Upper right arm pain at night. Arm Pain at Night: Causes, Symptoms, and Effective Treatments

14.08.202307.07.2023 by alexxlab

What causes arm pain at night. How to identify the underlying conditions. When should you seek medical attention for nighttime arm pain. What are the most effective treatments for relieving arm discomfort during sleep.

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Common Causes of Nighttime Arm Pain

Experiencing arm pain at night can be a frustrating and sleep-disrupting issue. Understanding the underlying causes is crucial for finding effective relief. Here are some of the most common reasons for nighttime arm discomfort:

Cervical disc problems
Cervical stenosis
Rotator cuff injuries
Bursitis
Thoracic outlet syndrome (TOS)
Referred pain from other conditions
Autoimmune diseases

Each of these conditions can manifest differently, making it essential to pay attention to specific symptoms and patterns in your arm pain.

Cervical Disc Issues: A Major Culprit in Nighttime Arm Pain

Cervical disc problems are a frequent source of arm pain that worsens at night. The cervical spine, consisting of seven vertebrae, relies on intervertebral discs for shock absorption and flexibility. When these discs become damaged or degenerate, they can irritate or compress nearby nerves, leading to various symptoms:

Pressure-like sensation in the arm muscles
Numbness or tingling
Electrical sensations radiating down the arm

Are certain sleeping positions more likely to aggravate cervical disc-related arm pain? Sleeping on your stomach or with your head elevated too high can increase pressure on cervical discs, potentially exacerbating nighttime symptoms. Experimenting with different sleep positions and using supportive pillows may help alleviate discomfort.

Cervical Stenosis: When Spinal Narrowing Leads to Arm Discomfort

Cervical stenosis occurs when the spinal canal in the neck narrows, potentially compressing the spinal cord and nerve roots. This condition can result from various factors:

Trauma to the cervical spine
Spinal instability
Disc protrusions
Overgrowth of facet joints
Thickening of spinal ligaments

How does cervical stenosis specifically contribute to nighttime arm pain? As you lie down, changes in spinal alignment and pressure can exacerbate nerve compression, leading to increased arm discomfort. Additionally, reduced movement during sleep may cause stiffness and heightened pain perception.

Rotator Cuff Injuries: A Common Source of Shoulder and Arm Pain

The rotator cuff, comprising four tendons that support and stabilize the shoulder joint, is susceptible to various injuries. These can result in persistent arm pain, often worsening at night. Factors contributing to rotator cuff injuries include:

Trauma
Overuse
Impingement
Age-related degeneration

Why do rotator cuff injuries often cause more pain at night? Lying down can increase pressure on the affected tendons, particularly when sleeping on the injured side. Additionally, the absence of daytime distractions may heighten pain awareness. To mitigate nighttime discomfort, consider using a supportive pillow to maintain proper shoulder alignment while sleeping.

Bursitis: Inflammation that Disrupts Sleep

Bursitis involves inflammation of the bursae, small fluid-filled sacs that reduce friction between tissues in joints. In the context of arm pain, shoulder and elbow bursitis are particularly relevant. Nighttime symptoms can be especially pronounced due to:

Increased pressure on bursae when lying down
Reduced movement during sleep, leading to stiffness
Changes in circulation and inflammation levels at night

How can you differentiate bursitis from other causes of nighttime arm pain? Bursitis often presents as a dull ache or burning sensation, typically worsening with movement or pressure on the affected area. Unlike some other conditions, bursitis pain may be more localized to a specific joint area.

Thoracic Outlet Syndrome: When Nerves and Blood Vessels Are Compressed

Thoracic Outlet Syndrome (TOS) occurs when nerves, arteries, or veins in the lower neck and upper chest area become compressed. This can lead to various symptoms affecting the arm, particularly at night:

Pain in the lower neck, collarbone area, arm, and hand
Numbness or tingling sensations
Weakness in the affected arm
Discoloration or temperature changes in the hand

Why might TOS symptoms worsen at night? Sleep positions that involve raising the arms above the head or compressing the chest and shoulder area can exacerbate nerve and blood vessel compression. Adjusting sleep posture and using supportive pillows may help alleviate nighttime TOS symptoms.

Referred Pain: When the Source Isn’t Where You Feel It

Referred pain occurs when discomfort is felt in an area different from its origin. In the case of nighttime arm pain, several conditions can cause referred pain:

Heart problems, including angina or heart attack
Gallbladder disease
Lung conditions
Spine issues in the neck or upper back

How can you distinguish referred pain from direct arm issues? Referred pain often has a diffuse, hard-to-pinpoint quality and may be accompanied by other symptoms related to the underlying condition. For example, arm pain due to heart problems might be associated with chest discomfort, shortness of breath, or nausea.

