Thursday, August 11, 2022

Why Is Shoulder Pain Worse At Night

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The Most Common Cause Of Shoulder Pain At Night

#1 Reason Why Shoulder Is Worse At Night!

As many of you know, no matter which side you try to sleep on, your shoulder pain wakes you up. Eventually, this will start to affect your quality of life and your psychological well-being significantly.

Inflammation of the rotator cuff and shoulder bursitis are probably the most common reasons why you cannot lay down and sleep through the night. The subacromial bursa is a small sack that sits on top of the rotator cuff tendons. A healthy bursa will lubricate the rotator cuff tendons in the shoulder to minimize friction between the rotator cuff and the bones of the shoulder.

The bursa can become inflamed because of various rotator cuff issues. Once angered, the bursa is likely responsible for a significant amount of your night pain.

Down below, we will cover ways to get this bursitis to quiet down.

The pain from bursitis is often on the outer side, or front of the shoulder. It is not usually on the top of the joint. Most people will complain of a deep dull ache. Some of you may feel a grinding or clicking sensation in the shoulder. The grinding is usually due to inflammation of the bursa and not a bone spur.

Very few of you will recall an injury that caused your night pain. Most of the time, there was no readily identifiable injury. That makes night pain in your shoulder very frustrating. You cannot identify an activity that caused it.

Keep reading down below, and we will cover ways to get more comfortable and hopefully sleep through the night.

Issues Associated With Shoulder Pain At Night

On top of the pain, most people with shoulder pain at night sleep poorly, which has a completely different set of problems associated with it. These can include:

  • Increased sensitivity to pain
  • Low energy
  • Mood disorders

Sleeplessness can become a vicious cycle of decreasing sleep and increased pain, which will only make your condition worse.

What If Conservative Management Doesnt Work

The majority of patients suffering from night pain respond positively to a combination of analgesic medication and a course of physiotherapy. Physiotherapy uses a combination of manual therapy techniques and individualised rehabilitation exercises to help reduce your symptoms, manage pain flares, and allow you to return to the activities that you love.

If Physiotherapy, the advice highlighted above, and over the counter pain medication is unsuccessful then a steroid injection may be appropriate.

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Sleeping In A Reclining Chair

Sleeping in the semi-sitting position can help many people with severe shoulder pain get to sleep. You can also prop yourself up on a couch or in bed with many pillows to get yourself elevated at least 45 degrees. Putting a small rolled-up towel behind your shoulder to push it forward can also help minimize the pain you are experiencing.

How Arthritis Disrupts Sleep

The Most Common Causes of Shoulder Pain at Night

Many studies show a link between arthritis and sleep deprivation. People with arthritis may have trouble falling asleep and staying asleep. They may also report lower quality sleep due to the pain that the condition causes.

A 2021 study involving 133 people with arthritis and 76 matched controls found that 54.1% of people with arthritis reported poor sleep quality. The issues included:

  • greater difficulty falling asleep
  • poor sleep quality
  • more daytime problems related to poor quality sleep

A 2018 study reached a similar conclusion. The researchers compared 178 people with arthritis 120 with RA and 58 with osteoarthritis with 51 people with no arthritis. The rate of insomnia was comparable between the OA and control groups, at 32% and 33%, respectively. However, insomnia was significantly more prevalent among the RA group, affecting 71% of these participants.

Both studies also found a link between arthritis and mental health. People with arthritis were more likely to report marital problems and experience depression, suggesting that insomnia may be a reaction not only to arthritis but also to stress.

The link between arthritis pain and sleep goes in both directions. For example, arthritis can make it difficult to sleep, but sleep deprivation can also worsen arthritis pain. A 2018 study found that pain intensified as sleep worsened. In addition, a

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Find A Better Sleeping Position

The first course of action to relieve shoulder pain at night is to find a good sleeping position for you. Tossing and turning at night is normal for most people, but can agitate your shoulder if you land on it wrong. Sleeping on the opposite shoulder can help avoid this pain, but try not to sleep on your back.

