Why Does My Shoulder Hurt?
Shoulder pain is one of the most common orthopedic complaints. It can range from mild discomfort — like difficulty brushing your hair — to intense, stabbing pain that wakes you at night.
But what causes shoulder pain? And what’s really going on inside the joint?
Understanding the Shoulder Joint
The shoulder is a complex structure made of bones, tendons, ligaments, and bursae. Its main function is to allow a wide range of movement. So when movement becomes painful, what’s usually to blame?
The answer is often subacromial impingement.
What Is Subacromial Impingement?
Subacromial impingement happens when the rotator cuff tendons rub against the acromion (a bony projection of the scapula). This repeated friction causes inflammation of the tendons (tendinitis) and the nearby bursa (bursitis), resulting in pain, especially when lifting the arm.
Standard Treatment vs. Advanced Options
Traditional treatment includes NSAIDs and physiotherapy. While this helps some patients, others may not improve for weeks or even months.
In our practice, we offer a faster and more precise solution using ultrasound-guided infiltration.
What Is Ultrasound-Guided Infiltration?
Here’s how the procedure works:
- A topical anesthetic is applied to numb the skin.
- Under real-time ultrasound, we insert a needle directly into the inflamed bursa.
- A targeted injection — either corticosteroids or PRP (Platelet-Rich Plasma) — is delivered precisely where it’s needed.
This reduces pain and inflammation almost immediately, allowing faster return to movement and improved outcomes with physical therapy. Many patients feel better within a day.
Why Ultrasound Matters
Unlike blind injections, ultrasound ensures that medication reaches the exact area of inflammation. If you’ve had a cortisone shot that didn’t work, it may not have been placed correctly.
Precision matters. That’s why we use ultrasound for every injection we perform.
When Is Surgery Needed?
In more advanced cases, especially with persistent or recurrent symptoms, we may consider arthroscopic subacromial decompression. This minimally invasive surgery removes bone spurs and reduces pressure on the rotator cuff tendons, allowing proper movement to return.
Final Thoughts
Most cases of shoulder pain can be treated without surgery. The key is early diagnosis, precise imaging, and the right intervention.
Stay tuned for future posts where I’ll cover more causes and treatments for shoulder pain.
Why Your Shoulder Pain Keeps Coming Back
Shoulder pain that returns after every round of physical therapy or cortisone injections can be frustrating and concerning. Many patients come to our clinic saying, “I thought I was better, but the pain came back after a few weeks.”
So, why does this happen?
The Root Cause Was Never Fully Treated
Pain relief is only one part of healing. In many cases, the inflammation subsides, but the structural issue — like a tendon tear, calcium deposit, or impingement — was never fully resolved. This leads to repeated flare-ups.
Common culprits:
- Partial rotator cuff tears.
- Undiagnosed calcific tendinitis.
- Subacromial bursitis from ongoing impingement.
The Injection Missed the Target
Many cortisone or PRP injections are done “blind” — without imaging. If the medication doesn’t reach the exact area of inflammation, the relief is incomplete and short-lived.
In my clinic, every injection is performed under real-time ultrasound guidance to ensure precision. We don’t guess—we treat what we see.
You’re Stronger… But Not Stabilized
Pain might go away after rest or therapy, but if the rotator cuff and scapular muscles aren’t properly reconditioned, the shoulder remains vulnerable. A small movement or poor posture is enough to cause a setback.
That’s why we work closely with physical therapists to build strength and stability after pain relief.
What You Can Do About It
- Get a precise diagnosis using ultrasound or MRI.
- Treat inflammation and the underlying structural issue.
- Follow a personalized rehab plan that focuses on long-term function.
- Don’t settle for temporary relief — aim for complete recovery.
Shoulder pain doesn’t have to be part of your routine. We use a combination of modern diagnostics and targeted treatments to help patients heal smarter and stay pain-free.
When to Worry About Joint Pain That Wakes You Up at Night
We’ve all had the occasional ache after a long day, but when joint pain wakes you up in the middle of the night, it’s usually a sign that something more serious is going on.
Nighttime pain is serious because it often points to inflammation, irritation, or structural damage inside the joint.
Here’s what you need to know.
Shoulder Pain at Night? Think Bursitis or Tendinitis
If you find it painful to lie on your side or wake up with a deep ache in the shoulder, the most common causes are:
- Subacromial bursitis (inflammation of the fluid-filled cushion in your shoulder)
- Rotator cuff tendinitis (irritation of the shoulder tendons)
These conditions are often made worse by certain sleeping positions and may not fully settle down without precise, image-guided treatment.
Hip or Knee Pain That Disrupts Sleep? It May Be Inflammatory
Joints that throb or burn at night could be showing signs of:
- Osteoarthritis in an advanced stage.
- Inflammatory arthritis (such as rheumatoid arthritis).
- CAM-type impingement (especially in younger adults with hip pain).
Inflammatory joint conditions often flare up during rest, which is why night pain is such an important diagnostic clue.
Back Pain Worse at Night? Don’t Ignore It
Nighttime back pain — especially if it wakes you up or is not relieved by changing positions — should be evaluated. It can sometimes indicate:
- Sacroiliitis or ankylosing spondylitis.
- Disc issues pressing on nerves.
- Referred pain from the hip or pelvis.
When Is It Time to See a Specialist?
Here are the signs that your night pain needs medical attention:
- It’s happening more than twice a week.
- It interrupts your sleep consistently.
- You feel stiff in the morning, and it takes time to “warm up.”
- You’ve already tried rest, stretching, or painkillers — and it keeps coming back.
What We Do Differently
In our clinic, we start by identifying the exact structure causing pain using ultrasound or imaging. Then, we treat it directly, often with a targeted injection under ultrasound guidance, followed by a personalized rehabilitation plan.
This approach not only relieves pain, but it also helps restore function and prevent recurrences.
Final Thought
Pain that wakes you up at night should never be dismissed as “normal.”
It’s your body’s way of telling you something’s not right, and early treatment often means faster recovery.