MyLupusTeam members often try to pinpoint the source of their various aches and pains, typically wondering if these issues stem from having lupus. “Have you ever had pain around your collarbone area?” one member asked. “I have terrible pain, sometimes on one side or both, but it’s always there. Ibuprofen helps. I don’t think it’s a fracture because I haven’t fallen or anything.”

Other members have asked, “Does anyone have inflammation or joint pain in the shoulder?” and “Does anyone feel like there are 10-pound weights on their shoulders?”

Collarbone and shoulder blade pain may be related to lupus, but they’re not necessarily lupus symptoms. Here are some possible underlying causes to consider as you try to solve the mystery of why you’re experiencing pain.

1. Lupus Symptoms Can Include Tendinitis

Tendons are the connecting tissues that attach muscles to bones. Lupus can cause inflammation in the shoulder tendons. This condition is called tendinitis, and it may be responsible for pain and soreness in the shoulder or other parts of the body.

Putting too much stress on a tendon can increase your risk of developing tendinitis, especially if you do it repeatedly, such as with certain sports or occupations. You can protect your tendons during physical activity by warming up first, exercising on a regular basis, and training gradually to build strength and flexibility.

Your health care provider can evaluate your shoulder to screen for tendinitis. They may recommend the traditional pain-relieving protocol known by its acronym, RICE:

• Rest
• Ice
• Compress
• Elevate

Over-the-counter pain meds can also help, but make sure your doctor knows about all your medication and supplements before you take something new.

2. Fibromyalgia Could Be To Blame

Some researchers estimate that 20 percent of people with systemic lupus erythematosus (SLE), the most common type of lupus, have fibromyalgia (versus 2 percent of the general U.S. adult population). Fibromyalgia causes widespread pain throughout the body and greater sensitivity to pain.

Although fibromyalgia isn’t associated specifically with collarbone or shoulder pain, it can raise your level of pain from other causes. Fortunately, you can get help to manage fibromyalgia and improve your quality of life with lifestyle changes, mental health support, and other treatments.

3. Steroids May Cause Avascular Necrosis

Many people with lupus rely on steroid medications to reduce inflammation, especially during lupus flare-ups. Unfortunately, steroids come with side effects, particularly when taken in high doses over long periods. One potential side effect is avascular necrosis, a condition that occurs when not enough blood gets to the bone, leading to pressure buildup, weakened bones, and cell death.

Avascular necrosis typically affects the shoulders, knees, or hips and can lead to stiff muscles and muscle spasms. If you have this condition and it limits your mobility or causes pain, your doctor may recommend surgery as treatment.

4. Rotator Cuffs Are Prone to Injury

The shoulder is fitted like a ball in a socket, and the rotator cuff is a group of four muscles that help the shoulder joint rotate and remain in the right position. Rotator cuff injuries are a common cause of shoulder pain, even in people without lupus, affecting two million people in the United States each year, per the American Academy of Orthopaedic Surgeons.

Risk factors for rotator cuff tears include:

• Being over age 40
• Doing repetitive lifting or overhead activities (like tennis players or painters do)
• Getting injured

To diagnose a rotator cuff tear, your doctor will test your arm strength and range of motion. They may also confirm the diagnosis with imaging tests, such as an X-ray, MRI, or ultrasound.

It’s important to see your doctor right away if you suspect you’ve torn your rotator cuff. Untreated tears can worsen over time. Usually, rest, physical therapy, and medication are enough to allow the shoulder to heal. However, studies show that autoimmune connective tissue diseases like SLE may increase the need for surgery to repair rotator cuff injuries. Researchers also observed that controlling inflammation could be beneficial for healing.

5. Lupus Pain Differs From Arthritis Symptoms

It’s crucial to understand the difference between joint problems caused by lupus versus other rheumatologic issues, such as arthritis. Having lupus raises inflammation levels throughout the body, often affecting the joints along with organs like the skin and blood cells. Most people with lupus (about 95 percent) experience joint problems. The most common joint issues with lupus are polyarthralgia (pain) or polyarthritis that affects five joints or more.

In other types of arthritis, symptoms are more likely to affect only the joints. Like with lupus, inflammation is responsible for joint pain in rheumatoid arthritis. When wear and tear from overuse is the reason you feel pain, you may have osteoarthritis. Sports injuries can also cause arthritis. Your rheumatologist must diagnose the cause of arthritis correctly to determine the right treatment.

People with lupus may feel stiff when they first wake up in the morning, and a warm shower can help. Medications that may help treat lupus-related joint issues include nonsteroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine (Plaquenil), steroids, and immunosuppressive drugs like methotrexate.

6. Chest Pain Must Be Taken Seriously

If the pain in your collarbone can be described as chest pain, don’t hesitate to check in with your health care provider. In the United States, someone has a heart attack every 40 seconds, according to Cleveland Clinic. Distinguishing a heart attack from less dangerous causes of chest pain is usually best left to medical experts. You should address pain that comes on suddenly and doesn’t go away after a few minutes. A heart attack can feel like there’s a balloon expanding in your chest. Other potential symptoms include shortness of breath, dizziness, racing heart rate, and cold sweats.

Luckily, not all chest pain is life-threatening. Most of the time, when people go to the emergency room for chest pain, they’re not having a potentially fatal heart issue. Other causes of chest pain include:

• Acid reflux or heartburn
• Asthma
• A blood clot in the lungs
• Pneumonia
• A pulled muscle in the chest wall
• Rib cartilage inflammation
• Rib injury
• Shingles

Even if you’re not having a heart attack, you need medical attention for these other conditions. When you have lupus, it’s important to take any new symptoms seriously.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, over 223,000 people with lupus come together to ask questions, give advice, and share their stories.

Does shoulder pain, chest pain, or pain in your collarbone affect your daily activities? Have you identified these issues as lupus symptoms or a separate health condition? Post your thoughts in the comments below, or start a conversation by sharing on MyLupusTeam.