If the pain persists, you can always trying wrapping your arm or wearing a sling to assist in preventing movement during sleep. Sleeping with a pillow under your knees can help alleviate any associated back pain.

When To Seek Treatment For Shoulder Pain

Living with shoulder pain, especially if it wakes you up at night or makes sleep difficult, is challenging. If your shoulder pain persists for a period of a few weeks or worsens it is recommended to seek consultation and treatment.

More worrying signs that may present with pain include weakness, loss of movement or instability. These additional symptoms warrant more expedient investigation.

The first step would be to see your family doctor who will ask you specific questions and examine your shoulder to narrow the diagnosis as well as order specific tests to help work out what is wrong with your shoulder.

Getting plain X-rays are very useful to check that you dont have arthritis, spurs or other bone issues that may be causing your night pain. Additional investigations to assess the soft tissues, including the rotator cuff tendons and the bursa, might include an ultrasound scan or an MRI scan.

Depending on what is found during these consultations your doctor might suggest an injection into your shoulder with corticosteroid to help reduce inflammation and pain and a period of rest. Seeing your physiotherapist for exercises to help settle the symptoms and then strengthen your shoulder is also a good option. If your symptoms persist despite these treatments, or if they worsen, your family doctor may suggest a review with a specialist shoulder orthopaedic surgeon for further treatment options.

Shoulder exercise photos provided by ActiveCare Physical Therapy

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There Are A Few Causes For This Condition

Most commonly, it is due to an altered shape of the acromion or a spur forming under the acromion. This extra bone reduces the space for the tendons to move and can cause direct injury to the tendons. There is a normal fluid filled sac called a bursa which sits between the acromion and rotator cuff tendons. The bursa helps buffer the tendons and forms a lubricating pillow to assist in making smooth movement, protecting the tendons from damage.

Some people are born or develop an abnormal shaped acromion as they age. Acromions that are flat create more room for the tendons and bursa to move. Unfortunately, some people have a curved or hooked acromion that reduces that space, causing shoulder problems.

When the space is reduced due to a spur or an abnormal shaped acromion, the bursa becomes compressed, aggravated and irritated. This angry and inflamed tissue causes the majority of the shoulder pain.

Movement of the shoulder further aggravates the bursa and tendons. Eventually the extra bone rubs on the tendon potentially causing a tear. This invariably causes further shoulder pain and dysfunction.

Gravity and your arms weight can pull the space apart when upright which can alleviate the pain temporarily. Unfortunately, this space compresses once you lie down and try to sleep which can lead to a restless night grappling with pain.

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How to Relieve Shoulder Pain at Night

When you have mild shoulder or neck pain, at-home solutions can often solve the problem. You can do simple stretches to keep your muscles flexible. Try squeezing your shoulder blades, rolling your shoulders down and backward or bringing your ear to your shoulder 10 times. Applying heat or ice reduces inflammation and relaxes the muscles. Over-the-counter painkillers can also help.

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What Can You Do If You Cant Sleep From Shoulder Pain And Why Is Shoulder Pain Worse At Night

Unfortunately for many, sleep disturbance is a common symptom for those suffering with shoulder pain. We know that sleep is key to good health and the tossing and turning that can be caused by shoulder pain, can lead to lower energy, daytime exhaustion, and low mood.

Shoulder pain can cause some patients to have to change their preferred sleeping positions and this can sometimes lead to difficulty falling asleep, poor sleep, and even neck pain and other discomfort from sleeping in an unusual position.

Several shoulder conditions are well known for causing sleep disturbance these include frozen shoulder, rotator cuff problems, and shoulder bursitis. Shoulder injuries including fractures and dislocations, and shoulder operations can also affect sleep.

Frozen shoulder is an inflammatory condition that causes the lining of the shoulder joint to become thickened, inflamed, and scarred, and leads to pain and progressive stiffness. Frozen shoulder is one of the top causes of shoulder pain that affects sleep.

