Left and Right Shoulder Pain at Night | All You Need To Know About It
Are you experiencing left shoulder pain or right shoulder pain? Here are tips to help you deal with the pain, from the causes, symptoms and treatment options available making it easier for you to know what to do.
Left and Right Shoulder pain |Why is it worse at night?
Left shoulder pain and Right Shoulder pain is more of a symptom of a condition than an actual condition. The shoulder is a very mobile joint and pain could occur from direct injury to the joint and repetitive overuse of the joint.
There are many disorders that could cause shoulder pain, I want us to talk about the disorders that could cause shoulder pain then we will talk about what conditions cause the pain to worsen at night
Shoulder problems are quite common, every three in ten adults have had an episode of shoulder pain at one point in their lives, frozen shoulder and rotator cuff disorders are more common in adults while joint instabilities are common in young people
Shoulder pains are also often in sports persons especially the sports that require a lot of joint movement. The pain lasts about 18 months for every person and therefore its important to get the right diagnosis and management.
Causes of Left and Right Shoulder Pain at Night
1. Frozen Shoulder
Also known as adhesive capsulitis, is a painful progressive condition that occurs due swelling, thickening and tightening of the shoulder joint that causes difficulty in moving the shoulder within its range of motion.
The tension around the shoulder causes the humerus bone (the upper arm bone) to have limited motion and you are unable to effectively perform activities of daily living. The symptoms occur in stages and may spread across months to years.
Stage 1:there is aching and stiffness of the joint before it starts to ache. The pain is usually worse at night and when you lie on the affected side. Symptoms may last up to nine months
Stage 2: the shoulder stiffness gets worse and the pain does not increasing in intensity, the muscles of the shoulder at this point can start to become wasted due to lack of use. This lasts four to twelve months
Stage 3: at this stage, the pain starts to reduce and healing starts to occur though episodes of stiffness still occur. The joint may not fully regain normalcy but will be able to perform activities better than in the previous stages. This stage may persist from five months to five years.
Although the cause is not yet known, there are risk factors that have been associated with it:
Surgery: this involves surgeries of the shoulder or of the upper arm that heal with shortening of the joint causing stiffness
Diabetes: if you have uncontrolled blood sugar levels, this could put you at risk of the condition
Other conditions: hyperthyroidism(a condition associated with excess thyroid hormones and hyperactivity)has been linked with the disorder, dupuy’s trent contracture(a congenital birth defect that is associated with bending of the little finger) has also been linked
- Use of pain killers like paracetamol to soothe the pain
- Physiotherapy to avoid disuse syndrome
- Surgery can also be considered but in most cases as a last resort
2. Rotator cuff disorders
The rotator cuff is a group of muscles and tendons that form a ring around the shoulder joint, tendons are tough fibrous tissues that attach bone to muscle. The rotator cuff keeps the joint in proper position and allows it to move as it normally does.
There are different types of rotator cuff disorders but which have common features which include:
- pain that involves activities that lift your arm above the shoulder level e.g: when you lift up your arms above the head as in when you are trying to comb your hair
- pain when you lift you move your arm in an arc position
- pain that occurs at night
- pain that is either at the front or at the back of your shoulder
Types of rotator cuff disorders:
Bursitis and Tendinitis
Bursa is a liquid filled sac that is found under the joint and in between the muscles and tendons. The sac can become inflamed and can start to swell causing bursitis, when the tendons are inflamed, it causes a condition called tendinitis.
When both of this are inflamed and start to swell, there is limitation in the movement of the muscles and thus joint movement is also limited.
This is elicited by pain when you try to move the joint. Swelling and inflammation is caused by injury to the joint or arm overuse in people who use their arms quite frequently and forcefully as in sportsperson’s who throw the javelin and the discus.
