Hard, Soft, Painful Lump on Shoulder, Under Skin, Muscle, Bone, Spine

Lumps do not often show up on the shoulder. When they occur, they mostly are benign lumps such as lipomas and cysts. Like with any other part of the skin, boils and abscesses may also appear as sore painful lumps on the shoulder. Some joint disorders and injuries to your shoulders are other possible causes of lumps. Very rarely will cancerous lumps show up in this region of the body.

It is a bit easier to diagnose a lump that has developed on the skin. A physical exam may be all that is required. For lumps under skin or originating on joints, imaging tests and biopsies may be required for diagnosis.

Common causes of lump on shoulder


Injuries on shoulder can be of the following forms:

  • Separated shoulder – the collarbone is attached to the shoulder blade by cords known as ligaments. When these ligaments are stretched or torn, a separated shoulder occurs. Mild injuries may not cause noticeable lumps. Severe injuries will on the other hand result in a painful lump on the shoulder blade. A separated shoulder doesn’t require surgery unless very severe. Given enough time, the ligaments will heal on their own. You can however try techniques such as physical therapy and ice treatment.
  • Muscle strain – a strain occurs when a muscle or a tendon stretches beyond normal limits or tears. Strains are common in joints and muscles. A muscle strain on shoulder will mostly occur near the collarbone. Medical treatment is only necessary if the lump is severely painful or causing reduced functionality. At home, you can follow the RICE technique for treatment of a shoulder muscle strain. RICE stands for Rest, Ice, Compression and Elevation.
  • Broken or fractured bone – bones can fracture or break due to injuries such as a blow from a blunt object. Such injuries will lead to formation of a lump on the shoulder blade or on the collarbone.


Lipomas are very common. They are classified as tumors but not cancerous ones. Basically, lipomas are growths that form on fatty tissues. The most distinctive feature is formation of soft, rubbery, doughy, movable lump under the skin. Most grow slowly and in most cases with no noticeable symptoms. If large enough, a lipoma on throat can cause a symptoms of a lump in the throat feeling.

A lipoma lump on top of the shoulder can be subcutaneous or intermuscular. Subcutaneous lipomas are more common and form just beneath the skin. Intermuscular lipomas are located deeper in soft tissues. A lipoma can be identified after a physical exam. Imaging tests and biopsies may be required to rule out the possibility of cancerous cells. If not bothersome, a lipoma can be left without treatment. Surgical removal, anti-inflammatory medications and liposuction are the main treatment options available.

Contusion or bruise

Contusion is the medical term for a bruise. It is a type of a hematoma or abnormal collection of blood under skin. It develops when blood vessels are injured. As a result, blood leaks into nearby areas to form a small lump. Bruises do not cause damage on outer skin. They are common during athletic activities. Treatment is usually not required. With time, the damaged blood vessels will heal while the leaked blood will be reabsorbed. You can however try home treatment techniques such as warm compress.

Sebaceous cyst

A lump on top of the shoulder can be a sebaceous cyst. If it originates from the epidermal cells, it is referred to as an epidermoid cyst. Epidermoid cysts develop when epidermal skin layers mover deeper into the skin. If the cyst originates from a hair follicle, it is referred to as a pillar cyst. Sebaceous cysts contain keratin, a white, thick material. It is for this reason that some sebaceous cysts form hard lumps, most of which are painless. You can, however, develop a painful lump behind the ear caused by a cyst or a lump on the outside of the eyelid caused by a chalazion.

Cysts are not dangerous and can therefore be left untreated. The problem is that they never disappear unless removed. Surgical removal is the best treatment option for cysts.

Other causes of lump on shoulder

Below are other possible but rare causes of a lump on the shoulder:

Muscle spasm

Muscle spasm is a sudden involuntary contraction of a solitary muscle or a group of muscles. It is common after strenuous activities. Muscle spasms last for a few minutes and are harmless. However, they are in most cases painful.


Arthritis is a disorder of joints. There are about 100 types of arthritis. Osteoarthritis and rheumatoid arthritis are the likely types to cause hard nodules or bumps on shoulder joints. Acromioclavicular joint arthritis can also occur on shoulder joint.


Soft-tissue sarcoma is a rare type of cancer that develops on connective tissues. Melanoma is another not common type of cancer that can develop on skin on shoulder. Cancerous lumps are in most cases painless and hard. All will gradually gain mass and increase in size. Note that cancerous lumps can develop on any part of the body. For example, you can have a cancerous lump on the penis shaft. Such cases are however quite rare. No matter the odds, always make a point of having a lump checked by your doctor.

Hard lump on shoulder

Hard lumps on any part of your body should cause concern. In fact, it is always advisable to check with your doctor in the advent of such a lump.

A hard lump on the shoulder may be a bone spur. People who for example are used to carrying heavy objects on their shoulders can develop a bone spur.

Bone spurs are basically bony growths that originate on normal bones. Their aim is to cushion normal bones to prevent friction and pressure that may lead to bone damage. Bones spurs can become painful if they are to rub on nearby tissues or other bones.

A bone spur on shoulder can also be caused by osteoarthritis. This is common in the elderly and people who have sustained injuries on shoulders. Some bony growths seem to form from nowhere. A good example is a lump under the tongue caused by a mandibular torus.

Other than a hard lump on the shoulder, a bone spur may be accompanied by the following symptoms:


Bone spurs may develop large enough to press against a nerve in the shoulder region. This will cause pain, which can be felt even at rest.

Reduced shoulder joint functionality

Joints are involved in different types of movements. It is for this reason that quite a number of structures and materials are located in a joint. Large bone spurs can end up blocking or inhibiting normal joint movements. It can also cause pain and thus discomfort during shoulder movements.


Naturally, bones interlocking in a joint do not rub against each other. But since bone spurs are abnormal growths, they will keep rubbing against nearby bones. The body will as a result release chemicals aimed at addressing this abnormality. These chemicals can lead to inflammation.

As mentioned earlier, a hard lump on the shoulder can be cancerous, though chances are low. The only way you can know for sure is after a biopsy or imaging tests.

When to see a doctor for lump on shoulder

Telling a benign lump from a potentially dangerous one can be quite difficult without diagnostic tests. It is therefore important to check with your doctor if you notice a lump on your shoulder that persists for more than a week or is accompanied by lump in the lung symptoms.

Some patients are diagnosed with unlikely causes of shoulder lumps such as chronic bursitis. It is very unlikely that even your doctor will suggest such causes even after a physical exam. The bottom line is that medical diagnosis is very important if the actual cause of a lump on shoulder is to be identified correctly.