Arm pain at night only: Causes, Treatment, and When to See a Doctor
Causes, Treatment, and When to See a Doctor
Arm pain is generally experienced on the outside of the shoulder and can sometimes radiate further down toward the elbow. Causes of arm pain include overuse conditions, traumatic injuries, and other conditions that can lead to discomfort.
Illustration by Alexandra Gordon, Verywell
It is helpful to separate arm pain into categories based on the causes of discomfort. We will separate arm pain into three major categories: overuse conditions, traumatic injuries, and pain that travels to the arm from another location.
The most common cause of pain is tendinitis or bursitis around the shoulder or rotator cuff tears. While the rotator cuff is typically considered a shoulder joint problem, the pain that is experienced with tendinitis, bursitis, or tears of the rotator cuff is often felt further down the arm.
People often complain of a deep aching sensation over the outside of the arm. Pain that occurs as a result of a rotator cuff problem is often experienced when lifting the arm up overhead, and many people complain of pain at night. In fact, the pain at night can be significant enough to awaken you from sleep, particularly when the shoulder is held in an awkward sleeping position.
Other overuse conditions that can cause arm pain include tennis elbow. This condition is the result of irritation of the tendons on the outside of the elbow joint. Much of this discomfort is experienced in the lower portion of the arm.
There are several traumatic conditions that can cause pain in the arm. Fractures around the shoulder joint or the humerus bone are a source of arm pain and should be considered in anyone who has had a recent fall or other significant injury. Dislocation of the shoulder or dislocation of the elbow can cause significant arm pain. Muscle contusions can also be a source of discomfort after an injury.
Other Sources of Arm Pain
Pain in the arm can also occur as a result of conditions elsewhere in the body. This can lead to so-called “radiating” symptoms. While the pain is often experienced in the arm, the source of the problem may be elsewhere in the body.
The most concerning of possible radiating symptoms is the result of angina, or a heart attack. Sometimes people with heart problems will experience pain radiating down the arm.
Another source of radiating pain is a result of a pinched nerve in the cervical spine. Problems such as a herniated disc can cause compression on the nerves leading to pain, tingling, and numbness radiating down the arm.
Lastly, a condition called thoracic outlet syndrome can cause compression of the blood vessels or nerves in the shoulder region, also leading to pain going down the arm.
When to See a Doctor
Many causes of arm pain can be managed with some simple treatments, but there are signs that you should see a doctor urgently.
Some of the signs of a more concerning source of arm pain include:
- Pain or pressure in your chest, symptoms of a heart attack
- A sudden injury that causes severe pain or deformity, indicating a possible fracture or dislocation
- Severe pain is not improved with appropriate simple treatment steps
- Worsening swelling or redness around the painful region
Making the diagnosis of the source of arm pain is best accomplished by first taking a careful clinical history of the condition. This can help guide your doctor to determine if the source is coming from within the arm, or is coming from elsewhere in the body.
A physical examination of the cervical spine, shoulder, and elbow can help to determine the specific source of the problem. Imaging studies including X-rays, MRIs, ultrasound, can all be useful in helping to establish the source of the pain.
There may be situations where other tests, such as laboratory studies or an EKG, can help to guide treatment, particularly if the condition is felt to be a problem radiating to the arm from elsewhere in the body.
As with any medical condition, the treatment should be guided by the underlying condition that is causing the problem.
If arm pain is felt to be the result of a serious condition or a recent trauma, that should be carefully evaluated and treated by a medical professional.
For more common overuse causes of arm pain, some simple treatments include:
- Rest: Avoiding lifting, pushing, or pulling can be helpful. In some situations, wearing a sling can be supportive, but also a good reminder to rest the extremity.
- Ice application: Applying ice to the shoulder and arm region can help to reduce inflammation and also relieve pain. Ice can be helpful at preventing swelling in the affected area.
- Anti-inflammatory medication: Nonsteroidal anti-inflammatory medications are effective at reducing inflammation and decreasing pain. These medications can have possible side effects and should be taken under the direction of your doctor.
- Physical therapy: Many conditions that lead to arm pain are the result of poor mechanics of the shoulder and upper extremity. Even muscular people who regularly perform physical activity can develop significant arm pain as a result of abnormal mechanics of the joints. Working with a skilled physical therapist can help to alleviate these problems.
- Cortisone injections: A cortisone injection is a powerful anti-inflammatory medication delivered directly to the site of a problem. The benefit is delivering a significant anti-inflammatory medication directly to the problem, although there are possible side effects of a cortisone injection.
- Surgery: Surgery is generally performed when the simpler treatments fail to provide adequate relief. However, surgery can be performed to repair rotator cuff tears, remove the inflammation from around the shoulder, repair fractures of the arm, as well as treat other conditions that are a possible source of arm pain.
A Word From Verywell
Pain in the arm can occur as a result of overuse conditions, traumatic injuries, as well as pain radiating from another part of the body. The most common reason why people have pain in their arm is from overuse conditions of the shoulder joint. Specifically, rotator cuff problems are notorious for causing symptoms of arm pain. While simple treatments are often effective at managing arm pain, it is important that the cause of the problem is correctly identified in order to ensure that the treatment can be targeted to the appropriate source. There are some serious conditions, notably heart problems, that should be considered in people who have the abrupt onset of arm pain without a known injury.
Night Time Shoulder Pain and What To Do About It: Restore Orthopedics and Spine Center: Orthopedic Surgeons
One very common complaint I hear from patients with shoulder problems is “doc my shoulder pain wakes me up at night”.
The pain can occur whether or not one lies on the painful shoulder, opposite side or on their back. Patients cannot find a comfortable sleeping position. The pain just does not let them sleep well.
Night time shoulder pain is probably the most common symptom I see in patients with shoulder conditions such as tenditinis, bursitis, tendinosis, impingement, rotator cuff tears and capsulitis. All of these conditions cause some level of shoulder stiffness and inflammation.
The reason that shoulders hurt at night is not fully understood. It may be related to the inflammation that occurs when the joint is in a prolonged static position or it might be due to the inward position of the arm while at rest. When the arm is up against the body the blood flow to the rotator cuff tendon and bursa is slightly restricted. This position might partially account for the pain. What we do know is that night time pain is a red flag that something is wrong.
When I evaluate patients with night time shoulder pain my goals are 1) to make the correct diagnosis and 2) to provide efficient and appropriate treatment to permanently relieve the pain.
Regardless of the pathology, one of the most common non-operative recommendations I emphasize is stretching of the shoulder joint, a.k.a. the glenohumeral joint. In my experience, once the flexibility or range of motion (ROM) of shoulder is optimized the pain improves. In cases where the pain is caused by inflammation, such as tendinitis or bursitis, the night time pain may permanently resolve. If the painful arm does not move as fluidly and completely as the opposite non-painful shoulder it is a stiff joint. The mechanism by which stretching improves ROM is not totally understood however it is likely due to adaptions to elongation of the muscle and tendon units around the glenohumeral joint. These tissues are visco-elastic so they respond to prolonged passive stretching.
I emphasize this: A Stiff joint = A Painful Joint
The majority of the the shoulder conditions that cause night time pain also cause shoulder stiffness. When the shoulder stiffness is recognized the first treatment measure I recommend is a prolonged passive stretching program. The exercise routine needs to be effective, safe and easy to do. The maneuvers do not need to be too forceful but they do need to be prolonged.
The longer you hold the stretch the more effective you will be at improving shoulder motion.
I recently collaborated with one of my local physical therapy groups Coury & Buehler in Orange County to create www.MoraStretches.com stretching videos. Out of the four shoulder stretches highlighted in the link the two most effective for relieving night pain is the “statue of liberty” and the “cross arm” stretch. Please follow the instructions closely and repeat the stretches daily. You can do these exercises on your own.
Unless you have had recent shoulder surgery or you suffer from instability these stretches are safe. If you have had surgery or suffer from instability (loose shoulder) it’s very important that you consult with your doctor and ask if these exercises are appropriate. They are usually are okay even if you have had rotator cuff tear surgery.
Start the exercises slow. You should expect some level of “stretch pain”. The longer you hold the stretch position the better it is for you. Sometimes the shoulder will ache for a few minutes after the exercise. That is normal. This should diminish with time. You should see improvements in ROM after a 1-2 week of doing these exercises diligently.
