Why does shoulder tendonitis hurt at night

Direct pressure through this hypermobile joint can compress both the joint and surrounding soft tissue structures, such as the rotator cuff tendons. This can exacerbate any underlying issues that may be present. Poor sleeping positions are often responsible for compressive shoulder pain. When sleeping on your painful side your shoulder is subjected to the extra weight of your torso. This increased weightbearing, over a prolonged period of time, can cause pain.

It is important to try to sleep on your back or opposite side to avoid compressing your painful shoulder. To stop yourself rolling back onto your painful side you may need stabilise yourself with some pillows. Gaining an accurate and timely diagnosis is crucial to accessing the most appropriate treatment options. Accurately diagnosing the cause of your night pain is a complex procedure which is routinely conducted by a physiotherapist , orthopaedic consultant or G.

Assessment starts with a clinical interview, used to understand your symptoms. Your clinician will also complete a series of clinical tests designed to pin point your pain causing structures. This may provoke your symptoms for a short period however, it helps the clinician understand your situation better.

Unfortunately, research has revealed that clinical tests for the shoulder are not specific enough to accurately diagnose the cause of pain. A formal diagnosis for shoulder pain can only be made using diagnostic imaging.

Diagnostic ultrasound has been proven to be as effective as MRI for assessing shoulder injuries, including tendons, muscles and bursa small friction reducing washers located at high pressure points throughout the body.

Diagnostic ultrasound can quickly and accurately assess for swelling and inflammation in the shoulder. At Complete our highly experienced team of clinicians are dual trained physiotherapists and musculoskeletal sonographers. An assessment by one of our team involves a clinical interview, physical examination and a formative musculoskeletal diagnostic ultrasound scan. Once a formal diagnosis has been made your clinician will be able to advise you on the most effective, evidence-based treatment options available.

The majority of patients suffering from night pain respond positively to a combination of analgesic medication please consult your GP or pharmacist before starting any 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.

Corticosteroid injections, a potent anti-inflammatory medication, is a highly effective technique used to reduce pain associated with inflammation. Research states that steroid injections are highly accurate and effective when administered under ultrasound guidance. To ensure you get the best outcomes possible all our injection procedures are ultrasound guided. All our clinicians are fully qualified to advise you on the most effective medication and prescribe it for you all in the same appointment.

These can include:. Sleeplessness can become a vicious cycle of decreasing sleep and increased pain, which will only make your condition worse. 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:. Rotator cuff tendinitis is known to affect millions of people in the U. During the day, the shoulder is being actively used while you are in a vertical position. The tendons engage and are pulled downward by gravity, which allows space to be made in the muscle groups in the shoulder. This additional space allows for an increase in blood flow and oxygen that alleviates the stiffness and pain that would be present otherwise.

When you lay down to rest or sleep at night, you are generally in a horizontal position. This removes the effect of gravity and allows the shoulder muscles to relax. The lack of movement and the relaxation of the muscles allows the fluids in your joints to settle and decreases the flow of blood, allowing the joint to become inflamed. People also tend to lie on their shoulder while sleeping, which can compress the joint even further, and thereby worsening the inflammation.

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.

Along with fixing your position while sleeping, always make sure to try to stick to a sleeping schedule. Good sleep hygiene can make all the difference in your sleeping patterns. Having a consistent bedtime ritual that helps wind you down at the end of the day can do wonders in terms of reducing stress and tension, and improving sleep length and quality.

Try something relaxing before bed like a shower and make sure you fall asleep in a dark room with no electronics. Medication can also help you sleep, but be cautious of how often you use them. Constantly requiring sleep aids can be a major sign of a problem and the more you use over-the-counter drugs, the more you will need to be effective.

Exercising a few hours before bed can also be useful as it will increase blood flow throughout the whole body. This can alleviate pain, but also relax you enough to ease sleeping troubles. Try something low impact like a brisk walk or a bike ride, and then allow your body to cool down again before going to bed. Further, certain shoulder stretches can help you reduce the tension and stress that has built up during the day.

Not only are shoulder stretches an easy option, but they take only a few minutes at night. Stretching has huge health benefits like increasing flexibility, range of motion, and blood flow. Another big plus is that they are simple to do in your own home and require no special equipment. Before you go to bed, try these seven shoulder stretches to alleviate some tension and reduce your stress. If you start to feel pain at any time during a stretch, stop immediately.

Stretching should be done to the point of mild strain. If you experience pain, you are going too hard and could injure yourself. This is especially true if the pain is sharp or sudden. It is a good idea for chronic pain sufferers to consult a pain doctor before starting too strenuous of a stretching routine as overexertion could exacerbate certain conditions.

