Shoulder pain: persistent, nocturnal, when raising your arm

Shoulder pain can be caused by:

Most people think that the shoulder is between the neck and upper arm, but the pain coming from the shoulder is felt in the upper arm region and can radiate into the elbow.

Pain originating from the neck is usually felt between the shoulder and cervical spine.

Pain behind the shoulder blade can be caused by:


Appearance of pain:

Constant shoulder pain

Most shoulder problems increase during movement.
Tears and tendonitis of the rotator cuff (including the supraspinatus muscle (upper bone muscle), the infraspinatus muscle (lower bone muscle), the teres minor muscle (small round arm muscle) and the subscapularis muscle (lower shoulder blade muscle)) cause greater pain during activity, e.g. when lifting the arm or throwing a ball.
Constant pain is rare with these problems; as a rule, it is only present in the acute phase, i.e. until two days after the trauma.
Some conditions that cause constant, movement-independent pain:

  • inflammation of the neck nerves,
  • arthritis,
  • Bottleneck syndrome of the upper thoracic aperture.


In principle, this condition can affect anyone, but the likelihood increases in people with autoimmune diseases and rheumatoid arthritis.
Fibromyalgia causes muscle pain and tender points, especially on the neck, back, hips, knees, and the back of the shoulders.
Symptoms include:

Nocturnal shoulder pain

Night pain is typical for rotator cuff injuries.
If there is a lesion or tendinitis, those affected often wake up at night or have problems falling asleep because the shoulder hurts.

With tendinitis of the rotator cuff, pain occurs in the first hours after falling asleep.
For those affected, nocturnal pain is very stressful because it disturbs the night’s rest and makes a restful sleep impossible.

Normally, at night, the body’s repair and healing processes are activated, but if there are problems with the rotator cuff, the patient is in pain.
During the day, there are often no complaints at all, because the shoulder is vertical when standing and sitting.
The trunk is in a vertical position and the dead weight of the arm exerts a tensile stress on the shoulder, increasing the space between acromion and the head of the humerus.
This way:

  • decreases the pressure on bursae and tendons in the joint,
  • the blood can circulate to the tendons without obstacles.

At night, the body lies horizontally and gravity does not exert traction; Pain occurs because the upper arm presses the supraspinatus tendon and obstructs blood flow.
The resulting lack of oxygen and arterial blood causes inflammation of the supraspinatus tendon, resulting in nocturnal shoulder pain.
Anyone who pushes the elbow under the pillow while sleeping can aggravate the situation, because the large humer humer pushes the supraspinatus even further against the korakoakromial ligament.


Arthritis is an inflammation of one or more joints that can cause pain. In the case of joint inflammation, the following symptoms are present:

  • joint pain in the shoulder;
  • Swelling;
  • restriction of movement;
  • stiffness of the joint, especially in the morning for about an hour;
  • Overheating of the joint.


In the event of a fall or bruise of the arm, pain may arise in the shoulder and back.

  • swelling of the shoulder and other areas of the body;
  • Effusions of blood;
  • restriction of movement of the arm;
  • Myasthenia.

Shoulder pain when raising your arm

Shoulder movement may be restricted due to various diseases, but in different ways.
A distinction is made between:

  • Active range of motion (range of motion that the patient can achieve alone)
    If active mobility is limited, the cause is usually found in the rotator cuff.
    In this case, the muscle does not work as usual, the shoulder feels stiff, but if someone lifts the patient’s arm, the shoulder can be moved normally.
  • Passive range of motion (which can be achieved with the help of the physiotherapist) Loss of passive range of motion occurs in shoulder stiffness (frozen shoulder)
    and arthritis.

Frozen shoulder is characterized by an accumulation of scar tissue around the shoulder, resulting in limited mobility even if someone else tries to perform the movement.
Rheumatoid arthritis in the shoulder can cause pain and cartilage abrasion, which can limit range of motion.

Sports accidents
Sports accidents
may occur during the exercise of sporting activities due to poor physical condition or inappropriate sports equipment.

Symptoms of shoulder dislocation
depend on the severity; Patients report of:

  • stabbing pain;
  • deformations of the shoulder;
  • no joint movement possible;
  • Swelling;
  • Effusions of blood.


Myofascial pain syndrome This syndrome
means pain 
of the muscles and fascial connective tissue.
It is caused by a muscle injury or excessive muscle strain.
Symptoms include:

  • Ache;
  • stiffness of the joint near the muscle in question;
  • sleep problems due to nocturnal pain;
  • when palpating, a knot-like mass is felt in the affected muscles;
  • prolonged sitting at the PC can lead to neck and shoulder discomfort.

Lesion of the rotator cuff

The rotator cuff is involved in lifting and turning the arm, and it also gives stability to the shoulder joint.
The following symptoms may occur with injury to the rotator cuff:

  • Weakening of the shoulder muscles.
  • Pain when lifting the arm or when the hand is led back to the back or night pain.
  • Crackling noises during arm movement in certain positions.
  • Pain when lowering the previously raised arm.
  • Weakness when turning or raising the arm.

Frozen shoulder

Frozen shoulder, shoulder stiffness or adhesive capsulitis occurs:

  1. after immobilization of the arm for several weeks,
  2. after surgery,
  3. for unknown reasons.