As the ROM improves the night time pain should start to diminish.
If you do not see improvement after 2-3 weeks you should set up an appointment with your doctor. You will probably need X-rays and an MRI.
I hope this information was helpful. Please let me know if I can be of service. If you know someone suffering from shoulder problems please share!
Restore Orthopedics and Spine Center
Why Does My Arm Hurt? 10 Possible Causes of Arm Pain
If your arm hurts, there could be a number of reasons why. Arm pain is usually described as pain, discomfort, or stiffness that occurs anywhere from your shoulders down to your fingers in one or both arms. Most often, it’s caused by an injury or overuse. But there are many other health conditions that can cause your arm to hurt.
Pain in your left arm could be related to a heart condition. Angina, which is caused by decreased blood flow to the heart, can cause pain in the arm shoulder. A heart attack can cause pain in one or both arms. A heart attack happens when the oxygen supply to part of your heart is cut off due to a blockage that prevents blood from flowing into the muscle.
If you’re having a heart attack, your arm pain will probably come on suddenly.
You also may experience:
If you’re having these symptoms, call 911.
Sometimes, you can trace arm pain to a sports injury or simply using it too much. Other times, another condition could be to blame. Here are some other possible causes:
- Broken bones: If your arm starts to hurt right after a physical injury, you may have fractured it. You might also have swelling, bruising, numbness, or weakness. See your doctor right away so your arm will heal properly.
- Strain or sprain: An injury can cause damage to your muscles (a strain) or your ligaments (a sprain). Symptoms include pain, swelling, bruising, weakness, and muscle spasms. Both conditions will usually heal on their own, but if your symptoms are severe, you should see your doctor as soon as possible.
- Tendinitis: This happens when the tendons in your shoulder or arm become inflamed. Those are bands of tissue that connect muscles to bones. One example of tendinitis is “tennis elbow.” You could feel the pain in your shoulder, elbow, or wrist. It could be a result of an injury or – more often – overuse.
- Rotator cuff injury: This part of your shoulder is made up of muscles and tendons. It allows your shoulder to move or stay in place. As we age, tendons in the rotator cuff begin to wear down or tear. If you have a job where you make overhead motions over and over, you can damage it, too. Symptoms range from a dull ache and weakness in your arm to severe, constant pain. If you suspect a rotator cuff injury, see your doctor. You may need physical therapy.
- Carpal tunnel syndrome: Doing the same movements over and over with your wrist can cause damage to the main nerve in your hand. It can lead to numbness, tingling, weakness, and pain.
In some cases, you can’t trace your arm pain to physical injury or overuse. It could be caused by diseased arteries in the upper part of your body. It might also be the result of stress, a new medication, or another medical condition, including:
- Pinched nerve: This happens when bones or tissues in your shoulder, neck, or elbow press against and compress a nerve. It causes pain, numbness, weakness, and tingling.
- Herniated disk: These are little cushions between the hard bones (vertebrae) that make up your spine. They allow your back to flex or bend. If one of the disks in your neck ruptures, it could cause a burning pain, numbness, weakness, and tingling or burning in your arms.
- Autoimmune diseases: If you have one of these conditions, your body’s natural defense system (immune system) attacks itself. Some of these — like rheumatoid arthritis, lupus, and Sjogren’s syndrome — can cause pain in the neck, arms, elbows, wrists, and hands.
Waking Up With Arm Pain | Dr. John Cybulski
This blog was written by John Cybulski, DC. He discusses some common causes of arm pain while sharing a few tips to keep your arms healthy and pain free.
Have you been waking up with arm pain lately? Does the pain appear as you’re waking up, or does the pain cause you to wake up?
If your arm pain is so severe that it wakes you up many times during the night, consult your doctor right away. However, if you’re like many people who struggle with arm pain in the morning, you may deal with an overuse injury.
Why Does My Arm Hurt?
Our bodies have limits. The body’s heart can only beat so fast, and lungs can only hold so much air. Fortunately, our bodies set up safeguards that help keep us from breaking our limits. The question then becomes, if you’re in pain, which anatomical limits are you pushing?
Your muscles do more than just move your bones. One of the primary jobs of muscles is to help pump blood through your body. Sometimes, arm pain can be a symptom of a blood clot or a cardiac problem. If you’ve already ruled out these medical conditions with your doctor, it’s time to turn your attention to the other functions of the muscular system.
The question then remains, what muscular or joint dysfunctions might contribute to your arm pain?
Muscle Weakness and Overcompensation
Do you have tension and pain in your upper shoulders and neck? Do your hands, wrists, or elbows bother you after a long day at work?
If you answered yes to the above questions, then it’s very possible there are underlying muscular imbalances that are causing your arm pain. You may overuse your stronger muscles to compensate for weakness in other muscles. By overcompensating for your body’s lack of strength, you put undue stress on those muscles and risk developing a painful strain or tear.
Do you have pain in areas near your arm that could lead to waking up with arm pain?
Many people don’t consider their neck or shoulder problems may contribute to their arm pain since it’s a distinct part of the body. We often call this “referred pain,” as pain from previous injuries will subtly radiate to nearby areas of the body as we sleep. Sometimes the referred pain may appear to be a separate injury.
How to Fix Your Arm Pain Fast
Your muscles are capable of many things, from running and jumping to throwing and lifting. However, even the strongest muscles can occasionally move beyond their limits. Understanding and consciously abiding by your own body’s limits is an important step in avoiding injuries that can lead to pain. Learning how to correct muscular imbalances as they appear is crucial to swift and effective pain relief.
Fortunately, the best solutions are often the simplest. If you know a muscle is holding too much tension, you can stretch it. Or, if you notice some muscles are weaker than others, you can do exercises to strengthen them.
As a Doctor of Chiropractic, I believe in finding and fixing the cause of pain, rather than simply treating the symptoms. If you wake up with arm pain that’s too much to bear, I encourage you to seek your nearest Airrosti provider. Our providers seek to resolve injuries like arm pain at the source to help bring fast, effective relief. We also provide tools and resources to help you address problem areas as they appear, so you can keep doing the things you love pain free.
Prefer to connect virtually? We also offer remote telehealth appointments in addition to in-clinic visits. Call us at (800) 404-6050 or click the button below to schedule your appointment today.
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Shoulder Pain at Night
One of the most common complaints I hear in my office is that a patient cannot sleep due to shoulder pain from sleeping. They tell me that no matter what side they try to sleep on, it still hurts. Some patients report stiff or dull pain that becomes worse when they raise their arm or shift from side to side. Other symptoms may include numbness and tingling in your fingers or a muscle spasm.
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.
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.
How To Relieve Shoulder Pain At Night
Shoulder pain at night is a very common issue among chronic pain sufferers. The shoulder is one of the most vulnerable joints as it has such a wide range of motion, which opens it up to various injuries and problems. So, why are you experiencing shoulder pain at night and what can you do to find relief? We discuss five treatment options ranging from shoulder stretches to chiropractic to interventional procedures.
Issues associated with shoulder pain at night
On top of the pain, most people with shoulder pain at night sleep poorly, which has a completely different set of problems associated with it. These can include:
- Increased sensitivity to pain
- Low energy
- Mood disorders
Sleeplessness can become a vicious cycle of decreasing sleep and increased pain, which will only make your condition worse.
Causes of shoulder pain when night
Although many shoulder disorders can cause pain, the most common cause of shoulder pain at night comes from rotator cuff tendinitis. It usually is caused by irritation of the shoulder tendons leading to inflammation and pain. This condition can be caused by many things, including:
- Poor posture
- Repetitive work injuries
Rotator cuff tendinitis is known to affect millions of people in the U. S. each year and is a major cause of shoulder pain when sleeping.
Some of the other causes of shoulder pain at night are:
Why exactly does the pain increase at night even though it might be fine during the day?
Why do I have shoulder pain at night only?
While this nighttime shoulder pain cannot always be explained, a lot of the pain comes down to:
- Being still at night
- Unrelieved tension and stress from the day
- The sleeping position you choose
- Your mattress
During the day, the shoulder is being actively used while you are in a vertical position. The tendons engage and are pulled downward by gravity, which allows space to be made in the muscle groups in the shoulder. This additional space allows for an increase in blood flow and oxygen that alleviates the stiffness and pain that would be present otherwise.
