Upper right arm pain at night. Upper Arm Pain at Night: Causes, Treatments, and When to Seek Help

13.08.202307.07.2023 by alexxlab

What causes upper arm pain at night. How can you alleviate nighttime arm discomfort. When should you consult a doctor for arm pain during sleep. Discover effective treatments and preventive measures for nocturnal arm pain

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Common Causes of Nighttime Arm Pain

Experiencing arm pain at night can significantly disrupt sleep and negatively impact quality of life. Understanding the underlying causes is crucial for effective management and treatment. Let’s explore some of the most common reasons for nocturnal arm discomfort:

Cervical Disc Problems

The cervical spine, consisting of seven vertebrae, is susceptible to various injuries that can lead to arm pain. Disc bulges and herniations can compress or irritate nerves, resulting in nighttime discomfort. This pain may manifest as pressure in the muscles, numbness, tingling, or electrical sensations down the arm.

Cervical Stenosis

Narrowing of the spinal canal, known as cervical stenosis, can compress the spinal cord and exiting nerve roots. This condition may be caused by trauma, instability, disc protrusion, facet joint overgrowth, or thickening of spinal ligaments. Compression of these structures can lead to arm pain, particularly noticeable during nighttime hours.

Rotator Cuff Injury

The rotator cuff, comprised of four tendons (supraspinatus, infraspinatus, subscapularis, and teres minor), provides crucial support and stability to the shoulder. Injuries to these tendons, whether due to trauma, overuse, impingement, or degeneration, can cause arm and shoulder pain that worsens at night.

Bursitis

Bursae, fluid-filled sacs that allow tendons and muscles to glide smoothly over bony surfaces, can become inflamed or irritated. When sleeping on your side, increased pressure on these bursae may result in throbbing arm pain during the night.

Less Common but Serious Causes of Nighttime Arm Pain

While the aforementioned conditions are more prevalent, it’s essential to be aware of less common but potentially serious causes of nighttime arm pain:

Thoracic Outlet Syndrome (TOS)

TOS involves the compression and irritation of nerves, arteries, and veins in the lower neck and chest area. This condition can cause intermittent or constant pain in the lower neck, collarbone, arm, and hand. Numbness in the hand is common, and symptoms typically worsen when lifting the arm overhead.

Referred Pain

In some cases, arm pain at night may be referred pain, meaning the actual source of the discomfort is in a different location. A classic example is a heart attack, where the pain is felt in the arm despite the actual tissue injury occurring in the heart muscle. Persistent referred arm pain warrants immediate medical evaluation.

Autoimmune Diseases

Certain autoimmune conditions, such as Rheumatoid Arthritis and Lupus, can cause arm pain that may be more pronounced at night. These diseases involve the immune system attacking the body’s own tissues, leading to inflammation and discomfort in various parts of the body, including the arms.

Risk Factors and Prevention of Nighttime Arm Pain

Understanding the risk factors associated with nighttime arm pain can help in prevention and early intervention. Some key factors to consider include:

Age: Advancing age increases the risk of conditions like rotator cuff tears and cervical disc problems.
Gender: Some conditions, such as rotator cuff injuries, may be more prevalent in women.
Smoking: Tobacco use can impair healing and increase the risk of various musculoskeletal issues.
Poor posture: Maintaining incorrect posture, especially during sleep, can exacerbate arm pain.
Occupational factors: Jobs involving repetitive arm movements or overhead work can contribute to arm pain.

To reduce the risk of developing nighttime arm pain, consider implementing the following preventive measures:

Maintain good posture during daily activities and sleep
Practice proper ergonomics at work and home
Engage in regular exercise to strengthen arm and shoulder muscles
Take frequent breaks during repetitive tasks
Use supportive pillows and mattresses to maintain proper sleep alignment

Diagnostic Approaches for Nighttime Arm Pain

Accurate diagnosis is crucial for effective treatment of nighttime arm pain. Healthcare professionals may employ various diagnostic techniques to identify the underlying cause:

Physical Examination

A thorough physical examination allows the doctor to assess range of motion, strength, and areas of tenderness. They may also perform specific tests to evaluate nerve function and muscle integrity.