When to Seek Immediate Medical Attention

While many causes of nighttime arm pain are not emergencies, certain symptoms warrant prompt medical evaluation:

Sudden, severe arm pain accompanied by chest discomfort or shortness of breath
Arm pain following a significant injury or fall
Severe pain with visible deformity or inability to move the arm
Arm pain accompanied by fever, redness, and swelling

Autoimmune Diseases: When Your Body Attacks Itself

Autoimmune diseases occur when the immune system mistakenly targets healthy tissues. Several autoimmune conditions can contribute to nighttime arm pain:

Rheumatoid arthritis
Lupus
Polymyalgia rheumatica
Sj??gren’s syndrome

Why do autoimmune-related arm pain symptoms often worsen at night? Several factors may contribute:

Natural fluctuations in hormone levels, particularly cortisol
Reduced physical activity and movement during sleep
Changes in body temperature and circulation
Heightened pain perception due to fewer distractions

Managing autoimmune-related arm pain often requires a comprehensive approach, including medication, lifestyle modifications, and stress reduction techniques.

Diagnostic Approaches for Nighttime Arm Pain

Identifying the underlying cause of nighttime arm pain typically involves a combination of clinical evaluation and diagnostic tests. Common diagnostic approaches include:

Detailed medical history and physical examination
Imaging studies (X-rays, MRI, CT scans)
Nerve conduction studies and electromyography (EMG)
Blood tests to check for inflammatory markers and autoimmune indicators
Specialized tests for specific conditions (e.g., stress tests for heart-related issues)

How can patients prepare for a diagnostic evaluation of nighttime arm pain? Keeping a detailed pain journal, noting factors that worsen or alleviate symptoms, can provide valuable insights for healthcare providers. Additionally, being prepared to discuss your complete medical history, including any recent injuries or changes in physical activity, can help guide the diagnostic process.

Conservative Treatment Options for Nighttime Arm Pain

Many cases of nighttime arm pain can be effectively managed with conservative treatments. These may include:

Over-the-counter pain relievers (NSAIDs, acetaminophen)
Physical therapy and targeted exercises
Application of heat or cold therapy
Ergonomic adjustments to sleeping positions and environments
Stress reduction techniques (meditation, deep breathing exercises)
Gentle stretching routines before bed

How long should you try conservative treatments before seeking further medical intervention? While this can vary depending on the specific condition and severity of symptoms, a general guideline is to give conservative treatments 4-6 weeks to show improvement. If pain persists or worsens despite these measures, consult with a healthcare provider to explore additional options.

The Role of Sleep Hygiene in Managing Arm Pain

Improving sleep hygiene can play a significant role in managing nighttime arm pain. Consider implementing the following strategies:

Maintain a consistent sleep schedule
Create a cool, dark, and quiet sleep environment
Limit exposure to blue light from electronic devices before bedtime
Avoid caffeine and heavy meals close to bedtime
Practice relaxation techniques to reduce muscle tension

Advanced Treatment Options for Persistent Arm Pain

When conservative measures fail to provide adequate relief, more advanced treatment options may be considered:

Prescription pain medications or muscle relaxants
Corticosteroid injections to reduce inflammation
Regenerative medicine treatments (e.g., platelet-rich plasma therapy)
Nerve blocks or radiofrequency ablation for specific pain conditions
Surgical interventions for structural issues or severe cases

How do healthcare providers determine when to escalate to more advanced treatments? This decision is typically based on a combination of factors, including the severity and duration of symptoms, impact on quality of life, response to conservative treatments, and the underlying cause of the arm pain. A thorough evaluation and discussion of potential risks and benefits are essential before pursuing more invasive options.

Lifestyle Modifications to Prevent and Manage Nighttime Arm Pain

Implementing certain lifestyle changes can help prevent the onset or recurrence of nighttime arm pain:

Maintain good posture throughout the day
Practice ergonomic techniques when working or performing repetitive tasks
Engage in regular, low-impact exercise to improve overall musculoskeletal health
Manage stress through relaxation techniques and mindfulness practices
Maintain a healthy weight to reduce strain on joints and muscles
Stay hydrated to support proper muscle and joint function

How can you incorporate these lifestyle modifications into your daily routine? Start by making small, sustainable changes and gradually build upon them. For example, set reminders to check and correct your posture throughout the day, or begin with short daily stretching sessions and progressively increase their duration.

The Importance of a Supportive Sleep Environment

Creating a sleep environment that supports proper body alignment can significantly impact nighttime arm pain. Consider the following factors:

Choose a mattress that provides adequate support for your body type and sleeping position
Use pillows to maintain proper neck and shoulder alignment
Experiment with different sleeping positions to find the most comfortable option
Consider using body pillows or specialized orthopaedic pillows for additional support

Understanding the Connection Between Stress and Nighttime Arm Pain

Stress can exacerbate many pain conditions, including nighttime arm pain. The relationship between stress and pain is complex and multifaceted:

Increased muscle tension
Altered pain perception
Disrupted sleep patterns
Heightened inflammation in the body

How can you effectively manage stress to reduce its impact on nighttime arm pain? Implementing stress-reduction techniques such as mindfulness meditation, progressive muscle relaxation, or engaging in enjoyable hobbies can help mitigate the effects of stress on pain perception and overall well-being.

