Shoulder pain at night or when sleeping can be distressing. Those with night pain know how disruptive it can be. So what are the common causes of shoulder pain at night, and what are simple remedies that can ease night pain?

Causes of shoulder pain at night 

Here is a list of the more common causes of night shoulder pain. Follow the links to learn more about these diagnoses, or keep reading about some simple treatment options for simmering night pain.

Rotator cuff tendonitis 

 

rotator cuff injury

 

As we age, the rotator cuff tendons start to wear away, leading to tendonitis. Generally, pain occurs with activities but also happens at night. In more severe cases, such as a tendon tear, pain can be brutal.

Frozen shoulder 

Frozen shoulder, also known as adhesive capsulitis,  is a condition driven by inflammation of the shoulder joint’s capsule. Often, people report pain and stiffness of the shoulder. Commonly, pain from the frozen shoulder is worse at night.

Shoulder arthritis 

Shoulder arthritis is common in elderly patients, leading to pain and shoulder movement restriction. In addition, inflammation in the joint is nasty at night when not using the shoulder.

Shoulder calcific tendonitis 

Calcium deposits often form in the rotator cuff tendons. These deposits often cause intense inflammation that will keep you up at night and limit your arm’s movement. Generally, the story of calcific rotator cuff tendonitis is the same: you are between 40 and 60 years of age. First, you develop a dull ache in your shoulder that suddenly increases over 1-2 days until you have to see a doctor.

AC joint arthritis 

The AC joint connects the collarbone to the top of the shoulder. After the age of 35, we develop arthritis in this joint. In addition, when we sleep on the shoulder, the AC joint gets compressed, leading to increased inflammation and pain.

Why is shoulder pain worse at night? 

 

pain at the back of the shoulder

 

Night pain is often related to a build-up of inflammation. This is because, during the day, we move our shoulders and arms. However, at night, our shoulder is entirely still, meaning that inflammation can accumulate in the shoulder. Also, sleeping on the shoulder can compress inflammation leading to even more inflammation and a feeling of pain perception.

How to help shoulder pain at night

If you are up in the middle of the night with shoulder pain, here are a few simple treatments to help you ease your pain:

Hot water bottle or heating pad

Surprisingly, a hot water bottle placed on the painful shoulder can ease inflammation pain. We suggest using it for 15 mins, then taking it off for 15 minutes. After that, you can repeat it as many times as you like.

Improving the position of the shoulder

Sleeping with the top part of the bed propped up and placing a towel behind the shoulder can force the shoulder forward. This position relieves the pressure on inflamed structures in the shoulder and can ease the pain. Also, try to sleep on your other side.

Ibuprofen gel and tablets 

Ibuprofen is an NSAIDs or anti-inflamamory. Applying ibuprofen cream or ointment can be shooting for a painful shoulder. Sometimes, in more severe pain, ibuprofen tablets are more effective.

Capsaicin cream

Capsaicin is bought over the counter and is a skin irritant. We believe that irritation causes a depletion of a substance called Substance P  in the nerves around the shoulder tendons and joints. This calms the nerves down and leads to pain relief.

Physiotherapy

Physical therapy to address movement restriction and shoulder strength will help with night pain. Treatment should consist of 2-3 sessions for up to 6 weeks.

Cortisone injeciton for shoulder pain at night 

 

cortisone injection AC joint or for weightlifters shoulder

Injecting cortisone into a painful shoulder structure such as the bursa or joint reduces pain. Generally, we inject cortisone with the help of ultrasound to improve accuracy and effectiveness. In other words, ultrasound allows us to get the right spot. Also, you should seek a doctor who has experience in ultrasound-guided injections. 

Ususally, cortisone starts working within 3-4 days but sometimes sooner.

Final word from Sportdoctorlondon about shoulder pain at night

Night pain is a common feature in many shoulder disorders. You should see a sports doctor who can get an early diagnosis and suggest appropriate treatment.

Related conditions: Shoulder pain at night

Dr Masci is a specialist sports doctor in London. 

He specialises in muscle, tendon and joint injuries.