Imaging Studies

Depending on the suspected cause, imaging studies may be ordered to visualize the internal structures of the arm, shoulder, and neck. Common imaging techniques include:

X-rays: To evaluate bone structure and alignment
MRI (Magnetic Resonance Imaging): For detailed soft tissue visualization, including muscles, tendons, and nerves
CT (Computed Tomography) scan: To assess complex bone structures and soft tissues
Ultrasound: For real-time imaging of soft tissues and blood flow

Nerve Conduction Studies and Electromyography (EMG)

These tests evaluate nerve and muscle function, helping to identify potential nerve compression or damage that may be causing nighttime arm pain.

Treatment Options for Nighttime Arm Pain

The treatment approach for arm pain at night depends on the underlying cause and severity of symptoms. Here are some common treatment options:

Conservative Treatments

Many cases of nighttime arm pain can be managed with non-invasive approaches:

Rest and activity modification
Physical therapy exercises
Application of ice or heat
Over-the-counter pain medications (e.g., NSAIDs)
Ergonomic adjustments to sleeping position and workspace

Medications

In some cases, prescription medications may be necessary to manage pain and inflammation:

Muscle relaxants
Prescription-strength NSAIDs
Corticosteroids (oral or injected)
Nerve pain medications (e.g., gabapentin, pregabalin)

Interventional Procedures

For more severe or persistent cases, interventional procedures may be recommended:

Corticosteroid injections
Nerve blocks
Platelet-rich plasma (PRP) therapy
Regenerative medicine treatments (e.g., stem cell therapy)

Surgical Interventions

In cases where conservative treatments and interventional procedures fail to provide relief, surgery may be considered. Surgical options depend on the underlying cause and may include:

Rotator cuff repair
Cervical disc surgery (e.g., discectomy, fusion)
Decompression surgery for cervical stenosis
AC joint resection for impingement

Lifestyle Modifications to Alleviate Nighttime Arm Pain

In addition to medical treatments, certain lifestyle modifications can help reduce the frequency and intensity of nighttime arm pain:

Sleep Position Adjustments

Changing your sleep position can significantly impact arm comfort during the night. Consider these strategies:

Use a supportive pillow to maintain proper neck alignment
Try sleeping on your back with a pillow under your knees to reduce pressure on the spine
If side sleeping is preferred, place a pillow between your knees and hug another pillow to support your upper arm
Avoid sleeping with your arm under your head or pillow

Stretching and Strengthening Exercises

Regular exercises can help improve flexibility and strength in the arm, shoulder, and neck muscles:

Gentle shoulder rolls and neck stretches before bed
Rotator cuff strengthening exercises (under guidance of a physical therapist)
Posture-improving exercises to reduce strain on the neck and shoulders

Stress Reduction Techniques

Stress and tension can exacerbate nighttime arm pain. Incorporating stress-reduction techniques into your routine may help:

Practice relaxation techniques such as deep breathing or progressive muscle relaxation before bed
Consider meditation or mindfulness exercises to reduce overall stress levels
Engage in calming activities before bedtime, such as reading or listening to soothing music

When to Seek Medical Attention for Nighttime Arm Pain

While occasional arm discomfort at night may not be cause for concern, certain symptoms warrant prompt medical attention:

Sudden, severe arm pain, especially if accompanied by chest pain or shortness of breath (may indicate a heart attack)
Arm pain following a traumatic injury or fall
Persistent pain that doesn’t improve with rest or over-the-counter treatments
Pain accompanied by weakness, numbness, or tingling in the arm or hand
Visible deformity or swelling in the arm
Fever along with arm pain, which may indicate an infection

If you experience any of these symptoms, it’s crucial to consult a healthcare professional for proper evaluation and treatment.

Future Perspectives in Nighttime Arm Pain Management

As medical research advances, new approaches to managing nighttime arm pain are emerging. Some promising areas of development include:

Wearable Technology

Smart devices that monitor sleep patterns and body positioning may help identify triggers for nighttime arm pain and suggest personalized interventions.

