Shoulder Pain At Night

min read


The Sports Injury Clinic

Lachlan Heron

August 9, 2012


Having shoulder pain at night is quite annoying. It is common with people that have physically demanding jobs like athletes. For others, it may come as a sign of age, and our body tells us to slow down. Nevertheless, it is good to understand what this inconvenient body ailment means, how to avoid it, and how to treat it.

The shoulder has the greatest range of motion of any joint. Our shoulders allow us to put our hands where they need to be for work, play, and all of our daily activities. For our body to accomplish this, the shoulder has to have the right balance of strength, flexibility, and stability.

Loss of this balance affects shoulder posture and can lead to pain and injury, including pain in the evening, which can be particularly distressing.

Maintaining this balance through exercises aimed at stretching and strengthening can help avoid shoulder problems.

Common Shoulder Injuries Among Active People

The shoulder is at risk for injury in many activities. The rotator cuff can be injured through overuse or through trauma. Rotator cuff tendinopathy is common in overhead sports and any repeated manual tasks of reaching or lifting. Rotator cuff tears can occur if the tendons are overloaded with repetitive or one-off strenuous activities.

The shoulder has ligaments that hold the joint stable. The shoulder has a very large range of motion due to its shape and surrounding tissue flexibility but also requires strength stability. If the ligaments become stretched or torn, this can lead to instability.

Instability will allow the shoulder to either move or translate within the socket, or slip part way out of the socket, called a subluxation. When the shoulder comes completely out of its socket, this is called a dislocation. Subluxation or dislocation can occur with nearly all sporting activities. The ligaments of the shoulder are attached to the socket at the labrum. Tearing of the labrum sometimes occurs with instability.

Another part of the shoulder commonly injured is the acromioclavicular or AC joint. The clavicle or collarbone meets the shoulder at the acromion, where a small joint is found. This joint can be injured to varying degrees in a fall onto the outer part of the shoulder.

AC injuries are graded depending on the degree or position of separation. They occur in contact sports and are frequently seen in skiing and cycling falls.

Rotator Cuff Injuries

The shoulder joint is surrounded by four rotator cuff muscles and their tendons. A bursa sits adjacent to the rotator cuff, which helps the tendons slide, protecting it from the above bone, the acromion. The rotator cuff is susceptible to many problems which can cause weakness, tenderness, and pain. These problems include tendon pain and tendinopathy, which can be caused by certain activities involving shoulder elevation and rotation- causing a potential reduction in the space for the rotator cuff to move, potentially leading to tears. This discomfort may also result in shoulder pain at night.

Overhead sports such as throwing, swimming, or tennis can lead to tendinopathy. Suppose the space between the rotator cuff and the bone above it is narrowed. In that case, the rotator cuff tendons and the overlying bursa can be compromised. This will lead to Subacromial Bursitis and tendon damage, which can cause shoulder pain during the day and night. This can also lead to impingement of the tissue in the subacromial space.

Occasionally a calcium deposit may form in the rotator cuff. We call this calcific tendinopathy. The rotator cuff tendons are also susceptible to the process of aging. As we get older, the rotator cuff tendons degenerate and weaken. A rotator cuff tear can occur due to this degeneration alone or when the weakened tendons are stressed during activities or accidents. Most rotator cuff problems can be treated with rest, medication, and gentle exercises. Still, pain that persists for more than two weeks should be evaluated by a physiotherapist.

Management Options

When shoulder pain hinders your daily activities, it is essential to explore various management options. These options range from diagnostic tests to determine the exact cause of the pain to therapy, medications, and sometimes surgical interventions.

Here’s an overview of the different management options that can be considered to alleviate shoulder pain and restore function:

  • An ultrasound and X-ray may be performed to determine the presence of any bony or soft tissue injury. A surgeon may also request an MRI if needed.
  • You may commence physiotherapy to address any muscle weakness or instability issues around your shoulder, and this is best to begin early.
  • You may require soft tissue work around the shoulder to address any contributing soft tissue tightness, especially your postural muscles. This can also help reduce pain.
  • Injection therapy can be an option, and your Doctor or Physiotherapist may suggest this.
  • Awareness of modifying your activities to avoid aggravating your shoulder. You will be instructed on which actions to avoid.
  • Care to ensure that your shoulder does not progressively stiffen up. This can lead to a troublesome shoulder called adhesive capsulitis-commonly called a frozen shoulder.

Often a surgical opinion will be considered depending on the longevity of your symptoms. Surgical approaches will be assessed if conservative measures are not adequate. Surgery, if considered, will involve further exercise and rehabilitation.

Understanding and Managing Shoulder Pain at Night

One of the common manifestations of shoulder injuries is nighttime pain. When you lie down to sleep, the inflamed tissues in the shoulder can cause discomfort, affecting sleep quality. Here are a few tips for managing nighttime shoulder pain:

Sleep Posture: Avoid sleeping on the affected shoulder. Instead, sleep on your back or the opposite side. Use a pillow to support the affected arm and reduce strain on the shoulder.

Pain Medication Before Bedtime: Consult your doctor or physiotherapist about taking pain medication before bedtime to relieve pain at night.

Cold or Hot Packs: Applying a cold or hot pack to the shoulder before bed can help alleviate pain.

Nighttime Shoulder Stretches: Gentle stretching exercises before bed may help alleviate tightness and relieve shoulder pain.

Consult a Physiotherapist: If pain persists, it is important to consult a physiotherapist. They can help in diagnosing the cause and recommending a suitable treatment plan.

By incorporating these tips into your routine, you may find relief from nighttime shoulder pain and improve the quality of your sleep.

Understanding the complexity of the shoulder joint and how it can be affected by various factors is essential in managing shoulder pain, including shoulder pain at night.

Proper exercise, awareness, and timely intervention by a healthcare professional can significantly improve the quality of life for those suffering from shoulder ailments.

Are you in need of help in dealing with shoulder pain? Our fully trained physiotherapists are more than happy to assist you. Contact us today to make an appointment or have someone get on a call with you.


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