Shoulder anatomy showing some structures that can cause shoulder pain.

How Can I Stop My Shoulder Pain At Night

If you are experiencing shoulder pain at night, you should contact your physician. There is probably a reason your shoulder hurts, such as injury, and it may need additional treatment. Making some adjustments to how you sleep may lessen your shoulder pain at night.

A shoulder doctor may suggest you:

  • Adjust your sleeping position to your back, stomach or your healthy shoulder
  • Dont involve yourself in activities that could hurt your shoulder more
  • Use over the counter pain medication
  • Use a pillow as a barrier to not roll onto your affected shoulder
  • Exercise regularly to keep your joints strong
  • Stretch out your shoulder joint before bed and in the morning.
  • Apply ice or heat to the joint.

Your shoulder pain may flare up at night because you have tension and stress built up from using it throughout the day. This can cause shoulder pain at night even when you arent sleeping on it.

Stretching and physical therapy exercises are important to keep your muscles and joints healthy.

If these methods dont work and youre still having shoulder pain at night, consider talking to your physician about steroid, corticosteroid or PRP injections to promote healing.

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Anatomy Of The Shoulder

The shoulder joint is a ball and socket joint, where the rounded edge of the humerus fits within a shallow depression located on the scapula, otherwise known as the shoulder blade. The rotator cuff is a series of muscles and tendons that surround and support this area, as well as allowing movement of the arm and shoulder. The tendons of the rotator cuff are surrounded by a series of small sacs called bursa. These fluid-filled sacs provide protection and cushioning around the shoulder tendons. Sometimes these sacs or the rotator cuff tendons become inflamed and painful. In some cases, a tear occurs in a muscle or tendon that is part of the rotator cuff, and this is known as a rotator cuff tear.

How Do I Know If Its A Minor Strain Or A Serious Injury

Shoulder pain at night: Tips that actually work : Physiosunit

If you know the pain stems from carrying a heavy handbag or backpack, manual labor, or an intense workout, topical creams and at-home-treatments should relieve the pain within a couple of days. If time goes by with no improvement, you may have an injury.

If youre suffering from any of the symptoms listed below, schedule a medical appointment as soon as possible.

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Causes Of Shoulder Pain When Night

Although many shoulder disorders can cause pain, the most common cause of shoulder pain at night comes from rotator cuff tendinitis. It usually is caused by irritation of the shoulder tendons leading to inflammation and pain. This condition can be caused by many things, including:

  • Tears
  • Repetitive work injuries
  • Aging

Rotator cuff tendinitis is known to affect millions of people in the U.S. each year and is a major cause of shoulder pain when sleeping.

Some of the other causes of shoulder pain at night are:

  • Frozen shoulder
  • Shoulder dislocation

Why exactly does the pain increase at night even though it might be fine during the day?

What Causes Nighttime Shoulder Pain

Summit upper extremity surgeon J.P. Delaney, M.D., shares possible causes for nighttime shoulder pain and what to do about it.

At first blush, you might think that shoulder pain would be its worst during the day, when were up and around using our shoulders. At night, you might expect shoulder pain to diminish as you rest and relax. Unfortunately, the opposite seems to be true: shoulder pain commonly gets worse at night. And nighttime shoulder pain is what leads many people to seek treatment.

Its the numberone reason people with shoulder pain come in to seek treatment, Dr. Delaney said. They can avoid maneuvers that cause pain during the day, but they cant avoid pain when they sleep. When shoulder pain disrupts sleep, thats when many people decide to come in for help.

What causes nighttime shoulder pain? Although experts dont know for sure, research suggests that, as we lie down, existing shoulder inflammation combines with increased pressure on the shoulder to cause increased pain.

The pressure can cause underlying soft tissue stretching or tension when we sleep, causing increased pain, Dr. Delaney said.