The Role of Nutrition in Managing Arm Pain

While diet alone may not cure nighttime arm pain, certain nutritional strategies can support overall musculoskeletal health and potentially reduce inflammation:

Incorporate anti-inflammatory foods (e.g., fatty fish, leafy greens, berries)
Ensure adequate intake of vitamins and minerals crucial for muscle and nerve function (e.g., magnesium, vitamin D, B vitamins)
Stay hydrated to support proper tissue function
Limit consumption of processed foods and added sugars

When to Consider Seeking a Second Opinion

If you’re struggling with persistent nighttime arm pain despite treatment, it may be time to seek a second opinion. Consider consulting another healthcare provider if:

Your symptoms have not improved after several weeks of treatment
You feel your concerns are not being adequately addressed
You’re unsure about a proposed treatment plan or diagnosis
Your pain is significantly impacting your quality of life

How can you make the most of a second opinion consultation? Gather all relevant medical records, including imaging studies and test results, to provide a comprehensive overview of your condition. Prepare a list of questions and concerns to ensure you address all aspects of your nighttime arm pain during the consultation.

The Potential Impact of Underlying Medical Conditions

Certain medical conditions can contribute to or exacerbate nighttime arm pain. These may include:

Diabetes (which can cause peripheral neuropathy)
Thyroid disorders
Vitamin deficiencies (particularly B12 deficiency)
Fibromyalgia
Peripheral artery disease

Managing these underlying conditions effectively can often lead to improvements in nighttime arm pain. Work closely with your healthcare provider to ensure comprehensive care that addresses all aspects of your health.

Arm Pain at Night: Causes & Treatments

Arm pain at night can be miserable. The pain can interrupt your sleep and erode your quality of life. Irritability becomes increasingly more common. What are the causes? When should I worry about it? What are the treatment options for arm pain at night? Let’s dig in.

What Causes Arm Pain at Night?

There are many causes of arm pain at night. The most common causes are:

Cervical Disc Problems

The neck is composed of 7 boney building blocks numbered 1- 7. Sandwiched between the bones is a disc that functions as an important shock absorber. The cervical discs are susceptible to injury due to trauma, degeneration, repetitive motion, and surgery(1). Common disc injuries include disc bulges, and herniations. The injured disc can compress or irritate one or more nerves resulting in arm pain at night. It can feel like pressure in the muscles like a blood pressure cuff. Alternatively, there can be numbness, tingling, or electrical sensations down your arm. Arm pain at night is a warning signal that warrants your attention.

Cervical Stenosis

The spinal cord extends the entire length of the spine. The spinal canal is a hollow passage formed by neck bones and spinal fluid. The spinal cord travels the length of the spine within the spinal canal. If the canal is narrowing at any point the spinal cord and exiting nerve roots can be compressed. Narrowing of the spinal canal is called stenosis. It can be caused by trauma, instability, disc protrusion, facet joint overgrowth, and thickening of spinal ligaments (2). Compression of the spinal cord and nerve roots can cause arm pain.

Rotator Cuff Injury

The Rotator Cuff is a group of 4 tendons that provide support and stability to the shoulder. A tendon is a band of connective tissue that connects muscle to bone. The Rotator Cuff tendons are the supraspinatus, infraspinatus, subscapularis, and teres minor tendons. The Rotator Cuff is susceptible to injury as a result of trauma, overuse, impingement, and degeneration (3). Risk factors for a Rotator Cuff tear include advancing age, female gender, smoking and poor posture (4). A Rotator Cuff injury can cause arm and/or shoulder pain at night.

Bursitis

A bursa is a fluid-filled sac that allows tendons and muscles to smoothly slide over boney surfaces. There are multiple bursae in the shoulder and elbow that can become inflamed or irritated. Sleeping on your side can increase in the pressure on the bursae resulting in throbbing arm pain at night.

Thoracic Outlet Syndrome (TOS)

Thoracic Outlet Syndrome is a group of disorders that involve the compression and irritation of the nerves, arteries, and veins in the lower neck and chest. Pain is a major symptom and can be intermittent or constant and varies in severity and quality. The pain can involve the lower neck, collar bone, arm, and hand. Numbness in the hand is common. Symptoms are typically worsened with lifting the arm overhead.

Referred Pain

Referred pain is pain that is perceived or felt in an area that is different in the location from where the actual tissue injury occurs. A classic example is a heart attack. The actual tissue injury is in the heart muscle. The pain from a heart attack however is oftentimes is referred or felt in the arm. Arm pain at night can be referred pain and if it is persistent warrants evaluation.

Autoimmune Diseases

Autoimmune diseases are where your own immune system attacks itself. Common examples include Rheumatoid Arthritis and Lupus. Pain is common and can occur at night.

