Coughing with shoulder pain is a complex situation and falls into two categories: those where the shoulder pain is still caused by a shoulder condition and the coughing action causes shoulder pain as it causes a vibration in the shoulder, thus irritating the diseased tissue, and those where the cough is caused by a particular chest condition, such as pleurisy or tuberculosis, and the shoulder pain is an involved pain caused by that condition. Timely and appropriate treatment of shoulder disorders determines the prognosis of the disease, while internal diseases are potentially life-threatening, so whichever is possible, it is important to seek prompt medical attention to identify the cause.