Pain in upper right arm between elbow and shoulder at night

What’s going on?

The shoulder is one of the most agile joints of the body, allowing movement in all directions. Because of this, it can be more susceptible to injury. Painful conditions may also arise from overuse due to a specific activity or shoulder motion that you make repetitively. Any repetitive shoulder motion can cause an overuse injury, but racket and ball throwing sports are common culprits.

Typically, shoulder pain that gets worse at night may be caused by bursitis, tendinopathy or an injury to the rotator cuff.

Bursitis is an inflammation of the bursa, which is a fluid-filled pad that provides a cushion to the bones of the joint. When injured, fluid in the bursa increases and this swelling can be painful.

Biceps Tendinopathy is usually the result of long term overuse and deterioration of the biceps tendon that connects muscles and bones in the shoulder joint. Tendons may also get less flexible as we age, and more prone to injury. Tendinopathy is often part of the aging process. Biceps tendinopathy can give sharp pains in the arm with certain motions like reaching behind you.

Rotator cuff injuries usually involve a tear in these tendons. The rotator cuff includes four muscles that come together as tendons and connect your humerus bone to the shoulder blade. The cuff provides shoulder stability and enables movement. Damage to any one of the four muscles could result in inflammation,  swelling and general pain in shoulder.  Rotator cuff tears are a very common problem and may result from a fall or lifting something too heavy, too fast. But most tears occur as the tendons wear down over time.

Before you see the doctor

The first course of action is to reduce the swelling and pain. Things you can try at home include:

• Take anti-inflammatory medications such as ibuprofen, naproxen or acetaminophen
• Sleep in a recliner
• Apply ice or heat
• Wear a compression sleeve
• Discontinue any activities that may have contributed to overuse of the shoulder

If the shoulder pain doesn’t go away or worsens, see an orthopedic specialist. It’s important to see a doctor who specializes in shoulder care to properly diagnose your condition to ensure you’re getting the best treatment. The doctor will evaluate your X-ray or MRI and determine a care plan. Non-surgical treatments may include activity modifications, physical therapy and/or a cortisone shot to ease the pain. Newer treatments involving regenerative medicine may also be an alternative. This is typically the use of your own blood platelets or stem cells to heal the injured area. More information on these types of treatment can be found at our sister practice Regen Orthopedics.

If there is no improvement in your strength or the injury worsens over time, surgery may be the best option to restore function and alleviate pain.

We’re here to help

We would be happy to evaluate your shoulder condition or provide a second opinion. Call 844-SHOULDR (844-746-8537) to schedule an appointment.

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The Cleveland Shoulder Institute treats patients with all types of shoulder and elbow disorders resulting from traumatic injuries, arthritis, instabilities, rotator cuff and sports-related injuries. Led by nationally recognized Orthopedic Surgeon Reuben Gobezie, MD, the institute provides both surgical and non-operative treatments.

Dr. Gobezie is one of the country’s top specialists in advanced arthroscopic and open surgical techniques to restore damaged joints, ligaments and bones. He is also one of the most experienced and highest volume shoulder surgeons in the country. A number of studies have shown that surgical volume, the number of surgeries a surgeon performs each year, is a strong predictor of patient outcome. The more surgeries that a doctor and his surgical team performs, the better the results for patients.

Dr. Gobezie is Founding Director of The Cleveland Shoulder Institute , Regen Orthopedics and PT Genie.