For best results, always warm your muscles up a little before stretching. For the following stretches, it is best to do each for approximately 30 seconds to one minute for maximum effect. Also, make sure you are steadily breathing in and out in a controlled manner.

This is a quick stretch that is great if you spend way too much time staring at a computer monitor. Slowly extend your neck outward, making sure your keep your chin parallel with the floor. Then, pull it back in to a neutral position that is straight with your spine, slightly tucking the chin in. Sit in a cross-legged position on the ground.

Extend your arms in front of you and place your left elbow in the crook of the right arm. Now, bend your elbows back so your hands are touching. Hook one hand over the other so that your palms are facing each other. For this stretch, you should keep your palms together, elbows lifted in a 90 degree angle, and your hands in front of your face.

Try to keep your shoulders relaxed and down. You should feel a powerful stretch in your shoulder blades as well as the lower part of your neck. After this, change arms by placing your right elbow in the crook of your left arm and repeating.

Take your right arm and reach over your shoulder aiming to lay your palm in-between your shoulder blades. Then take your left arm and reach up your back not over the shoulder also placing the hand between the shoulder blades.

Try to interlock your hands and pull slightly. If you are having trouble interlocking your hands, you can modify this stretch. Keep a towel or something similar in your top hand, and then grasp it with your bottom hand instead of clasping the hands together.

Gently pull with each arm to feel your shoulders start to open up. While standing tall, reach out and place both of your hands on a wall. Make sure you keep the shoulder blades open and relaxed downwards during the whole stretch. Start by spreading your feet, so they are shoulder-width apart. Raise your arms above your head as far as possible and bring your palms together. The joint often gets earlier wear and tear from ageing and can suffer an AC joint injury and arthritis due to an injury from a fall or as result of playing sports that involve arm elevation.

Arthritis from this area presents with pain on top of the shoulder and is often worsened by sleep when your arm is crossed over your chest or when lying directly onto your shoulder. Shoulder pain at night is a very common problem and can be both disruptive and frustrating. The most common cause of night pain in your shoulder is due to a process we call rotator cuff tendinosis and shoulder bursitis.

Certainly, using your shoulder during the day means that the bursa is more inflamed and the rotator cuff tendon is over worked by the end of the day, hence the symptoms worsening by night time.

Other factors may be unrelieved tension of pressure and stress. During the day, the weight of the arm and gravity help to increase the space in your shoulder to reduce pressure and compression on the bursa and rotator cuff tendons. However, at night and during sleep, this is no longer the case as gravity is eliminated while lying flat. Direct pressure when sleeping directly on the painful side exacerbates the problem, especially when this occurs for an extended period of time while in deep sleep.

Pressure for prolonged periods throughout the night puts direct compression on the subacromial joint space and compresses this inflamed tissue and bursa. Uncontrolled movements of the arm or sleeping with your arm across your chest or above your head for extended periods abnormal positions are other factors that may contribute to more pain at night and after sleeping.

Going to sleep with shoulder pain is difficult and certainly if you wake due to shoulder pain, falling back asleep can be very troublesome. Resting your shoulder during day may reduce the inflammation, reducing the pain enough that you can sleep.

Taking tablets that help reduce pain and inflammation analgesics and anti-inflammatories can also assist in reducing pain during the night. Taking the tablets well before night time is advisable to allow enough time for them to work. If you wake up with a shoulder that hurts after directly lying on the shoulder, try sleeping on the opposite side.

Try placing a pillow behind you to stop you rolling over while sleeping on your affected shoulder and changing sides with your bed partner depending on which shoulder is involved. Sleeping propped up on a few pillows or on a special bed that has you a bit upright might also stop you rolling over onto the painful shoulder.

Doing some light stretching might also help to relieve shoulder pain. It may relax some of the tight muscles around the shoulder and also allowing the space to open up in the shoulder enough so that the pain reduces and you can try to get back to sleep.

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.

Additional investigations to assess the soft tissues, including the rotator cuff tendons and the bursa, might include an ultrasound scan or an MRI magnetic resonance imaging 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. Surgical options to help alleviate the pain and improve your shoulder function depend on the diagnosis. Most of this surgery can be performed using keyhole or arthroscopic methods. They include removing the inflamed bursa, removing bone spurs and reattaching torn rotator cuff tendons.

If your shoulder pain is from a condition called adhesive capsulitis frozen shoulder , your shoulder surgeon can release tight and inflamed structures ligaments and capsule in your shoulder that cause the pain and stiffness. Lastly, if your pain is due to severe arthritis, a shoulder replacement might be a good option to treat your pain and improve your shoulder range of motion and power. Shoulder exercise photos provided by ActiveCare Physical Therapy. Save my name, email, and website in this browser for the next time I comment.

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