Deep Dive Into the Conditions Cause Pain in Arms at Night

AC Joint Impingement

AC joint Impingement is a painful condition that occurs when the space beneath the acromion bone is narrowed. This narrowing can result in irritation of the rotator cuff tendons and bursa. A bursa is a fluid-filled sac that reduces the friction on tendons and muscles as they cross bony surfaces. A tendon is thick collagen tissue that connects muscles to bones. The rotator cuff tendons provide important support and enable movement in the shoulder. If severe, impingement can cause tears in the rotator cuff tendons. Patients with AC joint impingement typically have pain with elevation of the arm and or while lying on the shoulder.

Cervical Radiculopathy

Common Cervical Radiculopathy symptoms include neck pain, arm pain, shoulder pain radiating down arm to fingers, numbness, tingling, and weakness. Cervical Radiculopathy is a clinical condition in which a nerve or nerves in your neck become irritated or compressed. It is also known as ” a pinched nerve,” The causes are discussed below. It can affect individuals of any age with peak prominence between ages 40-50 years of age. Cervical Radiculopathy is due to spinal nerve inflammation, irritation, or compression. The most common causes of Cervical Radiculopathy are: Disc Injury – The disc is an important shock absorber. Unfortunately, it is susceptible to injury.

Craniocervical Instability

Craniocervical Instability is a medical condition characterized by injury and instability of the ligaments that hold your head onto the neck. Common symptoms of Cranial Cervical Instability include a painful, heavy head, headache, rapid heart rate, brain fog, neck pain, visual problems, dizziness, and chronic fatigue.CCI or neck ligament laxity treatment options depend upon the severity of the instability and clinical symptoms. When appropriate, conservative care should always be the first-line treatment.
Craniocervical Instability Surgery is often recommended when conservative care fails. This involves a fusion of the head to the neck which is a major surgery that is associated with significant risks and complications…

Read More About Craniocervical Instability

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a painful loss of shoulder movement and range in motion. The incidence of frozen shoulder is 3-5% in the general population and up to 20% in those with diabetes. The peak incidence is between 40-60 years of age. The exact mechanism is poorly understood. In general, the capsule becomes inflamed, thickened, and contracted with pain and significant restriction in range of motion. causes are poorly understood but risk factors include trauma, prolonged immobility, systematic diseases such as diabetes, stroke, connective tissue disease, and heart disease. Other causes include post-surgery, chronic inflammation causing stimulation of myofibroblasts

Lateral Epicondylitis / Tennis Elbow

Lateral epicondylitis otherwise known as tennis elbow is an overuse injury involving the extensor muscles that originate on the bony prominence (epicondyle) on the outside (lateral) aspect of the elbow. It is more properly termed tendinosis that specifically involves the origin of the extensor carpi radialis brevis muscle. In a study, Nirschl and Pettrone attributed the cause of lateral epicondylitis to be tearing in the origin of the extensor carpi radialis brevis (ECRB) muscle (1).
The extensor carpi radialis brevis (ECRB) muscle originates from the lateral epicondyle. It functions to move the wrist so that the hand moves away from the palm and towards the thumb.

Read More About Lateral Epicondylitis / Tennis Elbow

Medial Epicondylitis / Golfer’s Elbow

Golfer’s elbow involves tears in the ulnar collateral ligament and pain or soreness on the inside of the elbow. The bony bump you feel there is the medial epicondyle of the humerus (upper arm bone). There are five forearm muscles that attach at this point, all of which are involved in helping to flex or rotate the forearm and wrist. Pain can get worse when you throw a ball, grip a dumbbell, turn a screwdriver, and other movements that involve the fingers, hand, wrist, and/or elbow. Tennis elbow is similar, however, it refers to the outside of the elbow, at the lateral epicondyle.

Read More About Medial Epicondylitis / Golfer’s Elbow

Rotator Cuff Tear

Are you plagued by shoulder pain that has now transitioned from intermittent to constant and keeps you up at night? Are daily shoulder movements, such as dressing and reaching for objects in the kitchen cabinets, painful? Is your range of motion decreasing as your pain is increasing? You may have a full- or partial-thickness rotator cuff tear. Has conservative therapy in the form of heat, ice, stretching, rest, and acupuncture failed to provide significant relief? Has an MRI demonstrated a full-thickness or partial-thickness tear of the rotator cuff? What to do? If left untreated, full-thickness and 26% of partial-thickness tears will progress.

Shoulder Impingement Syndrome

Pain is the most common symptom. It typically occurs with the elevation of the arm, forced movement overhead, and when lying on the shoulder. Impingement can also cause shoulder pain when reaching across the body. Narrowing of the subacromial space is the most common cause of shoulder impingement syndrome (6). The subacromial space is the area between the top of the arm bone (humerus) and the AC joint. This narrowing compresses or pinches the rotator cuff tendons and bursa. If left untreated the rotator cuff tendons can become inflamed, damaged, and or torn.Bursa and tendons can not be seen on x-ray. An x-ray may demonstrate…

Read More About Shoulder Impingement Syndrome

Shoulder Labral Tears

The labrum is a cartilaginous cup that circles the shallow shoulder socket (the glenoid) to make the socket deeper. The labrum supports and stabilizes the shoulder joint. Causes of Shoulder Labral Tears
Injury to the labrum typically occurs from repetitive trauma in overhead throwers, such as in baseball. It can also occur from a traction injury to the arm, such as lifting a heavy object off the ground or getting your arm jerked. Symptoms of Shoulder Labral Tears. Typical symptoms include pain in the front of the shoulder or deep inside the joint. Treatment options initially include physical therapy which is designed to restore range of motion and strength to the shoulder.