When you lay down to rest or sleep at night, you are generally in a horizontal position. This removes the effect of gravity and allows the shoulder muscles to relax. The lack of movement and the relaxation of the muscles allows the fluids in your joints to settle and decreases the flow of blood, allowing the joint to become inflamed. People also tend to lie on their shoulder while sleeping, which can compress the joint even further, and thereby worsening the inflammation.
How-to relieve shoulder pain at night
If your shoulder pain is worse at night, there are ways to ease your pain.
1. Find a better sleeping position
The first course of action to relieve shoulder pain at night is to find a good sleeping position for you. Tossing and turning at night is normal for most people, but can agitate your shoulder if you land on it wrong. Sleeping on the opposite shoulder can help avoid this pain, but try not to sleep on your back.
If the pain persists, you can always trying wrapping your arm or wearing a sling to assist in preventing movement during sleep. Sleeping with a pillow under your knees can help alleviate any associated back pain.
2. Stick to a sleep schedule
Along with fixing your position while sleeping, always make sure to try to stick to a sleeping schedule. Good sleep hygiene can make all the difference in your sleeping patterns. Having a consistent bedtime ritual that helps wind you down at the end of the day can do wonders in terms of reducing stress and tension, and improving sleep length and quality.
Try something relaxing before bed like a shower and make sure you fall asleep in a dark room with no electronics. Medication can also help you sleep, but be cautious of how often you use them. Constantly requiring sleep aids can be a major sign of a problem and the more you use over-the-counter drugs, the more you will need to be effective. In addition, if you’re using other medications, they may react poorly with the sleep aids.
3. Perform stretches for shoulder pain at night
Exercising a few hours before bed can also be useful as it will increase blood flow throughout the whole body. This can alleviate pain, but also relax you enough to ease sleeping troubles. Try something low impact like a brisk walk or a bike ride, and then allow your body to cool down again before going to bed.
Further, certain shoulder stretches can help you reduce the tension and stress that has built up during the day. Not only are shoulder stretches an easy option, but they take only a few minutes at night. Stretching has huge health benefits like increasing flexibility, range of motion, and blood flow. Another big plus is that they are simple to do in your own home and require no special equipment. Before you go to bed, try these seven shoulder stretches to alleviate some tension and reduce your stress.
Shoulder stretch basics
If you start to feel pain at any time during a stretch, stop immediately. Stretching should be done to the point of mild strain. If you experience pain, you are going too hard and could injure yourself. This is especially true if the pain is sharp or sudden. It is a good idea for chronic pain sufferers to consult a pain doctor before starting too strenuous of a stretching routine as overexertion could exacerbate certain conditions.
For best results, always warm your muscles up a little before stretching. For the following stretches, it is best to do each for approximately 30 seconds to one minute for maximum effect. Also, make sure you are steadily breathing in and out in a controlled manner.
This is a quick stretch that is great if you spend way too much time staring at a computer monitor. Slowly extend your neck outward, making sure your keep your chin parallel with the floor. Then, pull it back in to a neutral position that is straight with your spine, slightly tucking the chin in. Repeat.
Sit in a cross-legged position on the ground. Extend your arms in front of you and place your left elbow in the crook of the right arm. Now, bend your elbows back so your hands are touching. Hook one hand over the other so that your palms are facing each other.
For this stretch, you should keep your palms together, elbows lifted in a 90 degree angle, and your hands in front of your face. Try to keep your shoulders relaxed and down. You should feel a powerful stretch in your shoulder blades as well as the lower part of your neck. After this, change arms by placing your right elbow in the crook of your left arm and repeating.
Take your right arm and reach over your shoulder aiming to lay your palm in-between your shoulder blades. Then take your left arm and reach up your back (not over the shoulder) also placing the hand between the shoulder blades. Try to interlock your hands and pull slightly.
If you are having trouble interlocking your hands, you can modify this stretch. Keep a towel or something similar in your top hand, and then grasp it with your bottom hand instead of clasping the hands together. Gently pull with each arm to feel your shoulders start to open up.
Standing wall stretch
While standing tall, reach out and place both of your hands on a wall. Walk your feet back until the arms are straight, but don’t let your arms reach too far above your head. Make sure you keep the shoulder blades open and relaxed downwards during the whole stretch. Also, avoid pushing against the wall and don’t allow your shoulders to press up and into your neck.
Shoulder blade stretch
Start by spreading your feet, so they are shoulder-width apart. Raise your arms above your head as far as possible and bring your palms together. Now, simply twist your waist by bringing one shoulder forward and simultaneously pulling the opposite shoulder back. Hold this stretch and then switch sides.
This stretch begins by lying face down on your stomach. First, place your right hand palm down on the floor like you are starting a pushup. Next, lift your chest slightly and slide your left arm under your chest. Finally, square your chest with the floor and lower on top of your arm. Hold this position and then switch your arms.
If you want a deeper stretch in this position, you can move on to the full dragonfly. This is accomplished by lying on your stomach face-down. Crisscross both arms near the collar bones and straighten your arms out as far as possible. Then, allow your body to drape onto your arms.
Stand your feet hip-width apart. Turn your right foot forward. Turn the left foot so it is perpendicular with the right and raise both arms to shoulder level straight out from the body.Stretch your right arm up and forward, pulling your body up slightly. Then slowly lower the chest forward over the right leg until it is parallel with the ground. Place your hand on your thigh or calf, while avoiding placing it on the knee directly. Try to keep as little weight in your hand as possible, focusing on keeping yourself upright with your core instead. Extend the left arm completely upward towards the ceiling, if it feels comfortable. Finally, turn your head upwards towards the ceiling or down towards the ground for an additional neck stretch.
4. Try yoga poses for neck pain
Since shoulder pain at night is often related to neck pain, trying the following yoga poses for neck pain could also help relieve your pain. This video also demonstrates the triangle shoulder stretch.
5. Talk to a pain doctor about interventional therapies
If these natural treatments don’t work to relieve your shoulder pain at night, it may be time to talk to a pain doctor. They can help diagnose the exact cause of your shoulder pain. If your pain isn’t due to an acute injury or fracture, they may suggest interventional treatments for chronic pain.
These shoulder pain at night treatments include:
- Physical therapy to increase flexibility and reduce pressure on your joint
- Chiropractic care to increase mobility and loosen tension
- A regimen of non-steroidal anti-inflammatory medications
- Joint injections that can relieve nerve irritation
- Surgery, but only for the most severe cases of shoulder pain at night
If more conservative treatments like chiropractic care or physical therapy haven’t worked, a joint injection provides a minimally-invasive treatment that doesn’t require surgery. You can learn more about this approach in the following video (while not a shoulder injection, it does showcase a knee joint injection using a similar approach).
Signs to watch for
It’s always best to consult a medical professional before starting any kind of treatment for shoulder pain. A proper diagnosis is always critical, so you may need an examination and other tests, such as an MRI or X-ray.
Shoulder joint pain can come from many different causes, but they share many similar symptoms such as being tender or warm to the touch. You should always talk to your physician if you are experiencing:
- Excessive stiffness, pain, or swelling in your shoulders
- Difficulty moving your shoulder or performing daily activities due to pain
Some types of shoulder pain such as arthritis can cause permanent damage, which can be mitigated if caught early enough.
If you experience any of the following symptoms, reach out to your doctor immediately:
- You begin to experience a fever or chills
- If severe shoulder pain is constant for more than four days or intermittently for two weeks
- You start losing weight without reason
- You have excessive night sweats
It is important to have these symptoms checked as soon as possible as these can be symptoms of serious conditions that should be treated immediately.
Do you experience increased shoulder pain at night? If you’re ready to learn more about treatment options that could work for you, reach out to one of our pain specialists.
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3 Most Common Causes and How to Fix It – Health Essentials from Cleveland Clinic
Shoulder pain, stiffness or weakness can make it difficult to carry out everyday tasks, like reaching for something on a high shelf, driving a car or brushing your hair. If you have pain that won’t go away, it’s time to see a doctor.
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There are a number of possible causes of shoulder pain, but the most common causes of shoulder pain are rotator cuff injuries, rotator cuff tears and osteoarthritis, says orthopaedic surgeon Mark Schickendantz, MD.
1. Rotator cuff injuries
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, and connect the shoulder blade to the upper arm bone. Bursae, small sacs near the joint, provide lubricating fluid that decreases friction among the bones, tendons and ligaments.