Advanced Imaging Techniques

Improved imaging technologies may allow for earlier and more accurate diagnosis of conditions causing arm pain, leading to more targeted treatments.

Regenerative Medicine

Ongoing research into regenerative therapies, such as stem cell treatments and tissue engineering, may offer new options for repairing damaged tissues and alleviating chronic arm pain.

Personalized Pain Management

Advances in genetic research and pharmacogenomics may lead to more tailored pain management strategies, optimizing medication efficacy and minimizing side effects for individual patients.

As research progresses, individuals suffering from nighttime arm pain can look forward to potentially more effective and less invasive treatment options in the future.

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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Six causes and what to do

There are several reasons why a person may experience pain in their right shoulder and arm. In many cases, the pain will occur as a result of muscle overuse, injury, or nerve damage.

Shoulder pain is the third-leading muscle and bone complaint in the United States. Researchers estimate that shoulder injuries account for 4.5 million doctor visits and $3 billion in healthcare costs in the U.S.

Sometimes, shoulder and arm pain have nothing to do with exercise or injury. Unexplained shoulder and arm pain can be a symptom of a heart attack.

Read on to discover the possible causes of right shoulder and arm pain and their associated treatment options.

Right shoulder pain varies depending on the cause. The pain may be constant or occur only when moving or lifting the shoulder. Sometimes, shoulder pain can be severe enough that it interferes with everyday activities.

Conditions such as shoulder impingement syndrome can cause pain in the top, outer part of the shoulder. This condition, along with tendonitis and brachial neuritis, can also cause weakness in the arm and aching at night.

If nerve damage is contributing to shoulder pain, it can cause numbness and tingling in the arm.

Shoulder pain may be severe and sudden for injuries such as a fracture or sprain or conditions such as frozen shoulder. Stiffness and reduced range of motion may also develop. Sometimes, shoulder pain can extend into the neck as well.

Swimmer’s shoulder describes a range of different shoulder injuries that may occur due to swimming. Swimmers are at increased risk of shoulder injuries due to the high number of swim stroke repetitions they perform during training.

Injuries associated with swimmer’s shoulder include:

Impingement syndrome: A tendon in the shoulder rubs and catches on surrounding tissue when a person lifts their arm.
Labral injuries: A tear occurs in a piece of cartilage called the labrum, which sits inside the shoulder socket.
Shoulder instability: The structures around the shoulder joint are not effective in keeping the upper arm bone in the shoulder socket.
Peripheral neuropathy: Damage occurs to one of the peripheral nerves, which generally causes numbness or weakness.

Rotator cuff tendonitis (RCT) refers to irritation or inflammation of the rotator cuff. This condition is particularly common among elite athletes and people who regularly play certain sports.

The rotator cuff is a group of muscles and tendons surrounding and supporting the shoulder joint. Together, they help hold the upper arm bone firmly in the shoulder socket.

Some causes of RCT include:

poor overhead throwing technique in sports such as baseball and javelin
direct trauma to the rotator cuff
falling on a straight arm

Overuse can cause damage and inflammation to the muscles in the arm and shoulder. This can result in muscle pain and fatigue, but a person may not experience these symptoms until hours after overexerting the muscles.

A 2018 review suggests that massage therapy can be the most effective treatment for fatigued muscles.

Other techniques that may relieve muscle inflammation and fatigue include compression garments and cold-water immersion.

Frozen shoulder, or adhesive capsulitis, is an inflammatory condition in which the shoulder becomes painful and difficult to move for months or years. It occurs when the tissue around the shoulder joint stiffens.

It is unclear why frozen shoulder occurs in some people. People aged 40–60 are most likely to develop frozen shoulder, and it is four times more common in females than males. People with a frozen shoulder may be more likely to have:

diabetes
thyroid issues
stroke
heart disease
Parkinson’s disease
cancer
an injury or surgery that immobilizes the shoulder

Frozen shoulder involves three stages:

stage 1 (freezing): The shoulder will feel painful and lose range of motion. This stage lasts from around 6 weeks to 9 months.
stage 2 (frozen): For around 4–6 months, pain may improve, but the shoulder will remain stiff and hard to move.
stage 3 (thawing): The shoulder will gradually become easier to move. However, it may take 6 months to 2 years to fully return to normal.

