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 may feel stiff or a dull pain may become worse when you raise your arm or shift from side to side. You may also 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 may also arise from overuse due to 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 may 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 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 shoulder. Rotator cuff tears are a very common problem and may result from a fall or lifting something too heavy, too fast. But most tears occur as the tendons wear down over time.
Before you see the doctor
The first course of action is to reduce the swelling and pain. Things you can try at home include:
- Anti-inflammatory medications such as ibuprofen, naproxen or acetaminophen
- Sleeping in a recliner
- Appling ice or heat
- Wearing a compression sleeve
- Discontinuing any activities that may have contributed to overuse of the shoulder
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. Non-surgical treatments may include activity modifications, physical therapy and/or a cortisone shot to ease the pain. If there is no improvement in your strength or the injury worsens over time, surgery may be the best option to restore function and alleviate pain.
Dr. Gobezie is founder/director of The Cleveland Shoulder Institute, GO Ortho and Regen Orthopedics. For more information, visit clevelandshoulder.com, regenorthopedics.com or godoctornow.com.