Slipping Rib Syndrome

Slipping Rib Syndrome can be incredibly painful and is often misdiagnosed. It is also known as rib dislocation, rib subluxation, Tietze syndrome, Davies–Colley’s syndrome, rib-tip syndrome, painful rib syndrome, costochondral separation, and clicking or moving rib syndrome. It is very common for athletes involved in contact sports to get a slipped rib. Trauma causes stretching and sometimes tearing of the ligament attachments of the rib, creating instability. We also see this in many of our motor vehicle accident patients, caused by the seat belt and/or airbag. Once damaged, it can take several weeks to resolve (4-12 weeks). After 3 months, if the rib continues to…

Spinal Instability

Spinal instability is a condition that occurs when the spinal column is not able to maintain its normal alignment and function under normal loads. It can be caused by various factors such as trauma, degenerative changes, infections, tumors, or congenital abnormalities. In a stable spine, the bones, discs, ligaments, and muscles work together to support and protect the spinal cord and nerve roots. However, in an unstable spine, the structures that support the spine may be damaged or weakened. This can lead to abnormal movement and excessive stress on the spinal cord and nerves. In most cases, bone and joint problems…

Thoracic Outlet Syndrome

The thoracic outlet is an area around the collar bone where the nerves that come from your neck meet up with the blood vessels from your heart and together supply the entire upper extremity (shoulder and arm). These blood vessels (subclavian artery and vein) and nerves (brachial plexus) travel from the base of your neck to your armpit (axilla) and are considered the “thoracic outlet”. Now that you know what the thoracic outlet is, what is thoracic outlet syndrome? Simply listening to a patient’s history and completing a physical examination is all that is needed to diagnose TOS. But more involved imaging such as X-rays…

Read More About Thoracic Outlet Syndrome

Ulnar Neuropathy

Simply put, ulnar neuropathy refers to the compression or damage to the ulnar nerve in the arm. It affects up to 6% of the population, based on reports.The ulnar nerve is one of three main nerves in the arm that run from the shoulder to the hand and is responsible for providing sensation to the small and ring fingers and for controlling the movement of specific hand muscles. When the ulnar nerve is damaged or compressed, it can lead to a range of symptoms, including pain, numbness, weakness, and tingling in the affected hand. The symptoms of ulnar neuropathy can…

When Should I Worry about Arm Pain at Night?

If arm pain is infrequent and mild it most likely is a result of overactivity and does not warrant worry or evaluation. Warning signs that are concerning include.

Arm pain that progressed from intermittent to constant
Increase in the severity of the pain
Reduced range of motion
Numbness and tingling
Loss of muscle strength
Shrinkage of the muscles (atrophy)

Treatment Options for Shoulder Pain

Identifying the underlying cause of the pain is key. Conservative care in the form of physical therapy is always the best first line of treatment when possible.

Cervical disc injuries can be effectively treated with PRP or stem cells depending upon the severity of the injury. PRP is rich in growth factors that can increase the blood flow in an area of tissue damage. A patient’s own stem cells are powerful tools to accelerate healing and orchestrate healing.

Cervical stenosis can arise from different causes. X-ray-guided injections of PRP can reduce disc or facet swelling and tighten lax spinal ligaments thereby improving clinical symptoms. To learn more about spinal stenosis please click on the video below.

There are different types of Rotator Cuff tendon tears. The three principal RC tears are partial-thickness tears, full-thickness tears, and full-thickness tears with retractions. PRP and a patient’s own stem cells can be injected directly into the tear under MSK ultrasound. Our recent midterm analysis of a multi-year shoulder Rotator Cuff randomized controlled demonstrated exciting results. It demonstrated that precise injection of high dose bone marrow-derived stem cells into damaged Rotator Cuff tendons helped patients avoid surgery (5).

A common treatment for bursitis is the injection of steroids. This should be avoided as the steroids are toxic. Steroids are very powerful anti-inflammatory agents but are also toxic to the cartilage, tendons, and ligaments (6). PRP is an effective alternative to steroid injections as it promotes healing.

Thoracic Outlet Syndrome is often treated by surgery which is very invasive with poor long-term results. At the Centeno-Schultz Clinic, we examine the many causes of nerve, vein, and artery compression and provide the best regenerative option. Orthobiologics are used instead of steroids. Orthobiologics are biological substances naturally found in the body that are used to promote quicker healing of muscle, tendon, and bone injuries. They have been reviewed in a previous blog. To better understand orthobiologics please click on the video below.

