortness of breath and coughing up blood
kidney problems

Granulomatosis with polyangiitis is a serious condition that can be fatal if left untreated, as it can lead to organ failure.

It’s usually treated with steroid medicine or other medicines that reduce the activity of the immune system.

Henoch-Schönlein purpura

Henoch-Schönlein purpura is a rare type of vasculitis that can affect the skin, kidneys or bowel.

Children often get it and it’s thought to be triggered by the body reacting to an infection.

a rash that looks like small bruises or reddish-purple spots (this may be less obvious on brown or black skin)
joint pain
tummy (abdominal) pain
diarrhoea
being sick
blood in urine or poo

Henoch-Schönlein purpura is not usually serious and often gets better without treatment.

Kawasaki disease

Kawasaki disease is a condition that mainly affects children under the age of 5.

The characteristic symptoms are a high temperature that lasts for 5 days or more, and possibly 1 or more of the following symptoms:

a rash
swollen glands in the neck
dry, cracked lips
red fingers or toes
red eyes

Intravenous immunoglobulin (IVIG), a solution of antibodies, and aspirin are the 2 main medicines used to treat Kawasaki disease.

Aspirin is not usually recommended for children under 16, so do not give aspirin to your child unless advised to by their doctor.

Microscopic polyangiitis

Microscopic polyangiitis is a rare and potentially serious long-term type of vasculitis that most often develops in middle-aged people.

It can affect any organ, but often affects the lungs, kidneys and nerves.

a rash
shortness of breath and coughing up blood
red and sore eyes
pins and needles or numbness
joint stiffness
muscle aches
loss of appetite
losing weight without trying
feeling tired
flu-like symptoms, such as a high temperature and an aching body
kidney problems

Microscopic polyangiitis is usually treated with steroid medicine or other medicines that reduce the activity of the immune system.

Polyarteritis nodosa

Polyarteritis nodosa is a rare type of vasculitis that particularly affects the arteries supplying the gut, kidneys and nerves.

It tends to develop in middle-aged people.

It can sometimes be triggered by an infection, such as hepatitis B, but the exact cause is uncertain.

muscle and joint pain
tummy (abdominal) pain, particularly after eating
a rash
pins and needles or numbness
bleeding and ulcers in the gut

Polyarteritis nodosa can be very serious if it’s not treated. The main treatment is steroid medicine, and sometimes other medicines that reduce the activity of the immune system.

Polymyalgia rheumatica

Polymyalgia rheumatica is a type of vasculitis that’s closely related to temporal arteritis.

It mostly affects adults over 50 and is more common in women than men.

pain and stiffness in the shoulders, neck and hips, which is often worse after waking up
a high temperature
extreme tiredness
loss of appetite and weight loss
depression

The main treatment is steroid medicine, which is usually used in lower doses than for temporal arteritis.

Takayasu arteritis

Takayasu arteritis is a type of vasculitis that mainly affects young women. It’s very rare in the UK.

It affects the main artery from the heart, as well as the major arteries branching off it.

extreme tiredness
a high temperature
weight loss
muscle and joint pain
painful, numb or cold limbs

Takayasu arteritis is usually treated with steroid medicine.

Other types of vasculitis

Behçet’s disease

Behçet’s disease typically causes mouth ulcers and genital ulcers, and is more common in people from Greece, Turkey, the Middle East, China and Japan.

Buerger’s disease

Buerger’s disease affects blood vessels in the legs and arms, leading to reduced blood flow to the hands and feet. It’s closely linked to smoking.

Cogan’s syndrome

Cogan’s syndrome is inflammation of the blood vessels in the inner ears and eyes.

Cryoglobulin-associated vasculitis

Cryoglobulin-associated vasculitis is caused by abnormal proteins in the blood called cryoglobulins.

It can sometimes happen after a hepatitis C infection and causes a rash on the lower limbs, joint pain, nerve damage, tummy (abdominal) pain and kidney problems.

Hypersensitivity vasculitis

Hypersensitivity vasculitis is usually caused by a reaction to a medicine, such as NSAIDs or certain antibiotics, and results in a temporary rash.

Primary angiitis of the central nervous system

Primary angiitis of the central nervous system is inflammation of the blood vessels in the brain.

Rheumatoid vasculitis

Rheumatoid vasculitis is vasculitis associated with rheumatoid arthritis.

Page last reviewed: 17 February 2023
Next review due: 17 February 2026

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Causes and types of cancer pain

Cancer pain has many different causes and there are different types. You can have pain control and get support to help you manage any pain you might have.

Causes of cancer pain

Most cancer pain is caused by the tumour pressing on bones, nerves or other organs in the body.

