A bump on top of the shoulder is a common problem that can affect people at any age.
Shoulder lumps may vary from something simple e.g. skin lesions or muscle knots, irritation of the soft tissues e.g. bursitis or tendonitis to something more serious e.g. fractures or tumors.
A lump between the neck and shoulder may be soft or firm, mobile or fixed, vary in size and may have developed gradually or suddenly.
In most cases, a lump on top of the shoulder will settle down fairly quickly with home treatments, but some will require medical intervention such as a course of physical therapy, medication or injections. Occasionally, greater intervention may be required such as surgery but this is rare.
Here we will look at both the common and rarer causes of a bump on top of the shoulder, the common causes and symptoms of each and then go on to look at how to treat them. We will also cover how to tell if it is something serious and when to seek medical advice.
Common causes of a bump on top of the shoulder are usually due to problems in the:
Let's start by looking at the most common causes of lumps on top of the shoulder, what causes them and the common symptoms associated with each so you can work out what is causing your shoulder bump, and find the best treatment options.
A common cause of a soft lump on top of the shoulder is bursitis.
Bursa are small fluid-filled sacs that sit between the shoulder bones and soft tissues to reduce friction at the shoulder joint. If the bursa becomes inflamed, excess fluid collects in it forming a lump which is typically soft and spongy to touch.
The most common type of shoulder bursitis that causes a bump on top of the shoulder is:
The subacromial bursa often fuses with the neighbouring subdeltoid bursa, located between the acromion and the deltoid muscle on the outer shoulder. When this happens they form a single bursa, which is actually the largest bursa in the human body.
These two bursae acts as cushions between the acromion and the rotator cuff tendons, particularly supraspinatus, helping to reduce friction and facilitate smooth movement of the shoulder joint.
Common causes of shoulder bursitis include:
Symptoms of subacromial bursitis typically include:
Treatment for shoulder bursitis usually involves conservative approaches such as rest, ice, anti-inflammatory medications, and physical therapy to reduce inflammation and improve shoulder mobility. In more severe or persistent cases, corticosteroid injections or, in rare instances, surgery to remove the inflamed bursa may be recommended.
Another type of bursitis that can result in a bump on top of the shoulder is supra-acromial bursitis - inflammation of the supra-acromial bursa when sits on top of the acromion, just underneath the skin, although this is very rare.
You can find out all about the common causes, symptoms, diagnosis and treatment options for this cause of a lump on top of the shoulder in the shoulder bursitis section.
Problems at the ACJ, aka acromioclavicular joint, can lead to the development of a lump on top of the shoulder.
The acromioclavicular joint is where the outer end of the collarbone (clavicle) meets the highest point of the shoulder blade (acromion).
Several issues can affect this joint, causing changes in its appearance and function, resulting in the formation of a lump between the neck and shoulder:
Treatment for an AC joint bump on the shoulder may include rest, physical therapy, anti-inflammatory medications, joint injections, or, in severe cases, surgical intervention. The specific treatment approach depends on the underlying cause of the bump on top of the shoulder and the severity of the condition.
Another possible cause of a bump on top of the shoulder is tendonitis. There are various tendons located around the top of the shoulder that play an important role in stabilising and controlling movement at the shoulder joint.
Tendonitis occurs when a tendon becomes inflamed, irritated or thickened, often due to overuse or repetitive strain. This can lead to localised tenderness and swelling often forming a lump on top of the shoulder, particularly at the front of the joint.
The three most common types of tendonitis that can result in a bump on top of the shoulder are:
If you think the bump on top of your shoulder is from tendonitis, here are a couple of simple tests you can try:
Treatment options for bumps on top of the shoulder from tendonitis may include rest, physical therapy, anti-inflammatory medications, corticosteroid injections, or in severe cases, surgical intervention to repair or remove damaged tissue.
Another common cause of a bump on top of the shoulder is a muscle knot.
Muscle knots typically result from a condition known as myofascial trigger points.
These knots are tight, contracted muscle fibres that can be felt as a nodule or lump on top of the shoulder directly under the skin. They are often tender to the touch and can lead to localized pain and discomfort. A firm lump between the neck and shoulder that is in the muscle is often due to a trigger point in the trapezius muscle.
Treatment for a bump of top of the shoulder from muscle knots typically involves a combination of self-care and professional interventions such as:
Find out more about the causes, symptoms and treatment options for lumps between the neck and shoulder from trapezius muscle knots.
A lump on the top of the shoulder may result from an injury, such as a fall, RTA or sporting tackle.
These injuries can result bone/joint displacement, the formation of scar tissue or bony lumps at the top of the shoulder.
The size of shoulder bumps resulting from trauma or injury can vary widely, from small bruises to larger haematomas, depending on the extent of tissue damage.
