Sometimes pain from the liver can radiate into the shoulder or arm after a flush. Usually a sign there are more stones moving through and pressing on different areas of the liver causing what is called referred pain. It may take a few more flushes to clear it. Taking a Tbsp of natural calm magnesium powder in warm water can help with this issue as it relaxes the liver ducts and let's the stones move through more easily. Also applying warm castor oil packs over the liver with a heating pad can help with this issue as well.