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March 27, 2007

Nighttime Shoulder Pain

Nighttime shoulder pain is a frequent part of rotator cuff tendonitis. Nighttime shoulder pain occurs fairly early on in the process. The patient will frequently complain of disturbed sleep. Nighttime shoulder pain is interesting in that during the night the body typically restores itself and does its own healing; however, during the night with this rotator cuff problems, there is actually more damage being done to the superspinatus tendon.

Nighttime shoulder pain occurs because during the day the arm acts as a traction upon the shoulder that opens up space and allows blood to flow freely to the tendons. At night, the body is horizontal and so gravity is lost as a traction force. Nighttime shoulder pain is caused by the top of the arm pinching the superspinatus tendon, and therefore, impairing blood flow and healing. This relative starvation of oxygen and blood to the superspinatus causes inflammation and this results in nighttime shoulder pain.

This is a problem for many reasons, primarily it sets up a rather vicious cycle as people tend to sleep horizontally. Typically if someone sleeps with their arm away from their head, that can make matters worse as the greater tuberosity of the upper part of the humerous will further impinge the superspinatus against the coracoacromial ligament.

Again, the nighttime shoulder pain is quite common with rotator cuff tendonitis and if this symptom is present, certainly the patient needs a medical assessment of the shoulder pain.

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