Why Does My Shoulder Hurt at Night?

Night pain is one of the most common reasons patients seek shoulder evaluation. It can come from inflammation, rotator cuff disease, arthritis, stiffness, or nerve-related pain.

Common causes

Pain at night often occurs when inflamed shoulder tissues are compressed or stretched while lying down. Rotator cuff inflammation, bursitis, arthritis, adhesive capsulitis, and biceps tendon pain are common causes.

Night pain can also be referred from the neck, especially when numbness, tingling, or pain radiates below the elbow.

When to be evaluated

Persistent night pain, weakness, loss of motion, or pain that does not improve with rest should be evaluated. Imaging may be needed if symptoms suggest a tear or arthritis.

Treatment options

Treatment depends on the cause and may include therapy, injections, anti-inflammatory strategies, sleep positioning, or surgery when a structural problem is present.

The most important step is identifying the source of the pain rather than simply treating the symptom.