Nighttime Shoulder Pain: the Basics of a Complex Issue

By: Mike Carroll

Nighttime shoulder pain is a frequent issue resulting from rotator cuff tendonitis that affects millions of Americans every year. When one is suffering from rotator cuff tendonitis, they will report nighttime shoulder pain early in the process. This pain also causes the patient to frequently experience disturbed sleep.

For the observer, nighttime shoulder pain is interesting in that it works counter actively to the restoration work the body conducts during this time. The body typically restores itself and does its own healing during the night, but when the body is suffering from rotator cuff problems, rather than healing and restoration of the shoulder, there is actually more damage being done to the superspinatus tendon.

The patient, however, will often not notice this chronic pain during the day because of the vertical position of the shoulder during this time. This chronic pain is alleviated to become nighttime shoulder pain because the vertical, active, daytime body leaves its arm to act as a traction upon the shoulder that opens up space and allows blood to flow freely to the tendons. At night, the body is horizontal and so gravity is lost as a traction force, causing the pain to return.

This loss of traction force is also compounded by the way the top of the arm pinches the superspinatus tendon, impairing blood flow and healing while resting horizontally. This relative starvation of oxygen and blood to the superspinatus causes inflammation and this results in nighttime shoulder pain.

This is a problem for many reasons, primarily it sets up a rather vicious cycle as people tend to sleep horizontally. Typically if someone sleeps with their arm away from their head, that can make matters worse as the greater tuberosity of the upper part of the humerous will further impinge the superspinatus against the coracoacromial ligament.

Again, the nighttime shoulder pain is quite common with rotator cuff tendonitis and if this symptom is present, the patient should seek a medical assessment of the pain in order to work toward relief.

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