Pain in the right shoulder is a common complaint in the doctor's office, often associated with muscle injuries, bad posture or repetitive strain. But what few people realise is that this pain can originate in an organ that, at first glance, seems to have no connection with the shoulder: the liver.
In osteopathyThis relationship is well understood and is part of an approach that considers the body as an interconnected unit.
What Is Referred Pain?
To referred pain is a phenomenon in which pain is felt in a different area of the body from its actual origin. In other words, the brain misinterprets the location of the painful stimulus because different structures share the same nerve pathways. This is a common response of the nervous system when an internal organ sends out alarm signals.
In the case of right shoulder painOften, the origin is in a liver dysfunction - such as inflammation of the liver, congestion from excess toxins or metabolic stress. Even if the shoulder is structurally healthy, the patient may experience pain, tension or discomfort in this region. This type of pain is often misinterpreted as a local muscle or joint injury, when in fact the cause lies elsewhere in the body.
The Relationship Between the Liver and the Right Shoulder
O liverThe largest internal organ in the human body, it is located in the upper right quadrant of the abdominal cavity. It is located immediately below the diaphragmThis is the main muscle responsible for breathing and is very close to various bone and muscle structures, such as the ribs, the thoracic spine and the accessory muscles of breathing.
This anatomical proximity and the sharing of connections through fascia, ligaments and nerves creates a direct relationship between the liver and the right shoulder region. When the liver is in distress - for example, due to an overload of toxins, inflammation, poor diet or emotional stress - it can cause a mobility restriction in the diaphragm.
This restriction interferes with respiratory biomechanics and can exert traction or compression on adjacent structures. As a result, postural and muscular compensations arise that affect the thoracic spine, ribs and right shoulder. The patient may feel pain, stiffness or even weakness in this area, even without obvious local damage.
This type of pain - silent in origin, but manifest at a distance - is an excellent example of how the body functions as an integrated whole, and how the osteopathy is an effective approach to treating the cause and not just the symptom.
Right Shoulder Pain and the Nervous System
To shared innervation between the liver and the right shoulder is another important factor. The phrenic nerve, which originates in the cervical vertebrae (C3-C5), carries sensory information from the diaphragm, but also participates in the innervation of the shoulder region.
Thus, when the liver sends pain signals to the brain, the nervous system can misinterpret these signals as coming from the shoulder - generating the referred pain in the right shoulder.
In addition, the body tends to prioritise vital organs in situations of dysfunction. This means that, when faced with a liver problem, the nervous system can redirect resources (such as blood and oxygen) to the liver, to the detriment of structures such as the shoulder muscles, which contributes to the feeling of fatigue or weakness in this region.
How can osteopathy help?
To osteopathy offers a global and integrative approach to treating this type of situation. Rather than focusing solely on the shoulder, the osteopath assesses the whole body, including the state of the liver, the functioning of the autonomic nervous system and the interactions between visceral and musculoskeletal structures.
The most commonly used techniques include:
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Visceral manipulationThis improves the mobility of internal organs such as the liver, promoting better drainage, vascularisation and metabolic function.
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Diaphragmatic techniquesThese are essential for releasing tension in the diaphragm, allowing for more efficient breathing and reducing compression on adjacent structures.
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Musculoskeletal treatmentThis includes releasing tension in the spine, shoulder and respiratory muscles, restoring postural and functional balance.
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Neurological and emotional approachThese factors include chronic stress, poor diet, poor sleep quality and a sedentary lifestyle, which directly influence the liver and the perception of pain.
When treating visceral causes of right shoulder painOsteopathy promotes not only the relief of symptoms, but also the restoration of the functional balance of the body as a whole.
Visceral Osteopathy is an integral approach to Osteopathy as a whole, we'll talk more about it here. here.
In many cases, it's also interesting to integrate a more comprehensive view of the situation. Shoulder orthopaedics to correctly define the diagnosis of pain.
When in doubt, always seek more opinions and be demanding in your recovery process.
