There are some phases of how adhesive capsulitis or frozen shoulder progresses. First, the inflammation is progressing, and the joint starts to freeze and become painful. And then inflammation will be followed with stiffness, frozen phase. And eventually, the recovery comes. Interestingly, some patients find that the problem is getting worse and hurt more at night, why?
So far, there is still no clearly answer of why pain of many health conditions (including for frozen shoulder) get worse at night. However, there are some arguments. The following are some possible reasons.
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When the sunset comes and the day is going to dark, some mechanisms in the body change, too. For instance, the way of how the stomachs and airways work in the body can be different at night. And this may have a role to exacerbate the pain.
When you are lying down for sleep, this can raise loading of elements of your spine and eventually will compress the spinal structures. As a result, the blood vessels that carry blood to the lower extremities are impeded, causing central pooling and swelling (central edema).
Another issue is about cortisone, a kind of hormone that can help control stress. Stress itself is a standalone factor that can worsen pain. And the natural cortisone in the body can vary throughout the day, but it is relatively lower in the evening and nighttime.
Moreover, some environmental factors may have an effect. Changes of moon can cause ion changes.
According to a theory, the elevated amounts of positive ions in the air may worsen pain. This may also cause other changes in the physical and mental functions of the body.
We all agree that the situation surrounding you can affect the way of how you get a good sleep. A calm and silent night is great thing for your sleep. But sometime, this can be the starting point where your pain may hurt more at night.
You are easier to feel isolated at night. It’s quiet and dark, making you feel you are all alone. And you are more likely to become more aware of your pain.
At night, most people usually have fewer distractions. That’s why they are easier to think about their pain.
In other words, the pain of frozen shoulder tends to become noticeable when you have no distractions or if there is little else going on.
If the pain has disturbed your sleep, it’s recommended to see a doctor since sleep deprivation can worsen the problem, and also affect your overall health.
Pain is actually a sensation you feel when your nerves are encouraged to intense degree. This stimulation can affect your brain, making you awake and difficult to fall asleep at night.
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And as noted before, bad sleep for people with painful condition such as frozen shoulder is a nightmare. When your sleep is affected, this can elevate your stress level and trigger other bad things that will make your pain worsen.
So, pain and bad sleep (sleep deprivation) can lead to a viscous cycle. The following are ways of how they are connected and can affect each other.
Your sleep’s architecture can be disrupted by pain
There are several stages of sleep – these include light sleep, deep sleep, and rapid eye movement ‘REM’ sleep. Normally, you should go through about 4-6 cycles of these stages in your sleep per night.
The problem comes when pain or other discomfort symptoms disturb your night sleep. If the pain often wakes you up, you can have sleep deprivation for REM and deep sleep, making you easier and more sensitive to pain.
According to a study released in April 2009 of Sleep Journal, people with low on rest are more sensitive to pain. This issue is not fully understood. But experts believe that bad sleep may trigger the elevated production of inflammatory chemicals.
Your sleep position may be affected, too
The uncomfortable condition of shoulder affected by adhesive capsulitis may prevent you from getting a comfortable position for sleep. As a result, you are difficult to fall asleep or often wake up in the middle of night.
Both chronic pain and bad sleep may lead to trouble for exercise!
When your joint is painful and you don’t get a restful night’s sleep, you are more likely to become a sedentary individual with low physical activity. This can lead to weight gain.
And excess weight will restrict your mobility, making you gain more pounds of weight. This viscous cycle eventually worsens the recovery of your frozen shoulder.
Pain of frozen shoulder is not the only one. Other chronic pain conditions such as in arthritis, heart disease, migraine, and CRPS (complex regional pain syndrome) tend to flare up or hurt more at night. The same goes for asthma, cough, headache, some menopause symptoms, and bronchitis.