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Rotator Cuff Tendonitis and Nighttime Shoulder Pain

ighttime shoulder pain is quite common with rotator cuff tendonitis. Nighttime shoulder pain occurs fairly early on in the process of the condition, and also causes the patient to experience frequently disturbed sleep.

However, oftentimes with rotator cuff tendonitis, the pain is only noticed during the night, which is a result of the different orientation of the body and that of the shoulder in respect to the rest of the body during the day and night.

Chronic pain is alleviated to become nighttime shoulder pain because the vertical, active, daytime body leaves its arm to act as a traction upon the shoulder that opens up space and allows blood to flow freely to the tendons. At night, the body is horizontal and so gravity is lost as a traction force, causing the pain to return.

Nighttime shoulder pain is also caused by way the top of the arm pinches the superspinatus tendon, and therefore, impairing blood flow and healing. This relative starvation of oxygen and blood to the superspinatus causes inflammation and contributes to nighttime shoulder pain.

For the patient suffering from rotator cuff tendonitis, the nighttime pain is a significant concern because the superspinatus tendon is being damaged during a period of restoration for the rest of the body. This means that while the rest of the body is conducting its own healing, the shoulder is actually getting worse.

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

Nighttime shoulder pain is a common side affect of rotator cuff tendonitis and if this symptom is present, the patient should certainly seek out a medical assessment of the shoulder pain.
>About the Author
Michael Carroll, MD is a board certified family physician with a special interest in sports medicine and chronic pain. He is the founding partner of Creekside Clinic, LLC, a progressive primary care center in Traverse City, Michigan. He is also a member of the American College of Sports Medicine, and the American Academy of Family Physicians. He also holds a special interest in shoulder pain and rotator cuff injuries.