Rotator cuff problems occur through overuse, and they include tendonitis, strains and partial and complete tears of the tendon.
Tendonitis is when the rotator cuff tendon becomes inflamed and irritated; bursitis is when the bursae swell. Tendonitis and bursitis cause pain in the front and side of the shoulder, and you might also feel some stiffness.
“These two conditions can occur with activities that involve using your arms overhead, like tennis, yoga or painting a room,” Dr. Schickendantz says. “Often the pain will be worse at rest and improve with activity.”
Treatment involves rest, applying ice, and taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which is sold under the brand names Advil and Motrin, or naproxen, which is sold under the brand name Aleve. After a few weeks, most people with tendonitis recover, Dr. Schickendantz says.
2. Rotator cuff tears
If you experience shoulder pain at night that makes it difficult to fall asleep or awakens you, you may have a tear in one or more of the rotator cuff tendons.
“Night pain is the hallmark of a rotator cuff injury,” Dr. Schickendantz says.
You also may have this type of injury if you feel pain when lifting your arm overhead and weakness in the shoulder when trying to lift anything above shoulder level.
A rotator cuff tendon can tear from a single event, like falling down on an outstretched arm. It also can happen from a motion that is repeated over time. For example, a plumber who frequently uses his or her arms overhead can develop a rotator cuff tear. The rotator cuff also can weaken with age.
Treatment is rest, avoiding aggravating activities, physical therapy, applying ice, and NSAIDs. Some people with more severe pain may be helped with a corticosteroid injection, which is a powerful anti-inflammatory medication.
“I usually reserve the use of corticosteroids for someone who has severe night pain and is not responding well to oral medications,” Dr. Schickendantz says.
Surgery to repair the rotator cuff tendon is an option if these measures don’t give relief.
Osteoarthritis happens when cartilage, which is the cushioning material that covers the ends of your bones, deteriorates, which leads to pain and stiffness.
Osteoarthritis causes a deep ache in the back of the shoulder. As osteoarthritis worsens, stiffness in the shoulder develops. People with osteoarthritis typically lose the ability reach behind their back.
“Patients often say they are unable to scratch their back or thread a belt,” Dr. Schickendantz says.
Osteoarthritis symptoms develop over time. For some people, an old shoulder injury from sports or some other activity, may kick off the degenerative process that years later results in osteoarthritis. But many people have no specific cause — it’s just wear and tear over time.
Treatment for osteoarthritis of the shoulder is similar to treatment for a rotator cuff tear, involving physical therapy, NSAIDs and ice. If the condition is severe, you can undergo shoulder joint replacement surgery, which is similar to joint replacement for hips and knees.
90,000 Pain and numbness in the fingers may indicate serious illness
Many people complain of numbness in their fingers and pain that wakes up at night and interferes with full work. However, not everyone goes to the doctor when the disease has not gone so far, and irreversible changes can be avoided. About what symptoms should cause concern, and in what cases surgical intervention is necessary, we talk with the orthopedic traumatologist of the Medical Diagnostic and Treatment Center Simonas SYAREIKA.
– What diseases of the hand and wrist are most often treated by patients?
– These are mainly diseases caused by pinched nerves – tunnel syndromes of the carpal and ulnar canals, as well as diseases caused by inflammation of the tendons – the so-called “clicking” finger and tenosivitis of the radius. Diseases of the joints, pain in the hand, and disorders of the subcutaneous structure are common.
The most common and well-known carpal tunnel syndrome is carpal tunnel syndrome.That is, compression of the median nerve under the transverse wrist ligament, which occurs between the three bony walls and the dense ligament that hold the tendons of the muscles that flex the fingers and hand. Carpal tunnel syndrome and diseases caused by inflammation of the tendons are more often diagnosed in women over 50 or in young people who are burdened with hard physical work. They cannot sleep at night due to numbness and pain in their fingers. During the holidays, these symptoms are most likely to improve. Pain in the wrist sometimes occurs after an injury, gradually worsens and begins to interfere with daily life.Ulnar canal syndrome affects both men and women over the age of 30. Dupuytren’s contracture (palmar fibromatosis) – a painless scarring and shortening of the palmar tendons – is inherited, more often observed in smokers, physically working men over 60 years old.
– How are the symptoms of these diseases different?
– With carpal tunnel syndrome fingers go numb at night, pain appears in 1-4 fingers, in the morning they are constrained.At the initial stage, the numbness after waking up disappears, with the progression of the disease it remains, and objects begin to fall out of the hands, it becomes difficult for the patient to button up the buttons, although at night there may be no pain at all.
Elbow syndrome most often manifests itself only in numbness of the fingers, less often in pain at night. 4-5 fingers are damaged. With the progression of the disease, the muscles of the palm weaken, strength goes away.
The main cause of stenosing tenosynovitis (“clicking” finger) is pain in the hand.The palm begins to hurt when the fingers move. The pain spreads to the forearm. With the progression of the disease, it becomes more difficult to unbend the finger, it “gets stuck”, a characteristic sound appears – a click, which gave the popular name to this disease. Sometimes the finger does not unbend at all, then it has to be returned to its place with the other hand. Snap finger syndrome is caused by a nodule in the extensor tendon. Most often, patients are damaged 1, 3, 4 fingers.
Dupuytren’s contracture is manifested by the inability to straighten the fingers, knotty compaction of the skin on the palms.At first it can be painful, then changes occur in the fingers – it is not possible to straighten them.
Hygroma of the wrist (hernia) is a small, rounded bulge under the skin. It occurs as a result of a sharp turn with a load or after a lot of physical exertion. Because of this formation, patients most often turn to a hand surgeon. A “bump” grows on the brush, it frightens people very much.
Diseases of the joints of the hand, wrists are very complex, so a thorough examination is necessary.
– What is the cause of this or that disease?
– The most common cause is excessive physical exertion or injury, as a result of which the tendons become inflamed, enlarged, begin to injure other tissues, pinch nerves. After an injury, the joints begin to wear out faster. Hormonal changes and, oddly enough, everyday habits also affect, for example, during sleep, take a pose with strongly bent arms, while working, constantly rest your elbows on the table, and for drivers – against the edge of the car door.The causes of some diseases are not fully understood.
– What symptoms should lead a person to a doctor?
– You should always consult a specialist if your fingers gradually or suddenly become numb – this is a sign of a pinched nerve, also if a neoplasm has appeared and it begins to grow. When a person does not go to a doctor due to diseases that manifest numbness of the fingers, night pains, the nerve is damaged more and more – the fingers lose sensitivity, the muscles of the hand begin to atrophy, the hands become weak, it becomes difficult to take small objects, the hands are afraid of the cold.In this case, even after the operation, the hand function may not fully recover. If the finger gets stuck and the disease progresses, even after the operation, movement may remain limited.
Very often it is difficult for patients to name clear symptoms, therefore conditions in which a nerve is pinched can remain undiagnosed for a long time. By contacting on time, the patient can receive qualified assistance. Very informative in these cases is a diagnostic study – electroneuromyography, which helps to establish the degree and amount of damaged tissues.
– What is the tactics of treating the listed diseases?
– At the initial stage, these diseases are treated conservatively. If this does not help, the doctor decides if surgery is required. It is important that the patient presents on time. Operations carried out in a timely manner are simple and very effective. When the disease gets far, the effectiveness of the operations is not so high.
Conservative treatment carpal tunnel and ulnar canal syndromes is reduced to reducing physical exertion on the arm, prescribing non-steroidal anti-inflammatory drugs, B vitamins that improve blood flow and nerve nutrition, vasodilating drugs, splints. Electroneuromyography helps diagnose these diseases and determine the treatment tactics.
Most often I start the treatment of the “snapping” finger with hormonal blockade by Kenalog. In the treatment of tenosynovitis , a splint, hormonal blockade is prescribed. A neoplasm – in the case of hernias of the wrist, finger joints, tendons – is punctured. Changes in the wrist joints are treated with splints, anti-inflammatory drugs, physiotherapy, and joint injections.
– When is surgery necessary?
– Always with Dupuytren’s contracture , in other cases – if the methods of conservative treatment do not help, and the symptoms persist or progress.
The operations are compensated by the Health Insurance Fund, so the patient can not wait in line and go to any clinic that can carry out such an operation, for example, to our Center. After all operations, the patient is discharged home the same or the next day.The main thing is not to hesitate at the first symptoms in order to prevent serious diseases.