In Conclusion

Arm pain at night can erode one’s sleep and well-being. There are many different causes of arm pain. The most common include injuries of the cervical spine or Rotator Cuff, cervical stenosis, bursitis, Thoracic Outlet Syndrome, referred pain, and autoimmune diseases.

Arm pain at night is a warning signal that you have a problem that requires attention. Warning signs that warrant evaluation include:

an increase in the frequency or severity of pain,
reduced range of motion,
numbness and tingling,
loss of muscle strength, and
muscle atrophy.

Treatment starts with identifying the underlying cause of the arm pain.

The Centeno-Schultz Clinic physicians are experts in the management of many of the causes of arm pain. While steroids should be avoided, PRP and a patient’s own stem cells are effective treatment options for cervical disc injuries, Rotator Cuff tears, mild to moderate forms of cervical stenosis, and bursitis.

Again, arm pain is a warning sign. If left untreated, it can become a much larger problem, which includes muscle shrinkage, permanent nerve damage, massive Rotator Cuff tears, and impaired arm and hand function.

👉 Schedule a telemedicine consult from home, where a board-certified physician will review your history, current imaging, and treatment to date. Learn what is causing your arm pain at night and the best regenerative treatment option. It is time to stop the sleepless nights!

References

1. Peng B, DePalma MJ. Cervical disc degeneration and neck pain. J Pain Res. 2018;11:2853-2857. Published 2018 Nov 14. doi:10.2147/JPR.S180018

2.Meyer F, Börm W, Thomé C. Degenerative cervical spinal stenosis: current strategies in diagnosis and treatment. Dtsch Arztebl Int. 2008;105(20):366-372. doi:10.3238/arztebl.2008.0366

3.Sambandam SN, Khanna V, Gul A, Mounasamy V. Rotator cuff tears: An evidence based approach. World J Orthop. 2015;6(11):902-918. Published 2015 Dec 18. doi:10.5312/wjo.v6.i11.902

4.Yamamoto A, Takagishi K, Kobayashi T, et al. The impact of faulty posture on rotator cuff tears with and without symptoms. J Shoulder Elbow Surg. 2015;24(3):446-452. doi:10.1016/j.jse.2014.07.012

5. Centeno CJ, Fausel Z, Stemper I, Azuiike U, Dodson E. A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis. Stem Cells International. 2020 Jan; 2020. https://doi. org/10.1155/2020/5962354

6.Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. Published 2015 Apr 27. doi:10.1177/2325967115581163

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How-to, other remedies, and when to seek help

Strengthening and mobility exercises can often help reduce shoulder pain and improve joint flexibility.

Shoulder pain is a common symptom that affects an estimated 18–26% of adults. In one 2017 article, researchers found that depending on the type of shoulder injury or pain a person had, exercises and manual therapy were effective treatments for the pain.

This article will discuss 10 exercises and pieces of mobility work for shoulder pain.

People who have poor posture or who do physical labor that requires actions such as heavy lifting or working overhead may be more likely to develop shoulder pain.

It is very important to remember that there are numerous causes of shoulder pain.

If a person does not know exactly what to do to ease shoulder pain, they may find these exercises helpful. However, if the pain worsens, they should discontinue the exercises and seek a professional medical diagnosis.

Mobility exercises

The following exercises fall into the mobility category.

1. Arm circles

Arm circles are an effective method of warming up the shoulder joints and improving flexibility. Doing arm circles may help relieve shoulder tension and pain.

Stand up straight with feet hip width apart.
Raise the arms and extend them to the side, creating a T shape with the body.
Make small circular motions with the arms.
Repeat this exercise for 10–15 seconds, then switch the direction of rotation.

2. Doorway stretch

The doorway stretch is a static stretch that can help improve the flexibility of the shoulders, specifically the pectoralis muscles. A person can do this in a doorway or the corner of a room.

Standing up, face a corner of the room close enough to touch each wall.
Flex the shoulders and elbows to 90 degrees so that the fingers point to the ceiling.
Place one hand on each wall, with the elbows at shoulder height.
Lean into the corner. This should stretch the chest.
Hold the stretch for 30–60 seconds.
Repeat this three to six times.

3. Thread the needle

This movement may help relieve mobility restrictions in the shoulders and upper back.

Start on the hands and knees.
Place the right palm in the center of the mat, directly under the chest.
Lift the left arm toward the ceiling, with the palm facing away from the body.
Lower the left arm, sliding it under the right arm. Keep the left arm straight and avoid collapsing the chest.
Deepen this stretch by lifting the right arm off the ground.
Hold this position for 30 seconds.

4. Eagle Pose

The Eagle Pose, also known as Garudasana, is a yoga pose that stretches the shoulder muscle. A person looking to stretch their shoulders can opt to do the upper body part of the pose only.

While standing or sitting, extend the arms to the sides.
Cross the arms in front of the body, with the right arm over the left.
Bend both the arms at the elbows.
Twist the right forearm behind the left forearm and bring the palms together.
Gently raise the arms upward to stretch the shoulders.
Hold this position for 30 seconds.
Lower the arms and gently release the position.