When the tendons and muscles become trapped between the bones, any movement causes a lot of irritation.in the event that the two conditions occur simultaneously, the condition is called impingement syndrome. If the tendon is constantly scrapped by the underlying shoulder bone, a tear could occur
This is a tendon or muscle cut that occurs in the area around the shoulder. The tear is most common in people above the age of 40 years due degeneration of cells. If the tear occurs in young people it is usually due to trauma due to an injury. Tears are very painful and need to be managed early to avoid further complication.
3. Shoulder instability
The shoulder joint is what we classify as the ball and socket joint where the ball is the humerus bone of the upper arm that fits into the socket of the shoulder blade. Ideally the two bones are supposed to if properly with each other but you would find that may not be always the case such that there is improper fitting of the joint or there is complete dislocation of the joint.
The symptoms of instability can range from vague to severe and can sometime be described as ‘dead arm’. These include: numbness, tingling sensation, weakness, locking or popping sensation and shoulder fatigue. The symptoms can start to get severe such that there is pain, the arm being visibly out of its socket, limited movements and muscle spasms
Shoulder instability could be traumatic where the arm is pushed out of the joint by an injury or the joint may gradually come out of its socket over time as a result of repetitive arm movements like swimming and throwing and such conditions occur in people under the age of 35years
4. Acromioclavicular joint disorders
This is the joint that connects the shoulder blades to the neck found at the top of the shoulders, the disorders could be due to
Torn ligament: these are fibrous tissue that connect bones together
Dislocation of the joint
Pain is the first symptom that is accompanied by limited movement of the shoulder
5. Shoulder separation
This occurs in the event of dislocation of the acromioclavicular joint that is different from a dislocation
Shoulder pain at night
Rotator cuff muscles disorders are the most common cause of shoulder pain at night, the group of four muscles become tenser at night especially if you overused the arms during the day
shoulder pain at nigh is normally constant and dull in nature, the pain is increased when you try to turn at night as this moves the shoulders, the pain also worsens when you lie on the affected shoulder. If the tendons are affected, pain occurs when you raise your arms. The pain is associated with tingling and numbness of the arm fingers
Treatment and Management of Left and Right Shoulder Pain at Night
Pain medications: use of NSAIDS e.g. brufen is recommended to manage the pain ,they are best effective when used regularly than when used when symptoms of pain appear, however it’s important to consult your doctor before you take the meds for a long time as they are associated with high blood pressure, kidney diseases and heart problems
Oral corticosteroids e.g. predisolone are also recommended as they help to manage the inflammatory process and eventually reduce the pain, however you will also want to use them cautiously as they are associated with increased glucose levels and excessive fat deposition
Injectable corticosteroids can also be used in very severe pain and can be used in frozen shoulder, the drug is injected directly into the shoulder and helps to reduce the pain especially in stage 1 of the frozen shoulder. This however should be used with a lot of caution as it causes skin atrophy at the injection site, depigmentation and some temporary pain
physiotherapy: this is important to reduce disuse syndrome. Once you are referred to a physiotherapist, it’s important to ask him/her what options they wish to use e.g.
ü massage: the use of the hand to manipulate the shoulder
ü laser therapy: use of light beams to stimulate nerves and thus reduce pain
ü TENS: transcutaneous electric nerve stimulation, the use of electrodes placed on your shoulder skin and electricity passes through them to your nerves to numb them and reduce pain
ü shoulder exercises: this is recommended to avoid wasting away of muscles and resultant stiffness, therefore if possible you should use the shoulder as often as possible
This is also a treatment option that could be considered in the case of frozen shoulder and rotator cuff tear. Two types of surgical procedures can be done for the frozen shoulder like manipulation where you are put under anesthesia and the shoulder is rotated and aligned after which physiotherapy follows to maintain stability of the shoulder and arthroscopic capsular release where an incision is made inside the shoulder and any scars inside the joint capsule that cause pain are removed.
in rotator cuff repair, surgery is only considered if the tear is too large and does not heal spontaneously on its own.