For all questions, please contact your personal manager
Beate Putramenete by phone: +370 687 99 342 (Russia, Viber, WhatsApp) or by email. by mail: [email protected], as well as by the general number of the department for the reception of foreign patients: +370 5 247 63 69
90,000 “Growing pains in children: what should parents do?”
Dr. Ivanov on why a child has joint pain
Due to joint pain, the child may sleep poorly, wake up and cry.The pain most often comes in the evenings or at night, it is very intense and disappears imperceptibly after half an hour. At the same time, no inflammation is found in the body. Things like this can happen to children up to about 11 years old, and doctors call it growing pains. In his new article for “BUSINESS Online”, doctor-osteopath Alexander Ivanov will tell you what growth pains are, what are their causes and what parents should do.
Joint pain may cause a baby to sleep poorly, wake up and cry
WHAT IS GROWTH PAIN
“Why does my child have joint pain?” – I often hear this question at a reception from parents whose children are from 4 to 11 years old. Moreover, the pain appears suddenly, usually in the evening, it can be intense and go away on its own. The child was examined for inflammation, such as arthritis, and, naturally, nothing was found. Most often, such pains are caused by excessive afferent impulses (feedback from the brain) from the tendons and ligaments of the muscles.Simply put, it is the pain of growing.
Joint pain can cause restless sleep in a child. This is usually benign pain that occurs at night. During the day, she does not appear – the main diagnostic criterion by which it is possible to separate growth pains from other, possibly dangerous, diseases. Usually the child wakes up at night, he cries, complains of pain in the legs. The pain can appear on one side or symmetrically on both sides, affecting the muscles of the legs and thighs. The duration of such pain is from several minutes to half an hour.
WHY GROWTH PAINS ARE IN CHILDREN
Most often, such pain occurs in physically active children. In the daytime, the child is as active as possible, and the information from the tendons and muscles is, as it were, lost in the flow of another in the brain. At night, when the child is resting and the flow of incoming information becomes less, pain impulses reach the central nervous system and pain appears, which prevents him from sleeping.
VITAMIN D DEFICIENCY AS A CAUSE OF GROWTH PAIN
Vitamin D deficiency can also be a cause of growing pain, as reported by many publications in the scientific literature.I also wrote about this fact in my blog. Let me remind you that in our country there is a total vitamin D deficiency in both adults and children. In order to identify its deficiency, you need to donate blood for analysis. According to the latest recommendations from pediatricians, children should be given vitamin D right from birth. Prophylactic dosages of vitamin D are 400-600 IU for children, for an adult – 1000-2000 IU daily.
Baby’s nutrition can also contribute to growing pains.
A child’s diet can also contribute to growing pains. Meals should be varied, be sure to include meat, fish, lots of vegetables and fruits. You should limit carbohydrates in the form of confectionery, flour (baked goods, bread) and sugar.
With a deficiency of vitamins and minerals in the body, growth pains may increase. For the prevention of hypovitaminosis, after agreement with the pediatrician, vitamin and mineral complexes should be given twice a year – in the autumn-spring period. It is important to monitor the child’s drinking regime – to give clean drinking water every day. You should also avoid consuming sugary carbonated drinks and coffee.
WHAT TO DO FOR PARENTS
If pain occurs, you should consult a pediatrician, especially if it is prolonged, observed during the day and is accompanied by lameness. First aid for growing pains is to calm the child down, to do a light massage of the limbs. If the pain is severe, age-related ibuprofen can be used.
I recommend showing the child to an osteopath, because there may be other causes of pain in the lower extremities, for example, associated with the problem of the feet (planovalgus placement of the feet, flat feet). Also, an osteopathic doctor will rule out other functional causes of pain. Growth pain may go away after osteopathic correction.
Ivanov Alexander Alexandrovich – Candidate of Medical Sciences, osteopath, neurologist, naturopath, member of the Russian osteopathic association, popularizer of a healthy lifestyle and a conscious approach to health.
The opinion of the author may not coincide with the position of the editorial office
Photo at the announcement: “BUSINESS Online”
90,085 The views of the blog authors do not necessarily reflect the views of the editors
90,000 Growing pains – SCCH
What is growing pain?
Growth pain – clinically insignificant pain in the legs.
How common are growing pains?
50% of children experience pain in the legs at any age.Leg pain usually occurs around the age of 4, but it is most common between the ages of 6 and 11.
Why do growing pains occur?
The condition is often hereditary.
The best explanation for the mechanism of growth pain is the stretching of the muscles and tendons with a rapid increase in the length of the leg bones.
During the day, the child is active and the information that his brain receives from the tense muscles and tendons is lost in the flow of information from many other events. At night, when the child falls asleep, and there are no distractions, pain impulses that come from tense muscles and tendons reach the higher nerve centers and the child wakes up from pain. Therefore, this condition is observed during the period of the most intensive growth of the child and after days of high physical activity.
Are growing pains dangerous?
Growing pains can cause anxiety for both parents and the child, especially when painful episodes are repeated several nights in a row.
How are growing pains manifested?
Growing pains never appear during daytime.
Regardless of the severity of the nocturnal pain attack, if these are pains of growth, then in the morning the child always feels good / great.
Most often, the muscles of the legs and hips, the area of the knee joints hurt. The upper limbs are rarely affected. The child may also have a headache or abdominal pain.
The child wakes up unexpectedly at night against the background of deep sleep and complains of pain in the leg. Parents immediately understand that the child has a health problem because he wakes up and cries in bed. Most often, these episodes occur several hours after the child has fallen asleep, but sometimes the child can wake up in the middle of the night. In typical manifestations, the child shows that he or she has pain in the knee – front or back, or pain in the muscles just above the knee. Usually, the pain disappears after ten or fifteen minutes with a light massage and does not remind of itself in the morning. In most cases, growing pains hurt large joints, such as the knee, rather than the fingers or toes.Sometimes a child may wake up in pain for several nights in a row, but more often such episodes happen from time to time – over several weeks or several months. Growing pains often appear after days when the child was especially physically active. They may disappear for several months or years and then reappear during a period of particularly rapid growth.
How is growing pain diagnosed?
Any child who has pain in the morning or during the day requires a complete medical examination.
It is necessary to assume another cause of the pain syndrome if the child has the following manifestations:
- prolonged pain in one limb
- combination of pain with lameness and / or general disorder
- symptoms occur in the morning or during the day
If atypical signs appear, it is necessary to consult a pediatrician, conduct at least a general blood test and determine the level of ESR.
Clinically insignificant leg pains (so-called “growing pains”) are diagnosed on the basis of clinical manifestations after arthritis has been ruled out.In children under 4 years of age, a different disorder should be assumed. It is necessary to assess the psychosocial background, especially in the presence of other manifestations (headache, abdominal pain). Recurrent limb pain without organic causes occurs in children during the growth period.
The main point in assessing growth pains is that in the morning after waking up, the child feels absolutely healthy.
What methods of treatment and prevention of growing pains are available?
In most cases, light massage and conversation is enough to get the child to sleep.Children with more severe pain often stop complaining after taking the usual dose of acetaminophen or ibuprofen at the average dosage for age. If the child wakes up for several nights in a row, in this case, pain reliever can be given before the child goes to bed. This will reduce pain sensitivity, so the child can sleep through the night peacefully. After two or three nights without pain, you must stop giving the child the medicine.
90,000 My child has joint pain. What to do?
Illustration by Roman Zakharov specially for Informburo.kz
Did your child wake up at night with pain in his knee or feel aching pain in his arm or leg, although he has not received any injuries or bruises? Don’t be in a hurry to panic. Many parents face this. We will show you how to distinguish growing pains from dangerous diseases.
Can joints hurt if there were no injuries?
Yes, they can. Often, joint pain occurs in children during periods of active growth. Pain may even be regular, but does not always require medication.There are also more serious causes, such as arthritis or cysts. With such diagnoses, medical attention is indispensable.
How do you know if your child needs medical attention?
Pay attention at what time of day and under what circumstances the child has joint pain. If he was active during the day, did not complain about anything, and felt pain in the evening or at night, it is likely that these are growing pains. Typically, children experience them between the ages of three and five and between the ages of nine and twelve. Growth pains in the joints begin when the child calms down.