Sometimes pain is due to your cancer treatment. For example, some chemotherapy drugs can cause numbness and tingling in your hands and feet. Or they might cause a burning sensation at the spot where you have the drug injection.

Radiotherapy can cause skin redness and irritation.

Remember that some pain might have nothing to do with your cancer. You could have the general aches and pains that everyone gets from time to time.

Acute and chronic pain

Cancer pain can be acute or chronic.

Acute pain

Acute pain is due to damage caused by an injury and tends to only last a short time. For example, having an operation can cause acute pain. The pain goes when the wound heals. In the meantime, painkillers will usually keep it under control.

Chronic pain

Chronic pain can be due to changes to the nerves. Nerve changes may be due to cancer pressing on nerves or due to chemicals produced by a tumour. It can also be caused by nerve changes due to cancer treatment. Chronic pain continues long after the injury or treatment is over and can range from mild to severe. It can be there all the time.

Sometimes pain can come on quickly, for example when you have a dressing changed or you move around and change position. This type of pain is called incidental pain.

Chronic pain is also called persistent pain.

Types of cancer pain

It is extremely important for your doctor to find out the type and cause of your pain. Then they can treat it in the right way. Different types of pain need different treatment.

Nerve pain

Nerve pain is also called neuropathic pain. It’s caused by pressure on nerves or the spinal cord, or by damage to the nerves.

People often describe nerve pain as burning, shooting, tingling or a feeling of crawling under their skin. It can be difficult to describe exactly how it feels. Nerve pain can sometimes be more difficult to treat than other types of pain.

Some people have long term nerve pain after surgery. Nerves are cut during surgery and they take a long time to heal because they grow very slowly. In time the nerves heal, and the pain does usually go.

Nerve pain can also happen after other cancer treatments, such as radiotherapy or chemotherapy.

Bone pain

Cancer can spread into the bone and cause pain by damaging the bone tissue. The cancer can affect one specific area of bone or several areas.

You might also hear bone pain called somatic pain. People often describe this type of pain as aching, dull or throbbing.

Soft tissue pain

Soft tissue pain means pain from a body organ or muscle. For example, you might have pain in your back caused by tissue damage to the kidney.

You can’t always pinpoint this pain, but it is usually described as sharp, cramping, aching, or throbbing. Soft tissue pain is also called visceral pain.

Phantom pain

Phantom pain means pain in a part of the body that has been removed. An example is pain in the breast area after removal of the breast (mastectomy).

Phantom pain is very real and people sometimes describe it as unbearable.

Doctors are still trying to understand why phantom pain happens. One theory is that your brain’s thinking section knows that part of your body has gone but your brain’s feeling section can’t understand this. Other possible causes are poor pain control at the time of surgery.

Over 50 out of 100 people (over 50%) who have surgery to remove an arm or leg feel phantom pain.
About one third of women (about 1 in 3 women) who have surgery to remove a breast feel phantom breast pain.

In most people the pain goes away after a few months, or gets less after the first year. But some people can still feel phantom pain after a year or more.

It’s important to tell your doctor or specialist nurse about phantom pain, because they can control it with painkillers.

Referred pain

Sometimes people can feel pain from an organ in the body but in a different part of their body. This is called referred pain.

For example, a swollen liver may cause pain in the right shoulder, even though the liver is under the ribs on the right. This is because the liver presses on nerves that end in the shoulder.

How much pain you might have

The amount of pain you have with cancer depends on:

the type of cancer you have
where it is
the stage of your cancer
whether the cancer or treatment has damaged any nerves

Other factors can also affect how you feel pain, such as fear, anxiety, depression and a lack of sleep.

It’s very important to let your medical team know straight away if you have pain. Don’t try to put up with it. This can cause nerve changes that could make the pain harder to control in the future.

Controlling chronic pain

Chronic pain is also called persistent pain. It can be difficult to treat, but often painkillers or other pain control methods can successfully control it.

Pain that is not well controlled can develop into chronic pain. So it is important to take the painkillers that the doctor prescribes for you. Trying to put up with the pain can make it harder to control in the future.

People with chronic cancer pain might have times when their medicines do not control the pain all the time. This is called breakthrough pain.

Tell your doctor or nurse if you’re taking regular painkillers but still get pain at times. They can prescribe extra doses of painkillers for you to take when you need them.

Read about treating cancer pain

Getting support with cancer pain

Pain can greatly affect your quality of life. Chronic pain can make it hard for you to do everyday things such as bathing, shopping, cooking, sleeping and eating.