After experiencing a frozen shoulder, around 15% of people will develop the condition again in their opposite shoulder within 5 years.

A shoulder fracture, or broken bone, may involve the collarbone, shoulder blade, or humerus (the bone extending from the shoulder to the elbow).

A broken collarbone or humerus may occur from a fall or a car accident. While a shoulder blade is more difficult to fracture, the condition can result from a high-speed car accident.

Depending on the type of fracture, symptoms may include:

pain
swelling
limited range of motion
bruising

A shoulder sprain occurs when a ligament in the shoulder is stretched or torn. Ligaments are the connective tissues between bones.

An acromioclavicular joint injury is a shoulder sprain where ligament damage can lead to separation of the collarbone and the bone at the top of the shoulder, called the acromion. This condition makes up over 40% of all shoulder injuries and may result from a fall, car accident, or a sporting activity such as a skiing accident.

Symptoms may include:

pain that can extend to the neck
swelling
bruising
reduced range of motion

Disuse syndrome is a general term for conditions that result from a period of immobility or physical inactivity. It typically involves muscle atrophy or wasting.

People who have recently undergone a period of bed rest are at particular risk of developing disuse syndrome.

A person may experience the following symptoms even after a short period of physical inactivity:

muscle stiffness
muscle shrinkage and wasting
muscles that are weak and susceptible to injury

The Physical Activity Guidelines for Americans recommend that adults perform at least 150 minutes a week of moderate-intensity aerobic activity.

However, some people have chronic conditions limiting their mobility or physical activity levels. People who have these conditions may find it helpful to talk with a physical therapist. They will work with the person to create an appropriate exercise program.

Brachial neuritis is a type of peripheral neuropathy that affects the following parts of the body:

chest
shoulders
arms
hands

Peripheral neuropathy is a disease of the nerves that transmit signals between the central nervous system and other parts of the body. Nerve pain and a loss of function in affected body parts characterize the condition.

Usually, people with brachial neuritis experience pain and weakness in the shoulder and arm on one side of their body. In 60% of these cases, it will occur on their dominant side.

Most people will experience pain on the outside part of the shoulder. It generally comes on suddenly and may worsen at night.

After a few days, the pain may disappear. A person can then experience the following symptoms in their shoulder and arm:

weakness
changes in reflexes
loss of sensation

Many people associate a heart attack with pain in the left arm. However, some people may feel pain in the right shoulder and arm or on both sides of the body.

Learn more about the symptoms of a heart attack here.

In some instances, gallbladder disease can cause pain in the right shoulder. This occurs in more than a third of gallbladder inflammation cases.

Learn more about gallbladder inflammation here.

People should call 911 immediately if they experience unexplained arm and shoulder pain alongside any of the following symptoms:

chest pain or discomfort, which may feel like pressure, burning, tightness, or sharpness
pain radiating to the jaw on one or both sides
shortness of breath
nausea
vomiting
dizziness
a rapid heartbeat
excessive sweating

Sports injuries, such as swimmer’s shoulder and RCT, may require medical attention if rest and ice do not alleviate symptoms. A doctor can prescribe pain relief and refer the person to a physiotherapist for further treatment.

Similarly, if other shoulder pain or stiffness develops that does not improve with rest or home treatments, it is important to see a doctor.

People with a fractured shoulder should seek urgent treatment. While minor shoulder sprains may not need medical evaluation, more severe sprains and dislocation typically require immediate treatment.

People with brachial neuritis may consult their doctor for a diagnosis and pain relief. However, there are few other treatment options available. The condition generally resolves on its own.

Pain in the right shoulder and arm is often due to muscle, tendon, or ligament damage. It can also occur as a result of damage to the peripheral nerves in those areas.

Unexplained shoulder and arm pain can sometimes be a warning sign of a heart attack, which is a medical emergency.

People should see a doctor if they are concerned about pain in their right shoulder and arm or if the pain is not improving. The doctor will work to diagnose the underlying issue and provide appropriate treatment.

Read the article in Spanish.

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.