Pain from active growth sounds strange. Why is this happening?
Doctors explain the phenomenon of growth pain by uneven growth of bones, joint capsules and tendons. Pain occurs when bone growth outpaces tendon growth. Pulling on the tendons causes discomfort in the muscles of the lower legs and thighs, or in the area of the knee joints. The upper limbs rarely hurt for the same reason. But keep in mind that there should be no redness, stiffness or high temperature due to growing pains.Otherwise, it’s best to see a doctor right away.
Even if it’s not dangerous, I don’t want my child to feel bad. How to help?
Simple stretching exercises for the tendons before bed can help get rid of joint pain. Ask your child to rest their hands on something solid, such as a wall, lean forward without lifting their heels off the floor, and stretch. If the pain wakes the baby up at night, a gentle massage of the sore spot and a soothing conversation will help. A warm heating pad or a sheet can be applied to the sore spot; it is enough to put on a warm sock on the foot.
Roman Zakharov for Informburo.kz
The pain subsided, but did not go away.
What else can you do?
Then ibuprofen or paracetamol in a dosage appropriate for the child’s age may help. For children who regularly wake up from pain in the middle of the night, it is better to give medicines before bedtime. How many days and in what dosage the baby should take the medicine, the doctor will tell you exactly. Another option is to smear the sore spot with an ibuprofen-based gel. It relieves inflammation and relieves pain.If the usual methods of treatment do not help within 5-7 days, doctors recommend examining the child.
When is it best to seek medical attention right away?
Complaints of pain in the morning or during the day are a good reason to consult a pediatrician or general medical practitioner. Perhaps a small patient will be advised to donate blood for calcium in the body. The growth and density of bones depends on this chemical element. Also, doctors may advise you to check the concentration of vitamin D.It is responsible for the regulation of calcium metabolism and is presented in two main forms: cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2). The first is produced by the body itself, and the second is obtained from food. Lack of vitamin D in fast-growing young children leads to rickets, a disease of the bone and nervous systems caused by metabolic disorders.
And if everything is in order with vitamin D and calcium. What else can cause joint pain in children?
In children from one to four years, arthritis can be the cause of pain.It depletes cartilage and narrows the space between joints. Arthritis often manifests itself through lameness, stiffness, lethargy, and redness of the joints. In older children, 7-8 or 12-14 years old, the cause of pain can be a cyst, which causes inflammation of the bone. The disease is difficult to diagnose, because it feels like it’s just bearable pain. A hollow tumor severely thinns the bone. Usually it is detected simultaneously with a fracture, which is easy to earn out of the blue. A timely x-ray of the affected limb will help to avoid this.
The author thanks the neuropathologist Konstantin Pushkarev for help in preparing the material.
Why joints hurt and what should be done at the same time
Why joints hurt and what to do at the same time
Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the correct treatment is started, the greater the success of the therapy.
Arthritis is considered “early” if the diagnosis is made within 6 months of the first symptoms of the disease. There are early arthritis clinics in a number of European countries.
Symptoms of arthritis are: joint pain, joint swelling, stiffness of movement, local increase in soft tissue temperature around the joint. Common symptoms such as weakness, fever, weight loss are possible. For a timely diagnosis and the appointment of the correct treatment, the patient should consult a specialist doctor – a rheumatologist.
Unfortunately, due to the widespread advertising of non-traditional methods of treatment, patients often turn to chiropractors, osteopaths, homeopaths – and time is lost. In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease are called the “window of opportunity” – this is the time when correct treatment can lead to persistent and long-term remission.
Now let’s talk about the symptoms of the most common rheumatological diseases.
Osteoarthritis is the most common joint disease that usually occurs in people over 40-45 years old.Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). With nodular osteoarthritis, there is a lesion of the interphalangeal joints of the hands (pain and deformity).
The main clinical symptom in osteoarthritis is pain in the affected joint during exertion. With arntrosis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when walking on stairs (especially when descending), when carrying weights. In addition to pain, the patient is worried about limitation of movement in the joint, crunching during movement.
Sometimes there is a swelling (effusion) of the knee joint (it can be swollen behind, under the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: pain appears at rest, not associated with exertion.
Rheumatoid arthritis usually affects middle-aged women.The most characteristic symptoms are symmetrical (on the right and left extremities) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pains are more troubling in the morning. It is difficult for the patient in the morning to clench his hand into a fist, raise his hand (comb his hair), step on his feet (due to pain under the “pads” of the toes). Joint pains are accompanied by a characteristic symptom – “morning stiffness”.
Patients describe morning stiffness as a feeling of “swelling, stiffness in the joints”, “hands with tight gloves. “In addition to articular syndrome, rheumatoid arthritis is characterized by such general symptoms as weakness, weight loss, weight loss, sleep disturbance, and fever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if diagnosed late and improperly treated. Often the disease begins gradually, often with arthritis of one joint, then other joints “join”.
In order to use the “window of opportunity” and promptly start treatment for persistent arthritis (2-3 weeks), especially for arthritis of small joints, it is necessary to consult a rheumatologist.To confirm the diagnosis, immunological tests, radiography, and MRI are used.
This is a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel diseases, reactive arthritis (associated with urogenital or intestinal infection), undifferentiated spondyloarthritis.
This group of diseases is united by common genes and common clinical symptoms.Spondyloarthritis usually affects young people (up to 40 years old). Spondylitis is an inflammation of the joints of the spine. Often, the first symptoms of spondylitis are pain in the lumbosacral region, alternating pain in the buttocks (sometimes on one side or the other). These pains are inflammatory in nature: they increase in the second half of the night or in the morning, decrease after a warm-up, do not go away at rest, are accompanied by morning stiffness in the spine. Spondyloarthritis often affects the hip joints (the first symptom is often groin pain).
Spondyloarthritis is characterized by the presence of asymmetric arthritis, mainly in the joints of the lower extremities. Unfortunately, the correct diagnosis is often made 8-10 years after the onset of the disease, especially when the patient has pain in the spine, but no arthritis.
These patients are followed for a long time by neurologists and chiropractors with a diagnosis of osteochondrosis. For a correct diagnosis, an additional examination is necessary: MRI of the sacroiliac joints, X-ray of the pelvis, blood test for the presence of a specific gene.
Men get gout about 20 times more often than women. Gout develops mainly during the fifth decade of life.
The “classic” symptom of gout is paroxysmal arthritis, usually of the I (big) toe. Arthritis occurs acutely, more often at night or early in the morning, after a heavy meal, drinking alcohol, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot step on his foot, does not sleep at night because of the pain, the pain intensifies even when the joint is touched with a blanket).In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack disappears after a few days (at the onset of the disease – even without treatment).
In the majority of patients, the second “attack” of gout is observed in 6-12 months. In the future, there is a gradual increase in the frequency of “attacks” of arthritis, there is a tendency for their more protracted nature.All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofuses (nodules with a significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased levels of uric acid. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease.This requires a comprehensive examination and treatment.
Older persons (after 50 years of age) get sick. At the peak of the disease, pain and limitation of movement are characteristic in three anatomical areas: in the shoulder girdle, pelvic girdle and neck. It can be difficult for the patient to determine what is hurting: joints, muscles or ligaments.
In polymyalgia rheumatica, the patient’s general condition suffers, often there are symptoms such as fever, weight loss, loss of appetite, poor sleep, depression.There is a marked increase in ESR.
Patients usually undergo a thorough cancer screening. If the patient does not consult a rheumatologist, then the appointment of the correct treatment is “postponed” for a long time. It should be noted that joint pain and arthritis are also a symptom of more rare diseases of the rheumatological profile – diffuse connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren’s disease, Behcet’s disease, systemic vasculitis).
There is a whole group of diseases of extra-articular soft tissues, the so-called “periarthritis” (tendinitis, tendovaginitis, bursitis, enthesopathy).
Changes in soft tissues can be one of the manifestations of systemic diseases, but much more often they occur as a result of local overloads, microtraumas, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injuries and require surgical intervention.These problems are dealt with by orthopedists.
Osteoporosis can be a complication of chronic joint diseases. Densitometry is required to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatologic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.
In conclusion, I would like to note once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. Treatment of articular pathology should be complex and differentiated. With the correct, timely diagnosis, treatment will be more successful.
