Living with fibromyalgia often feels like carrying pain in places no one else can see, explain, or fully understand. Among the most distressing and confusing areas affected are the shoulders, collarbone (clavicle), and underarm regions. These areas can ache relentlessly, burn, throb, feel bruised to the touch, or send sharp, stabbing sensations without warning. For many people, this pain becomes so persistent that even simple movements—reaching for a cup, fastening a bra, hugging a loved one, or lifting an arm—can feel overwhelming.
This type of pain is frequently misunderstood, even among healthcare professionals. People are often told nothing is “wrong” with their shoulders or chest after imaging comes back normal, leaving them feeling dismissed or doubting their own experiences. But the pain is real, and it has real physiological and neurological explanations rooted in how fibromyalgia affects the nervous system, muscles, connective tissue, and sensory processing.
Fibromyalgia is not simply widespread pain. It is a complex condition involving abnormal pain signaling, nervous system hypersensitivity, muscle dysfunction, sleep disruption, and chronic stress responses. The shoulders, clavicle, and underarm regions are particularly vulnerable because they are dense with muscles, nerves, lymphatic structures, and trigger points that are highly reactive in people with fibromyalgia.
One of the most important things to understand is that fibromyalgia pain does not originate from structural damage. There is usually no torn ligament, broken bone, or inflamed joint causing the symptoms. Instead, the pain comes from how the brain and spinal cord interpret signals from the body. In fibromyalgia, the nervous system amplifies sensations that would normally be mild or unnoticed, transforming them into intense pain.
The shoulders and upper chest area are especially affected because they play a central role in posture, movement, and stress responses. Many people with fibromyalgia unconsciously hold tension in their shoulders as a response to pain, anxiety, or fatigue. Over time, this constant muscle guarding leads to tightness, reduced blood flow, and the buildup of metabolic waste in the muscles, which further increases pain sensitivity.
The clavicle region is another hotspot. The collarbone connects the arm to the torso and acts as a structural bridge for many muscles and nerves. In fibromyalgia, this area often becomes exquisitely tender. Light pressure, such as a seatbelt, bra strap, or even clothing seams, can feel intolerable. This tenderness is not imagined—it reflects heightened pain receptor activity and altered nerve signaling in the region.
Underarm pain can be particularly frightening because it is often associated in people’s minds with lymph nodes, breast issues, or heart problems. While it is always important to rule out other causes, fibromyalgia can absolutely cause underarm pain. The axillary region contains muscles, nerves, and connective tissue that are highly sensitive in fibromyalgia. Pain here may feel deep, aching, sharp, or burning, and it may radiate into the chest, upper arm, shoulder blade, or neck.
Another contributing factor is the presence of myofascial trigger points. These are tight, hyperirritable knots in muscle tissue that can refer pain to other areas. In fibromyalgia, trigger points are more widespread and reactive. A trigger point in the upper back or shoulder blade can cause pain under the arm or along the clavicle. Pressing on one spot may reproduce pain in a completely different area, which can be confusing but is a well-documented phenomenon.
Nerve sensitization also plays a major role. The brachial plexus, a network of nerves that supplies the shoulders, arms, and chest, passes through the neck and under the collarbone. In fibromyalgia, these nerves can become hypersensitive, leading to pain, tingling, numbness, or electric shock–like sensations. Even normal arm movements can stretch or compress these nerves enough to trigger pain when the nervous system is already on high alert.
Sleep disturbance further worsens shoulder and underarm pain. Deep, restorative sleep is essential for muscle repair and pain regulation. People with fibromyalgia often experience fragmented sleep or fail to reach deep sleep stages. As a result, muscles remain tense and inflamed, pain thresholds drop, and areas like the shoulders never fully recover from daily strain.
Stress is another powerful amplifier. The shoulders are a primary site where the body stores stress. Chronic activation of the stress response keeps muscles contracted and increases the release of stress hormones that sensitize pain pathways. Emotional stress, trauma, or ongoing anxiety can therefore directly intensify physical pain in the shoulders and chest.
Hormonal fluctuations may also contribute, particularly in women. Changes in estrogen levels can affect pain sensitivity, muscle tone, and inflammation. Many people notice worsening shoulder and underarm pain during certain phases of their menstrual cycle, during perimenopause, or after menopause.
The pain itself can vary widely from person to person. Some describe it as a deep, bone-like ache in the clavicle. Others feel as if their shoulders are constantly bruised or inflamed. Underarm pain may feel like swollen lymph nodes even when none are present. For some, the pain radiates down the arms or across the chest, mimicking cardiac pain and causing understandable fear.
This unpredictability is one of the most challenging aspects of fibromyalgia. Pain can shift locations, intensify suddenly, or ease without a clear reason. On good days, the shoulders may feel merely stiff. On bad days, lifting an arm may feel impossible.
Because imaging and lab tests often appear normal, people with fibromyalgia are sometimes misdiagnosed or told their pain is psychological. This can lead to delayed treatment and emotional distress. Validation is crucial. Understanding that fibromyalgia pain has a neurological basis helps explain why traditional treatments like anti-inflammatory medications often provide limited relief.
Managing shoulder, clavicle, and underarm pain in fibromyalgia requires a multifaceted approach. Gentle movement is important, even when pain makes rest tempting. Prolonged immobility can worsen stiffness and sensitivity. Slow, controlled stretching helps maintain range of motion and reduce muscle tension. The key is to move within tolerable limits and avoid pushing through severe pain.
Heat therapy can be especially soothing for shoulder and upper chest pain. Warm showers, heating pads, or warm compresses increase blood flow and help relax tight muscles. Some people find alternating heat and gentle massage particularly effective.
Posture awareness is another important element. Poor posture places additional strain on the shoulders and clavicle. Simple adjustments, such as supporting the arms while sitting, using pillows during sleep, or adjusting workstations, can reduce daily stress on these areas.
Sleep support cannot be overstated. Improving sleep quality, even incrementally, can significantly reduce pain intensity. Creating a consistent sleep routine, minimizing sensory stimulation at night, and addressing sleep disorders can help break the cycle of pain and fatigue.
Stress management techniques such as deep breathing, mindfulness, and relaxation exercises may sound simple, but they directly influence the nervous system. Calming the stress response helps lower overall pain sensitivity, particularly in areas like the shoulders that are closely tied to emotional tension.
Some people benefit from physical therapy approaches tailored specifically for fibromyalgia. These focus on gentle strengthening, myofascial release, and education rather than aggressive exercise. The goal is not to “fix” damaged tissue but to retrain the nervous system and restore confidence in movement.
Medications that target nerve pain or improve sleep may also be part of treatment for some individuals. These are not cures, but they can help reduce symptom severity when used thoughtfully and monitored carefully.
Perhaps most importantly, self-compassion plays a critical role. Shoulder and underarm pain can make people feel weak, frustrated, or guilty for needing help. But fibromyalgia pain is not a personal failure. It is the result of complex biological processes that deserve understanding and care.
Living with fibromyalgia means learning to listen to your body without fear. Pain in the shoulders, clavicle, and underarms is a common and legitimate part of the condition. While it may not always be possible to eliminate the pain entirely, it is possible to reduce its impact, regain a sense of control, and improve quality of life.
If you experience persistent pain in these areas, especially when accompanied by widespread pain, fatigue, and sleep disturbances, you are not alone. Many others with fibromyalgia share these symptoms, even if they are rarely discussed openly.
Understanding why this pain occurs is the first step toward managing it. Knowledge replaces fear, validation replaces doubt, and informed care replaces dismissal. Fibromyalgia pain may be invisible, but it is real—and it deserves to be taken seriously.
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