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What Causes Severe Pain In The Shoulder Upon Waking Up?

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Posted on Mon, 17 Oct 2016
Question:      I have a pain in my right shoulder that is very intense in the morning after sleeping on my side all night. It also occurs at any other time that my arm as been inactive; such as after sitting and watching tv. I had a torn rotator cuff on my left shoulder and the pain is very similar. However, I don't have the weakness that I had with the torn rotator cuff. If someone puts resistance against my arm I can "lift" against the resistance. 2-3 years ago I took a fall while shovelling snow and suffered a partial shoulder serparation and am wondering if this might be associated with that. The tingling that I experience is similar to what you feel when you arm has "gone to sleep". The pain radiates into my neck; especially that thick tendon that goes from the shoulder to the neck.
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Answered by Dr. Nishad BN (3 hours later)
Brief Answer:
Most likely due to axillary nerve irritation.

Detailed Answer:
Hi

Thank you for asking HCM.

I have gone through your query. Your problem can be most likely due to axillary nerve irritation. Rotator cuff injury which coexist might be making this more worse.
A physical examination with orthopedician will be helpful to rule out this. Electromyography will be helpful to rule out nerve injury or weakness. MRI of shoulder and rotator cuff also will be needed.
Physiotherapy and muscle strengthening exercises will be helpful. I would also suggest neurotropic drugs like pregabalin and methylcobalamin in such case. Use soft pillows to place on both sides to support your shoulders while sleeping to avoid nerve irritation.
You can go on with conservative measures like neurotropic drugs and physiotherapy for 3 to 6 months. You should also do shoulder muscle strengthening exercises according to the physical therapist advise.
If no improvement after 6 months of these measures then you can go for surgical management.

Let me know if anything not clear.
I am happy to help you.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Nishad BN

General & Family Physician

Practicing since :2009

Answered : 5477 Questions

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What Causes Severe Pain In The Shoulder Upon Waking Up?

Brief Answer: Most likely due to axillary nerve irritation. Detailed Answer: Hi Thank you for asking HCM. I have gone through your query. Your problem can be most likely due to axillary nerve irritation. Rotator cuff injury which coexist might be making this more worse. A physical examination with orthopedician will be helpful to rule out this. Electromyography will be helpful to rule out nerve injury or weakness. MRI of shoulder and rotator cuff also will be needed. Physiotherapy and muscle strengthening exercises will be helpful. I would also suggest neurotropic drugs like pregabalin and methylcobalamin in such case. Use soft pillows to place on both sides to support your shoulders while sleeping to avoid nerve irritation. You can go on with conservative measures like neurotropic drugs and physiotherapy for 3 to 6 months. You should also do shoulder muscle strengthening exercises according to the physical therapist advise. If no improvement after 6 months of these measures then you can go for surgical management. Let me know if anything not clear. I am happy to help you. Thanks.