In the Multidisciplinary Professorial Medical Center “Vascular Clinic on Patriarch’s” you can get advice from a highly qualified rheumatologist with extensive experience in the leading scientific rheumatological organization of the USSR and Russia, Candidate of Medical Sciences Elena Efimovna Gubar.We can also carry out all types of laboratory tests, including immunological, biochemical, general, and genetic tests.
In our own pharmacy, we sell all the drugs necessary for the treatment of joint diseases.
We will be glad to see you from the clinic.
Growth pains: the main thing is that both legs hurt at night
Photo from health.qld.gov.au
Where do they come from?
The term “growth pains” itself is conditional.Why?
There is an established medical fact: many children 3-4 years old experience evening or night pain in the legs. After some time they pass, and then come back again at the age of 6-12 years.
But as for the cause of these pains, there is no firm certainty, but only a hypothesis. Presumably, they appear during periods of active growth of the child. The bones of the legs increase in length rather quickly, which causes tension in the muscles and tendons, hence the pain.
The second hypothesis is that the child’s daytime activity – running, jumping, climbing, other outdoor games – puts a lot of stress on the leg muscles, so they can hurt in the evening or at night.
This hypothesis is supported by the fact that 50% of children have pain in the legs at any age. However, not everyone grows at the same rate, so pains, if they are still caused by growth, can have their own age calendar for each child.
There is one more hypothesis.Some experts suggest that this kind of pain is present in those children who develop restless legs syndrome as they get older.
A person experiences discomfort in the lower extremities, most often in the evening and at night. The patient constantly changes the position of the legs, cannot calm down and fall asleep. The origin of this disorder is still not very clear.
One way or another, the phenomenon of children’s nocturnal pains in the legs was named “growth pains”.
How do they manifest?
Photo from consumerlab.com
Most often, the child has pain in the muscles of the legs and hips, knee joints. Sometimes it can cause a headache or abdominal pain.
In different children, these pains can have a different frequency: one they bother every night for a long period of time, the other they happen only occasionally.
Some of the legs hurt more often in the evening, while going to bed and interfere with sleep, others wake up pain in the middle of the night, the child begins to cry in bed.Most often, such episodes occur several hours after falling asleep, although an attack of pain is quite possible in the middle of the night. Typically, children complain of pointing to the knee in front or behind, just above the knee, or to the lower leg.
Usually an attack of pain lasts 10-15 minutes, and the next morning and further during the day does not remind of itself at all.
Sometimes a child wakes up for several nights in a row, but more often such pain attacks occur only from time to time for several weeks or months, then disappear for a while.Subsequently, they can resume.
How to understand that these are growth pains, and not some serious disease?
Photo from medicalnewstoday.com
The main symptom, as mentioned above, is that the pain bothers at night or in the evening, and the child feels normal in the morning and afternoon.
The second important symptom is pain in both limbs at the same time. If only one leg hurts, a different diagnosis should be assumed.
Another feature of growth pains: large joints (knee) hurt, not toes.
And, recall again, if a child is younger than three (and some experts believe that it is four) years old, then another explanation should also be sought for pain in the legs.
Growth pains are not dangerous, however, it is better to show the child to the doctor. With growing pains, the doctor examining the patient will not see anything alarming. In this case, analyzes and X-rays will be redundant.
When should I see a doctor?
- As mentioned above, if a toddler up to 3 (4) years of age complains of leg pain.
- If a child has prolonged pain in one limb.
- If pain in the legs is combined with lameness or a noticeable deterioration in general condition, fever.
- If a child complains that it hurts to walk.
- If the joints are swollen, and the skin at the sites of pain is reddened.
- If pain is accompanied by weakness, weight loss.
- If pain is accompanied by a rash.
For these symptoms, the pain may be caused by arthritis or an infectious disease.
In case of any doubt, it is still better to show the child to the doctor.
How to help a child suffering from growing pains?
Photo from parenting.firstcry.com
There are several ways to relieve pain.
First of all, you need to show attention and sympathy to the child. He needs to explain that nothing terrible is happening, the pain is not dangerous and will soon pass. Often this and light massage alone is enough to calm down the child and fall asleep.
Heat is a very effective way.It can be a heating pad, a warm bath, a compress, rubbing with a warming ointment (a doctor will help you choose it). Some experts recommend applying mustard plasters to the caviar for a very short time, although recently medicine has been somewhat skeptical about this good old way.
In any case, they should not be placed on children under 6 years of age, with very sensitive skin, a tendency to allergic reactions, or if the skin is damaged.
Some children can help relieve pain by jumping around the room or stretching.
Pain relievers – paracetamol or ibuprofen – is the most extreme measure. Both drugs are not harmless, and it is worth resorting to them only if the child is suffering very much, and other measures do not help in any way.
Just in case, check with your doctor ahead of time to find out what dose of pain reliever is right for your child. Do not give these drugs prophylactically under any circumstances, but only as needed.
90,000 Muscle pain: causes and symptoms.Diagnostics, prevention and treatment
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Causes of pain
Symptoms of muscle pain
Distinguish between acute and chronic myalgias
Muscle pain or myalgia is one of the common reasons for seeking medical attention 1 .About 30% of patients at a doctor’s appointment complain of pain, which is often associated with skeletal muscles 2 . This is because the muscular system is one of the largest in the human body. In total, there are more than 600 muscles in the human body 3 , their mass is 35-40% 3 of the total weight, and in a certain category of people, for example, athletes, this figure can reach 60% 3 .
Muscles are divided according to the type of structure into skeletal, which make up most of the muscle mass, and smooth, mainly represented in the muscles of the internal hollow organs (stomach, intestines, bronchi, vascular wall).
Causes of pain
It can be quite difficult to determine the cause of muscle pain, since myalgias can be caused not only by the pathology of the muscle itself, but often become a mask for other diseases – rheumatic, endocrinological, infectious and neurological 1 .
Main causes of muscle pain 1 :
- Injury: contusion, sprain, rupture, muscle separation. It is especially common in sports, usually does not pose a direct threat to life, is not always diagnosed in a timely manner and can lead to complications in the form of hematomas, inflammation, and the development of contractures.and have a clear localization.
- Excessive physical exertion, especially if the muscles are not warmed up or poorly trained. This is soreness or delayed muscle soreness, weakening after a maximum of 7 days.
- Rheumatic and systemic diseases (polymyalgia rheumatica 5 , fibromyalgia, osteoarthritis and others). They are characterized by damage to the musculoskeletal system and connective tissue, intense and stiffness of movements, especially in the area of the shoulder girdle, neck and back.
- Inflammatory processes in muscle tissue – myositis 7 . They can be infectious (enterovirus infection, toxoplasmosis, tuberculosis) and non-infectious origin.
- Taking certain drugs (eg statins to lower cholesterol 8 ). The severity of these symptoms can range from discomfort and minor pain to inflammation (myositis) and even death of muscle fibers (myonecrosis). Similar symptoms develop in 3-5% of patients 8 and often become the reason for refusal of further treatment with drugs of this group.
- Toxic effect, including viral. In these cases, the symptoms characteristic of viral infections come to the fore: fever, sore throat, nasal congestion, cough, etc. Muscle pain can be an indicator of the severity of the disease.
- Neurogenic pains (myopathies). Chronic, sometimes severe muscle pain, which is complemented by muscle weakness and other neurological manifestations.
- Electrolyte disturbances (lack of potassium, magnesium). A deficiency of trace elements can lead to impaired transmission of nerve impulses to muscle fibers, their pathological contractions, and as a result, pain.
- Vascular pathology. With circulatory disorders, the muscles suffer from a lack of oxygen.
- Endocrine diseases and metabolic disorders. In hypothyroidism, one of the symptoms is swelling, which can cause muscle pain.
- Hypothermia or mechanical stress associated with poor posture, maintaining a non-physiological posture, skeletal asymmetries 11 .
- Stress. Anxiety that accompanies stressful situations leads to muscle spasm, a decrease in the pain threshold and the formation of chronic pain syndrome 11 .
One of the most common problems is back pain. At the same time, the role of osteochondrosis of the spine is often overestimated and most of the pain manifestations are of muscle or myogenic origin 9 and are associated with the involvement of soft tissues, that is, muscles, fasciae – muscular membranes – or ligaments in 99% of cases 10 . Experts combine this phenomenon into myofascial pain syndrome, which has its own characteristics of the course and requires a special approach to treatment.