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Shoulder Injections For Night Pain:

When you are in our office, we will discuss options to improve your night pain. Not being able to sleep is very disturbing, so you may want to consider an injection. Injecting cortisone or a steroid into the bursa can be one of the fastest means of achieving meaningful pain relief.

Injections into the subacromial bursa, that area above your rotator cuff that tends to become inflamed, can be beneficial in some circumstances. We know that routine cortisone injections are not the best idea. Frequent injections near tendons can cause the tendons to degenerate further.

Injections of cortisone into the bursa, however, can be beneficial in people who are very unhappy because they cannot sleep. These injections often start working in one day and continue to work for a few weeks to months, so you can begin recovering from your loss of sleep.

Causes Of Shoulder Pain At Night

Shoulder Pain At Night – What’s Going on and How to Treat It Without Surgery ð

There are a number of different things that cause shoulder pain at night that usually fall into two categories:

  • Inflammation: inflammation builds up in the shoulder during the day as you use your arm, so is usually at its peak at the end of the day or
  • Compression: excessive pressure through the soft tissues

There may even be a combination of the two! There are also some medical conditions that tend to cause more pain at night e.g. rheumatoid arthritis and cancer, but these are rare and would usually be accompanied by other symptoms such as widespread pain, feeling unwell and unexplained weight-loss.

So lets have a look at the most common causes of shoulder pain at night:

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Shoulder Pain Associated Medical Conditions

  • Brachial plexus injury
  • Dermatomyositis
  • Dislocated shoulder
  • Frozen shoulder
  • Heart attack
  • Multiple sclerosis
  • Osteoarthritis
  • Pericarditis
  • Pneumothorax
  • Polymyalgia rheumatica
  • Rheumatoid arthritis
  • Rotator cuff injury
  • Shingles
  • Spinal cord injury
  • Sprains and strains

As it was mentioned, some causes would be common between the condition of arm and shoulder pain at night or any time during the day. And determining these causes are important for the patient to receive the dedicated treatment. If your arm and shoulder pain symptoms occur after a mild injury, all you may have to do is wait and watch. Over the counter pain killers may help in reducing the pain, and so may cold and hot compressions. However, if the injury is severe, or if the pain is occurring suddenly and is persistent, then things can cause a little concern. So in such a situation, get yourself diagnosed by a medical expert and let him advice you to take the required action.

Why Does Shoulder Pain Hurt Worse At Night

  • /
  • Why Does Shoulder Pain Hurt Worse At Night?

Increased shoulder pain at night is a common phenomenon that many shoulder injury sufferers experience. Why does shoulder pain hurt worse at night? What can be done to alleviate shoulder pain and what causes shoulder pain to become more severe and likely to keep you up at night?

The three types of shoulder conditions that typically hurt more at night are:

  • Bursitis
  • Here’s a bit of info about each…

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    Ways To Relieve Shoulder Pain At Night

    There are several simple remedies you can try at home to relieve shoulder pain. The most common ones include:

    1. Ice packs. If your pain is a result of an injury, applying a cold pack will help reduce swelling and numb the area, resulting in a reduction of shoulder pain. Keep in mind that this is a temporary treatment, so always seek medical treatment after experiencing trauma.

    2. Heat treatment. If your pain is a result of a chronic condition, applying a heat pack will soothe the area and improve blood flow.

    3. Stretching. The shoulders, neck, and upper back often carry the brunt of stress. Stretching exercises will help release the tension.

    4. Avoid heavy lifting. If lifting items is part of your job, ask whether your duties can be modified. If they cannot, take a couple of days off.

    5.Improve your posture. Slouching over a desk all day will cause huge amounts of stress on your neck, shoulders, and back. Being mindful of your posture will reduce the strain.

    If none of the suggestions above work, your doctor may suggest other conservative forms of treatment, such as anti-inflammatory medications, cortisone injections, or physical therapy. In the most extreme cases, the injury may require surgery.

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