5. Child’s Pose

The Child’s Pose, or Balasana, is a gentle, relaxing yoga pose that stretches the shoulders and back.

Kneel on the floor, or a yoga mat, with the knees slightly wider than hip width apart.
Go on all fours, placing the palms on the mat slightly in front of the shoulders.
Sit back on the heels and hinge forward at the hips, resting the stomach on the thighs.
Extend the arms in front of the body and rest the forehead on the floor.
Deepen the stretch by pressing the chest and shoulders toward the ground.
Hold this position for 30 seconds.

Strength exercises

The following exercises fall into the strength category.

6. Lateral raises

The lateral raise is a shoulder strengthening exercise. People can use lightweight dumbbells, resistance bands, or water bottles for this exercise.

Holding a pair of light dumbbells (under 5 pounds), stand with the feet slightly wider than hip width apart.
Raise the weights to the sides until they are at shoulder level.
Remember to engage the core muscles.
Slowly lower the weights down to the sides.
Repeat this exercise for two sets, with each set consisting of 12–15 reps, three to four times per week.

7. External shoulder rotation

External shoulder rotation is another good exercise for strengthening the rotator cuff muscles and improving flexibility. People can use a resistance band or towel for this exercise.

Kritchanut Onmang/EyeEm/Getty Images

Hold the light resistance band in both hands.
Keep both arms at the sides of the body and bend them at the elbow.
Keeping one arm still, rotate the other away from the body while maintaining the 90-degree bend in the elbow.
Hold this position for 5 seconds.
Slowly return the arm toward the body.
Repeat this exercise for two sets, with each set consisting of 12–15 reps, three to four times per week.

8. Internal shoulder rotation

Similar to the previous exercise, internal shoulder rotation can help strengthen the shoulder muscles.

Willie B. Thomas/Getty Images

Attach a resistance band or large elastic band to a doorknob.
Hold the other end of the band in one hand.
Bend the arm at the elbow and pull the forearm toward the body.
Hold this position for 5 seconds.
Slowly return to the starting position.
Repeat this exercise for two sets, with each set consisting of 12–15 reps, three to four times per week.

9. Reverse fly

The reverse fly exercise works the posterior deltoids, which are the muscles on the backs of the shoulders. People will need a pair of dumbbells, resistance bands, or water bottles.

Stand with the feet hip width apart.
Hinge forward at the hips and let the arms hang straight down.
With the palms facing inward, raise both arms out to the sides and squeeze the shoulder blades together.
Slowly lower the arms and return to the starting position.
Repeat this exercise for two sets, with each set consisting of 12–15 reps, three to four times per week.

10. Downward Dog

Downward Dog, or Adho Mukha Svanasana, is an inversion yoga pose that may help strengthen the shoulders and back muscles. It can also improve the mobility of the shoulders and thoracic spine (upper back) if a person performs it correctly.

Start in a tabletop position, with the hands and knees on the floor or a mat. The knees should be directly below the waist, and the hands should be under the shoulders.
Press into the hands and lift the hips toward the ceiling. Straighten the legs and lower the heels as close to the floor as possible.
Hold this pose for 30 seconds.

In addition to the mobility work and exercises above, a person can use the following tips to help relieve shoulder pain:

Use over-the-counter anti-inflammatory medications, such as ibuprofen or aspirin, to reduce inflammation.
Apply a cold compress to relieve inflammation and pain.
Apply a hot compress to relax tight muscles and relieve pain.
Rest the affected shoulder and avoid strenuous activities, such as lifting heavy weights.
Regularly complete mobility work of the shoulders and upper back to improve range of motion and flexibility.

The authors of one 2020 article recommend that people seek medical advice for shoulder pain:

if they experience severe pain that does not improve with at-home treatments
if the shoulder joint feels unstable
if they recently injured or dislocated their shoulder
if the shoulder appears swollen or flushed or feels warm to the touch
if they feel numbness in the arm or hand
if they have muscle weakness or paralysis in the arm

Shoulder pain can significantly affect a person’s ability to perform everyday activities.

The shoulder stretches and strengthening exercises in this article may help relieve shoulder pain and improve flexibility.

Pain in the right hypochondrium: Causes – “Sensitive”

Various specialists are seen at the Yeysk Medical Center, so with us you are guaranteed to undergo a full examination with a consultation with a doctor of the required specialization. One of the most common reasons for visiting a doctor is pain in the right hypochondrium, the causes of which may be different, as this is a symptom of a number of diseases. By itself, pain in the right hypochondrium cannot be the basis for a diagnosis, but is the basis for a comprehensive diagnosis.

The cause of pain in the right hypochondrium can be strong physical activity (running), overeating. And these are situations in which the pain goes away on its own, without being accompanied by any other symptoms. But often it can be caused by diseases of the genitourinary system, gastrointestinal tract, biliary tract.