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Muscle pain symptoms
Patients describe the most typical muscle pain as 10 :
Most often, the cause of muscle pain is associated with increased stress, which can lead to microtrauma, spasm or increased tone. After rest, muscle pain can resume, which distinguishes them from joint pain 10 .
Such sensations may be accompanied by stiffness during movement. Those muscles that are in tension for a long time, for example, “static”, that is, those that are involved in maintaining a certain posture or body position, can give stronger pain sensations, they are most often found seals and soreness during examination.
Muscle pain can be local or widespread, it can also have zones of reflection (irradiation), sensitivity disorders can accompany it 10 , especially when the pain is related to myofascial syndrome (MFS).
Additional criteria of the IFS: limitation of range of motion, tight muscle cord, reflected pain.
With an increase in temperature and pain in the muscles, inflammatory processes usually occur – myositis, including those of rheumatic origin, as well as viral infections – influenza, Coxsackie virus and others.
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Distinguish between acute and chronic myalgias
Acute pain is most often observed with injuries, overloads, infectious diseases.It can have different intensity – from mild to pronounced, usually disappears in 2-7 days.
Chronic pain can last for more than a month and usually indicates the development of myofascial syndrome.
These degrees of muscle pain are distinguished 9 :
1 degree . Local or local pain that manifests itself only when the muscle is exposed to pressure or stretching. On palpation, a seal can be found, and in response to palpation, there may be slight convulsive twitching.Muscle strength is normal.
2nd degree . The pain is spontaneous, pulling, throughout the muscle, the corresponding skin zones with increased pain activity are found. Muscle strength may decrease slightly, by about 25% 9 .
3rd degree . Spilled severe pain at rest, a whole group of muscles is involved, their strength is reduced by 30% or more.
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The diagnosis and the choice of treatment depend on what kind of muscle pain is observed in the patient.The main diagnostic criteria for myogenic, that is, having a muscle origin, pain are:
- seal, which manifests itself by changes in shape, size, configuration, length and consistency,
- increase in contractile activity, especially in response to palpation,
- impaired coordination between individual muscle groups.
It is not always easy to identify a specific lesion in the muscles, therefore, a thorough interview and examination must be carried out.
So, myogenic pain in the area of the muscles of the shoulder girdle can be manifested by pain in the temples, a feeling of a “heavy” head, loss of balance, painful sensations in the shoulder joint even at night, at rest 9 .
For the diagnosis of myalgia, laboratory and instrumental examination methods are prescribed.
Laboratory Methods 1 :
- general detailed blood test: changes in the leukocyte formula, erythrocyte sedimentation rate can indicate the presence of an inflammatory process, a decrease in hemoglobin (anemia) can also cause muscle pain;
- blood test for electrolytes and trace elements: potassium, magnesium, iron, calcium and others 7 ;
- determination of acute phase parameters (C-reactive protein) – their increase speaks in favor of rheumatic diseases;
- determination of the level of thyroid hormones to exclude hypothyroidism;
- immunological tests – to detect autoimmune processes in the body;
- determination of the level of specific “muscle” enzymes – CPK (creatine phosphokinase) 1 , when muscle cells are damaged, CPK enter the blood and the indicator turns out to be increased.
CPK is one of the important indicators for the diagnosis of myalgias.
Distinguish between myalgias with and without increased creatine phosphokinase activity.
The first include: inflammation of muscle tissue (myositis), toxic damage, trauma, the consequences of excessive physical exertion.
Of the instrumental methods, ultrasound and myography are used 1 .
Most often, chronic myalgias in myofascial syndrome require differential diagnosis with rheumatic and systemic diseases, such as polymyalgia rheumatica and fibromyalgia 1 .
Polymyalgia rheumatica is mainly diagnosed in people 55-60 years old.
- prolonged fever, weight loss,
- minor joint pain,
- a sharp increase in laboratory parameters such as C-reactive protein and ESR;
- muscle pain localized in the area of large joints, neck, thighs, observed constantly,
- there is no weakness with muscle pain;
- significant improvement occurs after prescribing even small doses of hormonal drugs (glucocorticoids) 1 .
Features of Fibromyalgia :
- women from 40 to 60 years old are more likely to suffer;
- pain, symmetrical, constant, extending to several muscle groups, ligaments and bones;
- is always accompanied by psychological disorders: anxiety, depression;
- improvement occurs with antidepressant medication.
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Treatment of muscle pain is always complex with a combination of medication and non-medication methods and must take into account the cause.
How to relieve muscle pain: general principles 1 :
- Rest the affected muscle.
- Use local anesthetic.
- Take non-steroidal anti-inflammatory drugs internally and locally in the form of gels, ointments, creams.
- Use hot, wet compresses and wraps.
- Do physical therapy: exercises for gentle stretching and muscle relaxation.
- Go for a relaxing massage.
- Treat the underlying disease or correct electrolyte and vitamin deficiencies.
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The action of drugs for myalgia should be aimed at reducing pain, relieving spasm and inflammation 1 . To do this, first of all, drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed, including Motrin®.
Motrin® is available as an oral tablet.The drug is indicated for muscle pain associated with inflammation, trauma, overload. It has analgesic, anti-inflammatory and antipyretic effects that can last up to 12 hours 12.13 . If you do not have the opportunity to visit a doctor in the near future, and the pain causes significant discomfort, then you can take Motrin® as follows: 2 tablets as a starting dose and then 2 tablets every 12 hours or 1 tablet every 8 hours. The course of admission without consulting a doctor, no longer than 5 days.If the intensity and nature of the pain does not change, then you must immediately contact a specialist (therapist, traumatologist, rheumatologist) to find out the cause of myalgia and complete treatment.
How else to get rid of muscle pain?
Folk remedies are most often used for chronic pain syndrome. Most of them are associated with distracting procedures, have an irritating or warming effect 11 . Such irritants can be: capsicum, essential oils of pine, fir, eucalyptus, mint and others.Also used are products based on bee and snake venom 11 . When applied to the skin, a feeling of warmth or burning sensation occurs, which can distract from the painful sensations.
When using such methods, it should be remembered that these methods are not a treatment for the cause of the disease, but can help to temporarily relieve symptoms a little due to the irritating effect.
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For the prevention of myalgias, it is necessary to strengthen the muscle frame, perform stretching and relaxation exercises 2 .This effectively protects against microtrauma and sprains. In case of chronic muscle pain, a change in lifestyle may be necessary: revision of load, physical activity, change of occupation, prevention of stress, changes in diet to correct the deficiency of vitamins and trace elements.
Periodic massage courses also help maintain muscle tone.
Any muscle pain that is not associated with a specific injury or overload should be a reason for seeking medical attention and careful diagnosis, as it can mask many serious diseases.
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The information in this article is for reference only and does not replace the professional advice of a physician. Consult a qualified professional for diagnosis and treatment.
- N.A. Shostak. Myalgia: approaches to differential diagnosis, treatment. Modern rheumatology, 2013, No. 3, p.21-24.
- O. V. Vorobyova. Back and limb pain in the practice of the therapist (focus on non-inflammatory myalgias).Outpatient doctor’s reference book. 2014; 06: 6-12.
- I.V. Gaivoronsky, G.I. Nichiporuk, A.I. Gaivoronsky. Human Anatomy and Physiology, 6th Edition. Textbook. Moscow. Publishing Center “Academy”, 2011, 498s.
- Prof. Francisco Biosca Director of the Department of Medicine and Sports Adaptation of FC Shakhtar (Donetsk, Ukraine). Muscle injuries. Actual aspects of sports medicine, Moscow, 2009. P.48-55.
- I.B.Bashkova, E.I.Buslaeva. Polymyalgia rheumatica: a rarely diagnosed but common condition.RMJ “Medical Review”, No. 1, 04.12.2017, p.48-52.
- G.A. Ivanichev. Pathogenetic aspects of the formation and manifestation of classic muscle pain syndromes. Manual therapy, 2009. No. 3 (35), pp. 3-12.
- T.A. Zakharycheva, A.S. Shirokova, N.V. Levun, M.V. Lazareva. Myogenic pain in the practice of a doctor. Far Eastern Journal of Infectious Pathology, No. 34, 2018. P.84-88.
- M.G. Bubnova *. Adverse Effects of Statin Therapy: Real Evidence.