Lumps and bumps from trauma are usually located at the site of the injury on the shoulder. They can feel swollen, tender, and may be associated with bruising. In some cases, there may be a visible deformity and significant pain and limitation of movement.
The most common injuries to cause a hard lump on top of the shoulder are:
If you experienced some trauma to your shoulder such as a fall, RTA or contact injury and there is an obvious deformity, significant bruising or swelling associated with the bump on top of your shoulder, you should seek immediate medical attention.
There are a number of other possible causes of a lump on top of the shoulder, but they tend to be less common:
A lump under the skin on the shoulder is often caused by a ganglion. Ganglion cysts are non-cancerous lumps filled with a thick jelly-like substance. A lump on top of the shoulder from a ganglion cyst is usually found near the acromioclavicular joint. Ganglion bumps can vary in size but are usually small, typically less than an inch (2.5cm) in diameter.
Ganglion cysts usually feel smooth, round and firm, and they can move slightly when pressed. They are often painless but may cause discomfort if they press on nearby structures.
Lymph nodes are part of the immune system and can become enlarged, known as lymphadenopathy. This can occur in response to infection or inflammation in the surrounding area.
Infections or inflammatory conditions in the shoulder, neck, head or upper chest regions can lead to enlarged lymph nodes which may present as small, soft moveable lumps on top of the shoulder that can be felt just beneath the skin. Enlarged lymph nodes can vary in size from pea-sized to a centimetre or more in diameter. They tend to feel rubbery or slightly firm and may be tender or painless, depending on the cause.
Skin conditions like moles, warts, or cysts can occur anywhere on the top of the shoulder. The size of skin lesion lumps on top of the shoulder can vary widely.
Although a cancer lump on shoulder is fairly rare, malignant tumors or cancerous growths can develop in the soft tissues around the shoulder, causing a lump on top of the shoulder or around the shoulder blade. Sarcomas, for example, are a group of rare cancers that can affect the shoulder region.
Tumor lumps can vary greatly in size from small nodules to larger masses. They typically feel firm and solid. Cancerous tumors may be painless or cause discomfort, depending on their type, size and stage. There are often other symptoms associated with a cancer lump on the shoulder such as fatigue, unexplained weight loss and night pain.
In rare cases, infections in the skin or deeper tissues of the shoulder can result in the formation of a lump on top of the shoulder, particularly near one of the joints or in areas of broken skin.
A bump on top of the shoulder from an infection may be warm, tender and red, and you may experience a fever. The lump may be firm and fixed or soft and moveable. In some cases, the lump may contain pus, particularly with bacterial infections e.g. abscesses. The size of top of shoulder lumps from infections will vary depending on the severity and extent of the infection
Lipomas are benign, i.e. non-cancerous fatty tumors that can develop beneath the skin.
They are typically soft, rubbery, mobile, and painless, unless they are pressing on nearby structures.
Lipoma lumps on top of the shoulder are usually well-defined and slow growing. They can vary in size but are usually less than 2 inches wide. Lipomas tend to be round or oval shaped and are particularly common in adults aged 40-60.
In most cases, shoulder lipomas don't require any treatment but they can be removed surgically if they start causing symptoms or for cosmetic reasons.
Rheumatoid arthritis (RA) is an autoimmune disorder where the body's immune system targets the synovium, the lining of joints. This condition can lead to the formation of firm nodules on different areas of the body, particularly the hands and arms and can result in lumps on top of the shoulder. The nodules are typically made up of fibrin (a protein associated with blood clotting), inflammatory cells and dead skin cells.
Rheumatoid nodules are typically quite small, ranging from pea-sized to walnut-sized. They are usually firm and immobile and while the lumps are often painless, there may be associated joint pain. The lumps may occur in isolation or in clusters.
Any new bump on top of the shoulder should be checked out by your doctor to make sure you get the right diagnosis.
A doctor can often identify the cause of the lump on top of your shoulder through your medical history and a visual examination. However, in certain situations, they might recommend additional tests like X-rays, MRI scans, CT scans, or a biopsy to gather more information.
Treatment for a lump between the neck and shoulder will vary depending on the underlying cause but may involve a combination of strengthening exercises, stability exercises, stretches, medication, steroid injections and occasionally surgery.
You can find out more about the best treatment options for the different causes of lumps on top of the shoulder:
There are lots of possible causes of a lump on top of the shoulder:
A large bump on the shoulder may be due to a displaced fracture, large cyst, tumor or lipoma
A cancer lump on the shoulder is often firm, non-mobile, grows rapidly, irregularly shaped, accompanied by other symptoms e.g. unexplained weight-loss, night pain and fatigue.
You may also be interested in the following articles:
Page Last Updated: 09/26/2023
Next Review Due: 09/26/2025