This can be hard for your close friends and relatives to understand. You might need support to deal with how pain can affect you and your loved ones.

Get support when you have pain

References

Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines M Fallon and others Annals of Oncology, 2018. Volume 29, Supplement 4
Cancer Pain Management
British Pain Society, 2010 (updated 2014)
Oxford Textbook of Palliative Medicine NI Cherny and others (Editors) Oxford University Press, 2015

Liver Cancer Symptoms

Liver cancer symptoms may vary depending on the type of liver cancer that a patient has. As is the case with many types of cancer, liver cancer may not cause any symptoms in its initial stages, while some patients may have vague symptoms that are related to more common conditions.

The liver is located in the right side of the upper abdomen, just under the rib cage, which is where many liver cancer symptoms will initially appear. Oftentimes, patients with liver cancer may notice swelling or the formation of hard lumps in this area, either of which may be accompanied by pain. This pain can sometimes also be felt in the back, below the right shoulder blade.

In addition to pain and swelling, a patient may experience a variety of other liver cancer symptoms. Some of these symptoms may include:

Fevers
Nausea
Vomiting
Jaundice
Loss of appetite
Chronic abdominal pain
Unexplained weight loss
Feeling very full after a small meal
Changes in the color of stool and urine

Since liver cancer symptoms may vary from person to person and can often be hard to identify, it’s particularly important for people to promptly speak with a physician about their symptoms. Early diagnosis of liver cancer can lead to better outcomes and improved quality of life.

How to reduce your risk of developing liver cancer

Drinking alcohol in moderation, or just not drinking it at all, can significantly help reduce your risk of developing liver cancer. This is because heavy, long-term alcohol consumption can cause scarring and inflammation in the liver. Cirrhosis of the liver, which is characterized by irreversible liver damage, is a form of liver disease caused by excessive, consistent alcohol use. It is also the main risk factor for liver cancer. This is due to cell mutations that can form as the body tries to repair damaged tissues. The American Cancer Society recommends no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women.

Limiting alcohol use can help prevent liver cancer, but there are a variety of other ways to reduce your risk, including:

Avoiding tobacco products
Maintaining a healthy weight
Exercising regularly
Taking steps to avoid becoming infected with the hepatitis B and C viruses (ex: avoiding unprotected sex and only using sterilized needles for medical purposes)
Avoiding exposure to arsenic and aflatoxins
Avoiding anabolic steroids to build muscle

What is metastatic liver cancer?

Metastatic (secondary) liver cancer is a malignant tumor that originates in a different part of the body and then spreads to the liver through the bloodstream or lymphatic system. It is diagnosed more often than primary liver cancer. Some of the most common symptoms of metastatic liver cancer include:

Persistent vomiting
Black stool
Unexplained weight loss
Difficulty swallowing
Jaundice
Abdominal pain or swelling/bloating
Fevers
Fatigue or weakness

There are a variety of cancers that can spread to the liver from other parts of the body, including:

Breast cancer
Lung cancer
Esophageal cancer
Thyroid cancer
Stomach cancer
Bladder cancer
Ovarian cancer
Uterine cancer
Pancreatic cancer
Kidney cancer
Prostate cancer
Melanoma
Squamous cell carcinoma of the anus
Sarcoma

Many liver metastases start as cancer in the colon or rectum due to a large blood vessel (the portal vein) that connects the blood supply between the gastrointestinal tract and the liver.

What to know about liver cancer screenings

If you are at high risk for developing liver cancer, routine screenings can help identify abnormalities in their earliest stages. Even if you are at low risk, your physician may recommend occasional screenings. Early detection and diagnosis offers the widest variety of treatment options and the highest survival rates for individuals diagnosed with liver cancer.

Moffitt Cancer Center’s approach to liver cancer

Moffitt’s Gastrointestinal Oncology Program has a multispecialty team composed of surgeons, radiation oncologists, pathologists, supportive care professionals and other experts who specialize in the diagnosis and treatment of liver cancer, as well as ways to reduce this condition’s side effects. If our physicians find that your symptoms indicate liver cancer, they will confirm a diagnosis and create an individualized treatment plan that may include surgery, radiation therapy, chemotherapy and other progressive forms of treatment. Patients who qualify may be recommended to participate in one of our clinical trials, which offers the latest treatment options not yet available anywhere else. Moffitt is home to a diverse team of physicians who are well versed in the most innovative treatments, allowing patients to receive the best available liver cancer treatments in one convenient location.

Contact Moffitt Cancer Center to learn more about our diagnostic services and how our team assesses liver cancer symptoms. Complete our new patient registration form, or call 1-888-663-3488.