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Shoulder pain at night: everything you need to know

If you suffer from shoulder pain (caused by arthritis, injury, or another common cause) it might feel worse at night. This is because you are less likely to be distracted from pain when lying in bed. We share methods for coping with shoulder pain at night to help you enjoy a better night’s sleep.

How can shoulder pain at night affect your health? 

Shoulder pain at night can prevent you from experiencing a good night's sleep. Harvard Health explains that poor sleep can create an increased sensitivity to pain by interfering with how your brain's perceives pain. If you have joint pain, this increased sensitivity to pain induced by a lack of sleep can make your symptoms worse. This vicious cycle of pain and poor sleep is referred to as painsomnia.

As well as causing heightened pain, chronic sleep deprivation from shoulder pain can also disrupt your immune system and lead to mental health problems such as depression and anxiety. We look at the common causes of shoulder pain at night and how you could receive treatment for your shoulder pain. 

There are many reasons why your shoulder joint pain (including your shoulder pain) might feel worse at night, as supported by The Arthritis Foundation. These reasons include:

Catastrophising: This involves being kept awake by anxious thoughts about your joint pain. Poor sleep makes it more challenging to cope with pain the following day, which can lead to more catastrophising and less sleep as a result.

Less distraction: There are less distractions from your pain at night, which might cause you to focus on your pain more intently. This is not your fault and does not invalidate the effect of your pain at nighttime.

The vicious cycle: When you are in pain, you cannot sleep, which exacerbates your pain, which affects your sleep. This vicious cycle commonly affects people with joint pain. This includes shoulder pain.

Harvard Medical states: “Whether it's from a bad back, arthritis, or headaches, chronic pain puts you in double jeopardy: the pain robs you of restful sleep and makes you more fatigued, and thus more sensitive to pain.”

Understanding your shoulder anatomy might help you better understand shoulder pain.

Your shoulder is a ‘ball and socket’ joint.

Your shoulder joint looks a bit like a golf ball resting on a tee. This joint is made up of your upper arm (humerus) and your shoulder blade (scapula). The top of your humerus (head of humerus) rests inside the shallow cup-like component of your scapula. This is known as your glenoid.

The surfaces of your shoulder bones are coated with a smooth, white tissue known as articular cartilage. This helps reduce friction in your joint when your bones rub together as you move.

Johns Hopkins Medicine reports that wear and tear mostly describes cartilage damage in the lining of one of your joints. This often leads to shoulder pain.

According to a 2008 EPIFUND study, restorative sleep (which describes the completion of all five stages of sleep) is vital for brain function. It releases growth hormones that repair the cells in your body, allowing you to heal and grow. The natural, restorative benefits of sleep might help relieve your shoulder pain, improving your sleep patterns as a result.

The Arthritis Foundation also reports that lack of sleep can increase pain and inflammation, stating: “Studies in healthy individuals have found that sleep deprivation is associated with an increase in inflammatory markers measured in the blood. It is possible that an acute inflammatory response to sleep deprivation could lead to more long-term problems.”

The impact of sleep deprivation on joint pain and inflammation continues the vicious cycle of no sleep and chronic pain. 

Shoulder pain, which often leads to increased pain at night, can occur for a number of reasons. These include:

  • Trauma or injury: This happens through a hard blow to your shoulder, often caused by an injury during contact sport or a serious incident (such as a car crash). This involves a fracture or broken collar bone, which is likely to be painful at night.
  • Arthritis (osteoarthritis or rheumatoid arthritis): Arthritis causes inflammation and swelling in your joints, often resulting in severe pain and reduced mobility. If you have osteoarthritis, your shoulder pain is likely to keep you awake at night. According to The Arthritis Foundation, research shows that osteoarthritis pain can become “centralised” at nighttime. This happens when pain pathways become over-stimulated and pain is amplified beyond what would be a typical level for the damage in your joints.
  • Bursitis: Bursae are fluid-filled sacs that prevent your joints from becoming worn and inflamed. Bursitis happens when your bursa is inflamed or irritated. If the bursa that sits between your rotator cuff and acromion is inflamed, it can result in shoulder impingement. This often leads to shoulder pain.
  • “Wear and tear”: Johns Hopkins Medicine reports that wear and tear mostly refers to a tear in your rotator cuff, or the thinning of cartilage in the lining of one of your joints. Wear and tear can be a natural cause of shoulder impingement and osteoarthritis. These often lead to shoulder pain.

There are several ways that you can manage your shoulder pain, which will help you experience shoulder pain relief in turn. These include:

  • Cognitive Behavioural Therapy: Cognitive Behavioural Therapy (CBT) is often used to treat sleep issues. CBT for sleep issues involves a structured programme, helping you address thoughts and actions that could negatively affect your sleeping habits.
  • Pain relief: Painkillers might help manage your pain. Paracetamol or an anti-inflammatory medicine like ibuprofen often reduces pain, helping improve mobility in turn. Before taking medication, speak with your doctor.
  • Heat therapy: The Arthritis Foundation recommends heat treatment for joint pain. According to the foundation, a heating pad will help relax your joints, improving your mobility and pain levels. Alternatively, placing a cold compress on your shoulder throughout the day could numb your shoulder pain, providing relief.
  • Physiotherapy: The Arthritis Foundation also recommends physiotherapy to manage joint pain. Your physiotherapist will teach you shoulder pain exercises tailored to your medical needs. These will help strengthen your muscles, reduce your pain and improve your mobility. We have many specialist physiotherapists to help you manage your shoulder pain.
  • Hydrocortisone (steroid) injection: The hydrocortisone (steroid) injection is injected into your painful joint. This reduces pain and swelling. It also makes movement easier. The hydrocortisone injection can improve joint pain for months at a time.

Discover more about painsomnia (the vicious cycle of no sleep and chronic pain).

There are many causes of shoulder painIf you’re suffering from shoulder pain at night, we have many joint pain specialists who can help.

Book an appointment online today to see one of our specialist shoulder Consultants.

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