When it hurts in the right hypochondrium in healthy people

Doctors of the medical center Yeysk “Sensitive” note that the physiological cause of pain in the right hypochondrium can be:

Exercise: occurs as a result of a sudden increase in blood flow to the liver in case of exercise or overeating. Doesn’t pose a danger.
Pregnancy: in the third trimester of pregnancy, the uterus begins to put pressure on organs, including the liver, and progesterone (the hormone that preserves pregnancy) expands the bile ducts, and pain appears during exercise. It also poses no danger.
Menstruation: with a sharp imbalance between estrogen and progesterone at the end of the cycle, a spasm of the biliary tract can occur, which causes pain in the right hypochondrium.

Pathologies that cause pain in the right hypochondrium

In the upper right square of the abdomen there is a part of the diaphragm, liver, gallbladder, right kidney, duodenum and pancreas. Any of these organs during the development of the disease can make itself felt with pain in the right hypochondrium. Most often, the cause of pain in the right hypochondrium is a liver disease, but this symptom can also manifest itself under such conditions:

Bile duct obstruction. This is cholecystitis, which is accompanied by sharp acute pain, most often at night, as well as biliary dyskinesia. The symptom occurs due to the fact that the gallbladder is in increased tone, the frequency and strength of its contractions increase. If these symptoms appear, you should contact the Yeysk “Sensitive” medical center
Urolithiasis. With this disease, pain in the right hypochondrium radiates to the lower back or down the abdomen due to the fact that stones begin to move in the urinary system. In this case, the pain will intensify with each movement.
Renal colic. The situation is similar to the previous case.
Peptic ulcer. Heartburn, belching, vomiting, intestinal dysfunction are added to the pain syndrome, the heartbeat also quickens, and a breakdown occurs. This is dangerous for the life of the patient and requires urgent surgical intervention.
Pancreatitis. This is an inflammation of the pancreas, in which there is a throbbing intense girdle pain. This is a dangerous condition that may require surgery.
Intercostal neuralgia. It is characterized by sharp severe pain, which is associated with a dagger strike. The pain is accompanied by a pulsation in this area and also a strong spasm, tension.

Other causes of pain in the right hypochondrium

Shingles causes pain in the right hypochondrium, which is accompanied by skin rashes and itching. Also, with pyelonephritis, in case of damage to the right kidney, the pain will radiate to the right hypochondrium, and be accompanied by high fever. Pneumonia and bronchitis in fluffy forms can cause such pain due to the fact that when coughing, muscle strain occurs, spasms of the respiratory system. Also, if a person has heart failure, then with stagnation of blood in the liver, this will be a causal pain in the right hypochondrium.

Causes of pain in the right hypochondrium

Acute cholecystitis (inflammation of the gallbladder) is the most commonly diagnosed cause of pain in the right hypochondrium. It is characterized by prolonged (more than 4-6 hours) pain in the right hypochondrium and epigastrium (upper abdomen), bloating, nausea, and vomiting.

Biliary colic (or hepatic colic) is a characteristic clinical manifestation of cholelithiasis, less often – biliary dyskinesia. It is characterized by severe pain in the right hypochondrium or epigastrium with irradiation to the right shoulder blade, collarbone, shoulder, neck; an attack of biliary colic can be confused with an attack of angina pectoris. Accompanied by bloating, nausea, vomiting, increased sweating. The attack lasts from 30 minutes to several hours, if it lasts longer, the development of a complication is likely – acute cholecystitis.

Acute cholangitis (inflammation of the intrahepatic or extrahepatic bile ducts) is accompanied by severe pain in the right hypochondrium, a sharp increase in temperature, chills, increased sweating, jaundice. As the pathological process develops, nausea, vomiting join, confusion may be noted. The disease may have atypical manifestations in the elderly or immunocompromised patients.

Dysfunction of the sphincter of Oddi (dysmotility of its structures and patency of the bile and pancreatic ducts) is characterized by recurrent pain in the right hypochondrium or epigastrium, radiating to the back or shoulder blade. An attack of high intensity, usually occurs at night, often 2-3 hours after a meal, lasts 30 minutes or more, may be accompanied by nausea, vomiting, intolerance to a particular food (most often fatty).

Acute hepatitis (hepatitis A, alcoholic, drug) is characterized by pain in the right hypochondrium, loss of appetite, weakness, fatigue, nausea, vomiting, jaundice.

Liver abscess (limited cavity in the liver filled with pus) is characterized by dull, aching pain in the right hypochondrium radiating to the right shoulder blade or shoulder. The condition at different stages may be accompanied by fever, nausea, bloating, diarrhea, increased sweating, tachycardia, jaundice, weight loss, ascites.

Other causes of pain in the right hypochondrium include: liver cancer, preeclampsia, Budd-Chiari syndrome, portal vein thrombosis, urinary tract infections, liver, kidney, pancreatitis, indigestion, gastritis.

When should I see a doctor for pain in the right hypochondrium?

If you experience pain in the right hypochondrium for several days or more, make an appointment with your doctor to determine the cause. Emergency medical attention is needed for acute pain, fever, persistent vomiting, blood in the stool, tarry stools, jaundice, ascites, unexplained weight loss.