Shoulder pain at night, what is it?

△While a patient is sleeping, muscle movement is reduced and builds more stiffness, and it causes pain during the night. imageⓒshutterstock_tommaso79

The Most Common Reasons Are Frozen Shoulders or Adhesive Capsulitis.

By Winston Lee L. Ac, Ph.D., KMD

Some patients dread the night when they should be able to relax after a long day at work. Even if it hurts so much that it is difficult to sleep at night, the pain subsides during the day when they are active, so they do not go to the clinic in the end. However, this pain is a signal of danger sent by the body. Why does it bother them, especially at night?

Pain that comes at night is often caused by diseases related to joints or muscles. The most common reason is ‘Frozen Shoulder’ or ‘Adhesive Capsulitis.’ It is a disease in which the joint capsule, a pouch surrounding the shoulder joint, becomes inflamed, swollen, and painful as you age, and then fibrosis and stiffening of the shoulder. The prominent symptom is a pain in the entire shoulder when the arm is raised or rotated in a certain direction. This is a disease caused by stiffness of the muscles and tendons, so when there is no movement, such as when sleeping, the muscles become stiff and cause pain. Therefore, if patients warm their shoulders with a heated pad or a warm wet towel before bed, they can significantly reduce the symptoms. In the case of a frozen shoulder, it is often healed naturally in 1 to 2 years, but it is necessary to treat it early because they can suffer from tremendous pain.

In eastern medicine, it is good to use acupuncture to loosen the muscles and ligaments of the stiffened shoulder joint, chiropractic to increase the range of motion, and herbal medicine to help reduce inflammation in the joint itself and produce synovial fluid, which is the lubricant of the joint.

Rotator cuff disease, often confused with a frozen shoulder, also causes severe night pain. Rotator cuff disease occurs when some or all of the four muscles involved in shoulder movement are injured and torn. An accurate diagnosis of this is impossible with an X-ray and can be diagnosed through MRI. In the case of a complete rupture, surgery is inevitable, and if there is a slight rupture and inflammation, it can be recovered with non-surgical treatment. Especially in this case, when the patient lies down, the space between the shoulder muscles and the distal area of the clavicle narrows, causing more pain and making the patient not sleep well. In this case, if it is not a complete rupture that requires surgery, herbal medicine to reduce inflammation, acupuncture for the shoulder joint, and physical therapy to reduce pain, these three methods are sufficient to recover and prevent further injury.

Finally, there is degenerative arthritis. It is also more painful at night. In old age, when the cartilage and synovial fluid in the joints are insufficient, bones collide with each other, causing inflammation. In the beginning, it hurts only when the joint is used, but when it becomes severe, the pain continues even when it is not used. In this case, it is fine during the day, but in the evening or before going to bed, the joint used during the day tend to become fatigued and inflammatory substances accumulate, making the pain worse. The cause of this is ‘degeneration’, so it is difficult to cure the pain completely. Therefore, in this case, it is necessary to reduce pain, but it is also more important than anything else to prevent further degeneration and deformation of cartilage or bone itself. In western medicine, in this case, steroid injections that reduce inflammation, prescribing painkillers, or joint replacement surgery using an artificial joint are usually considered. In eastern medicine, physical therapy is combined with acupuncture and herbal medicine treatment to reduce pain, but unlike western medicine, it has a unique treatment method that slows degeneration by prescribing herbal medicine to strengthen the liver and kidney systems in eastern medicine.

After all, shoulder disease looks similar to a cervical disc or a lumbar disc from the general public’s view, but in reality, the treatment approach is often quite complicated, depending on the diagnosis. Therefore, if your shoulder hurts for more than 1-2 weeks, even though it was not sprained through any sudden accident or exercise, it is more important than anything else to see a medical professional and receive the most appropriate treatment after taking an accurate examination and diagnosis.