Doing some simple exercises might also assist you in easing your shoulder pain which erupts at night. It helps in relaxing some of the tissues and muscles around your shoulder, letting the space between various bones in Shoulder to open up enough so that the pain eases and you can get back to having a good night sleep. 

Standing wall stretch:

Keep both hands on a wall so they make a 90-degree position to your body as shown in the picture. Walk few feet backwards until the arms straighten and then bow, hinging forward at the hips. Do not push on the wall, and do not allow your arms to raise up too high in order to avoid shoulder impingement. Keep shoulder blades set back and avoid scrunching shoulders around the neck.

Shoulder rolls:

From a position of proper alignment, roll shoulders up, then back, then down in a fluid motion. Repeat this movement about a dozen times, then reverse it, rolling forward another dozen times.

Shoulder rotation:

With your back to a wall, allow the shoulder blade (scapula) to rest in a neutral position and bring both elbows out to 90 degrees (so the side of your biceps are in contact with the wall). Without moving the position of your elbows turn right arm upward, so the back of the right hand touches the wall, and left arm downward so the left palm touches the wall (or they come as close as possible). Slowly switch (right arm up, left arm down, then reverse it with left arm up and right arm down) for about 30 seconds, trying to keep arms at 90 degrees throughout.

Cow face arms:

Begin by kneeling on the floor, sitting your hips back onto your heels. Hold a towel in your right hand. Reach you right arm straight up, bend your elbow to let you right hand and towel fall behind your head. Take your left arm behind your back, bending you elbow to reach your left hand up your back. Grab hold of the other side of the towel with your left hand and use the towel to walk your hands towards one another. If you hands come all the way to touch, you can let go of the towel and interlace your fingers. Try to hold this for 30 seconds to one minute and then switch sides.

Thread the needle:

Start on all fours on the floor. Lift the left hand off the ground and thread the left arm through the space between the right arm and right leg, letting the back of the left hand arm slide along the ground. Allow the upper body (thoracic spine) to naturally rotate toward the right but keep hips level. Stop pushing the arm to the right at the point where your hips begin to open to the right. This may mean less of a range of motion than what you could do if continued to open.

When to seek treatment for shoulder pain?

Living with shoulder pain, especially if it wakes you up at night or makes sleep difficult, is challenging. If your shoulder pain persists for a period of a few weeks or worsens it is recommended to seek consultation and treatment.

More worrying signs that may present with pain include weakness, loss of movement or instability. These additional symptoms warrant more expedient investigation.

The first step would be to see your family doctor who will ask you specific questions and examine your shoulder to narrow the diagnosis as well as order specific tests to help work out what is wrong with your shoulder.

Getting plain X-rays are very useful to check that you don’t have arthritis, spurs or other bone issues that may be causing your night pain. Additional investigations to assess the soft tissues, including the rotator cuff tendons and the bursa, might include an ultrasound scan or an MRI (magnetic resonance imaging) scan.

Depending on what is found during these consultations your doctor might suggest an injection into your shoulder with corticosteroid to help reduce inflammation and pain and a period of rest. Seeing your physiotherapist for exercises to help settle the symptoms and then strengthen your shoulder is also a good option. If your symptoms persist despite these treatments, or if they worsen, seek a review with a specialist shoulder Orthopaedic surgeon for further treatment options.

Surgical options to help alleviate the pain and improve your shoulder function depend on the diagnosis. Most of this surgery can be performed using keyhole or arthroscopic methods. They include removing the inflamed bursa, removing bone spurs and reattaching torn rotator cuff tendons. If your shoulder pain is from a condition called adhesive capsulitis (frozen shoulder), your shoulder surgeon can release tight and inflamed structures (ligaments and capsule) in your shoulder that cause the pain and stiffness. Lastly, if your pain is due to severe arthritis, a shoulder replacement might be a good option to treat your pain and improve your shoulder range of motion and power. These are intricate operations that require good experience to achieve a successful outcome.