Right shoulder pain

Right shoulder pain causes


I have been reading a lot about right shoulder pain, pain between shoulders and clavicular pain in long COVID posts on Facebook. And I would like to share my view on this issue.

There are four main reasons for these problems. Please note that this is no medical advice and you should always check with your doctor.


4 possible reasons of right shoulder pain

and how to fix these.

  1. Referred pain from the burdend liver.

  2. Referred pain from the galblatter or bile duct.

  3. Tension from the diaphragm

  4. Trigger-point pain from the scalene muscles (these are accessory breathing muscles)


  1. The liver can be inflamed due to the latent virus or because of intoxication from meds or other toxins. The liver had a three step detox system which can be overloaded if it is stressed too much or for instance if you have a vitamin B12 deficiency. There can be more reasons but it is important to keep this option in mind. In my practice is see a lot of people with a blockage in the lymph system which can lead to pressure build up in the liver. This pressure can give diaphragmatic irritation that is referred to the clavicular and shoulder region. This is known as Kehr’s sign, it is transmitted via the phrenic nerve and often misdiagnosed. It can be treated with reducing toxin input, Vitamin B12 supplement of injections, osteopathy or other intervention depending on the cause.


  1. Cholecystitis, an inflammation of the galblatter can occur from blockage from galstones, or bile sludge. This results in a buildup that can cause inflammation. Covid is known for a possible cause of inflammation with or without the other problems mentioned. There is a substance called TUDCA which can help alleviate these issues. https://youtu.be/boTzigj646Q


  1. Every muscle in the body has an certain referred pain location that can be at a whole other location than where the muscle is attached. The diaphragm has a specific irradiation pattern that can give pain in neck and shoulders. In this link you can see some examples. The liver and galblatter are not 100% correct on this image but it can give you some insight to how ik works. Diaphragm can be really tensed by corona virus and we now know from clinical research that the resting tension of this muscle can be too much in an inhalation position. Therefore it can be difficult to fully inhale, because you are already partly inhaled. Specific breathing techniques and osteopathy can help release this tension and bring the diaphragm back to the normal resting position.  https://en.wikipedia.org/wiki/Referred_pain


  1. Since the diagram can be tight, the body searches for other option to respirate. So the accessory muscles start to be engaged. Normally you only use these for more intense physical activities like running or other sports. Because of that they don’t get the rest they normally get and start to get chronically tight. These muscles can refer pain in the shoulder, neck, upper spine and even in the arm. You can resolve this by treating these muscles with massage, stretch, dry needling and of course by restoring a normal breathing pattern http://www.triggerpoints.net/muscle/scalene



Hope this can help some of you!

Stay positive.

Tim Binkhorst

Manual Therapist Msc.

Tim Binkhorst