Symptoms of shoulder stiffness are divided by stages:

  • During the pain phase, the pain in the upper and back shoulder area occurs during movement, which is increasingly restricted.
  • At the stage of stiffening, the pain decreases somewhat in intensity, the shoulder becomes more and more stiff, and movement is significantly restricted.
  • In the solution phase, the range of motion of the shoulder gradually increases again.

Calcifying tendinitis

In tendinitis calcarea, lime is deposited in the tendons of the rotator cuff. These calcium deposits are often found in diabetics and the elderly.
Symptoms of this condition include:

  • Pain at a certain point of the shoulder.
  • Discomfort when lifting the arm above the head or turning inwards, as if you wanted to bring your hand behind your back.

Fracture An incomplete or complete fracture

of the bone is called a fracture.
There are different forms of bone fractures.
The following symptoms are associated with it:

  • twinge;
  • redness and bruising around the affected region and on the chest;
  • Deformation;
  • Swelling;
  • numbness or tingling along the upper limb;
  • no movement of arm and shoulders possible.

Simple muscle fatigue can be treated with home remedies, but if there is a serious condition, such as a fracture or lesion of the rotator cuff, a doctor or hospital must be consulted.
If the symptoms do not improve after 3-4 days of rest and self-treatment, a doctor should be consulted.

Symptoms of major shoulder disorders

Shoulder pain indicates a specific condition. The symptoms may be mild muscle pain that can be treated with home remedies, or there may be a serious injury, such as a collarbone fracture, which requires immediate medical attention.
In the case of mild pain, it is advisable to protect the affected area and – if swelling is present – to cool it with ice.

To relieve the pain, over-the-counter painkillers can also be taken, such as Ben-u-ron or ibuprofen.
In case of severe pain or unknown cause of pain, however, a doctor should be consulted so that appropriate treatment can be given.

Muscle weakness and shoulder pain

Since the shoulder is surrounded by 17 muscles, many factors are possible that can affect muscle strength.
The four muscles of the rotator cuff are fundamental for the movement of the shoulder joint.
These are not the large muscles used to lift heavy loads, but they play an important role in keeping the arm connected to the trunk; Problems with the rotator cuff significantly limit the strength of the shoulder.
The doctor can isolate each muscle of the rotator cuff with the help of special tests to find out where the cause lies.
There may be inflammation or the muscles may be injured or torn.

Instability and shoulder pain

An unstable shoulder feels like the arm is detaching from the joint.
In the case of a shoulder dislocation, the ligaments that hold the humeral head in the joint socket could have been damaged; often this feeling of detachment lasts for many months.

Other patients have loose ligaments, resulting in a chronically unstable shoulder.
This phenomenon is called subluxation and affects young, athletically active women who do not find the shoulder position stable.

Joint cracking or crunching of the shoulder

The causes of noise in the shoulder are manifold:
injuries to the socket lip of the shoulder blade (labrum glenoidale) or the biceps tendon can give the feeling that the shoulder “pops out”.

  • An unstable biceps tendon can slip out of its natural position and cause a snapping sound.
  • The socket lip of the shoulder blade is a cartilage margin, which provides a deepening of the joint socket in which the humerus is located.
    Injuries to the cartilage lip can provoke an unstable shoulder, during movement a click can be heard.
  • Arthritis can lead to cartilage wear in the shoulder joint.

If the cartilage on the joint surfaces is worn, the bones rub against each other and produce cracking and rubbing noises.

  • The subluxation of the shoulder joint (articulated connection between the humerus and the shoulder blade) or shoulder joint (between the collarbone and the upper end of the shoulder blade, the so-called acromion) can cause a click during arm or shoulder movements.

Stabbing pain in the shoulder

When you think about everyday activities, you realize that many of them involve the shoulder muscles and the shoulder joint directly or indirectly.
Excessive stress can thus cause severe pain, but there are also other causes.Muscle strain or muscle tear
The muscles of the shoulder can be injured as a result of a particularly hard training program.
A muscle tear can result from a violent movement that puts strong pressure on a sensitive part of the muscle.
A muscle strain causes stabbing pain when trying to move.
To prevent this pain, each workout should be preceded by an intensive warm-up phase.

Rotator cuff

Shoulder pain can result from an injury to the rotator cuff. The rotator cuff is a structure of muscles and tendons that help stabilize the shoulder in its position.
An injury can be caused by:

  • exaggerated training behavior,
  • repeated movements,
  • Violence on the shoulder, such as in a fall or accident.

High-risk sports for the shoulder are:

  • Tennis
  • Volleyball
  • American football
  • Judo
  • Shot put
  • Javelin throwing.

Kinesio taping for tension, inflammation, bruises and edema on the shoulder

Effect: stress-relieving-draining. Shape: two fan-shaped stripes. Length: 25 cm. Attach the front compartment while the arm is stretched backwards, the rear compartment with the arm led forward. Bone protrusions, such as the acromion of the shoulder blade, omit.

Postoperative shoulder pain

Postoperative pain varies depending on which procedure was performed.
In the case of acromionplasty, instability of the shoulder and reconstruction of the rotator cuff, the pain gradually subsides within about 6 months, but in certain situations symptoms may still occur after this time.

Shoulder pain during deep breathing If pain occurs in the shoulder when breathing deeply, coughing or sneezing

, the cause is probably at the level of the cervical and thoracic vertebrae.

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