QUESTION: “The pain in my shoulder keeps me awake at night. What causes this, and what can I do?”
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ANSWER: One of the most common complaints I hear in my office is that a patient cannot sleep due to shoulder pain. It may seem that no matter what side you try to sleep on, it still hurts. Your shoulder might feel stiff, or a dull pain might become worse when you raise your arm or shift from side to side. You also might feel a muscle spasm or numbness and tingling in your fingers.
The shoulder is one of the most agile joints of the body, allowing movement in all directions. Because of this, it can be more susceptible to injury. Painful conditions also might arise from overuse because of a specific activity or shoulder motion that you make repetitively. Racquet and ball-throwing sports are some of the main culprits, but any repetitive shoulder motion can cause an overuse injury.
Typically, shoulder pain that gets worse at night might be caused by bursitis, tendinopathy or an injury to the rotator cuff.
Bursitis is an inflammation of the bursa, which is a fluid-filled pad that provides a cushion to the bones of the joint. When injured, fluid in the bursa increases, and this swelling can be painful.
Biceps tendinopathy is usually the result of long-term overuse and deterioration of the biceps tendon that connects muscles and bones in the shoulder joint. Tendons may also get less flexible as we age and are more prone to injury. Tendinopathy is often part of the aging process. Biceps tendinopathy can give sharp pains in the arm with certain motions like reaching behind you.
Rotator cuff injuries usually involve a tear in these tendons. The rotator cuff includes four muscles that come together as tendons and connect your humerus bone to the shoulder blade. The cuff provides shoulder stability and enables movement. Damage to any one of the four muscles could result in inflammation and swelling and general pain in the shoulder. Rotator cuff tears are a very common problem and may result from a fall or from lifting something too heavy, too fast. Most tears occur as the tendons wear down over time.
If the shoulder pain doesn’t go away or worsens, see an orthopedic specialist. It’s important to properly diagnose your condition to ensure you’re getting the best treatment. A specialist will evaluate your X-ray or MRI and determine a care plan.
