Many shoulder problems cause difficulty with sleep at night. The #1 complaint that I hear in my practice is “I can’t get comfortable at night.” In fact, my patients are often dragged in to see me by their significant other because they toss and turn all night. Nighttime pain is often the most significant part of a problem with the shoulder. Other complaints include difficulty reaching above the head or behind the back, difficulty getting dressed, or difficulty reaching into a back pocket. Many times the pain radiates into the arm as well.
What causes nighttime pain? One word: inflammation. Inflammation is the root cause of many problems that affect the shoulder while resting and can result from one of several different underlying problems. Problems that cause inflammation include rotator cuff tendonitis or tears, “bone spurs”, and arthritis in the shoulder. Frozen shoulder is the result of inflammation as well. Of these, rotator cuff problems are the most common.
What can we do about it? Cortisone injections can help, although they are not the solution for every patient. Injections may completely eliminate the problem, permanently. In other cases, they may help for weeks or months. Besides cortisone shots, other treatments for shoulder pain are available. These include anti-inflammatory medication and physical therapy. Rarely, surgery may be necessary to correct a significant problem, such as a severely torn rotator cuff or large bone spurs which cause friction and rubbing. For a very small group of patients with arthritis, shoulder replacement may be the best option.
A physical exam, x-rays, and sometimes an MRI or in-office arthroscopy are necessary to establish a diagnosis. Make an appointment when pain has been going on for more than a week or two, as it is often helpful to “nip it in the bud” and prevent a problem from getting worse. Remember, it is not normal for a shoulder to be painful.
