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Ask Lisa, MSN, FNP-BC, CCRN Your Own Ques...
Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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Pain in upper arm, mostly right arm, mostly at night.

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Pain in upper arm, mostly right arm, mostly at night. Throbbing, interferes with sleep. I am working on theory that it is related to job requiring lots of computer keyboard and mouse used during the day. However I only occasionally have pain during the day, it is much more common in the night, especially after I have been in bed for a while. Tried swimming but no clear benefit. 64 year old female.
Submitted: 7 years ago.
Category: Health
Expert:  Lisa, MSN, FNP-BC, CCRN replied 7 years ago.


Thank you for writing in today. Your complain may be related to some overuse injury, such as bursitis; however, since the pain is worse at night, this is suspicious for a rotator cuff problem. When patient's present with this type of complaint, the rotator cuff issues must be considered. Due to the limitations of the internet, I can't assess you; however, I really think you should be evaluated by your primary provider, specifically to rule out an underlying rotator cuff problem, particularly if you have a past medical history of injury or sports. You may need some imaging to assess for underlying structural problems. Generally, rest, ice, and anti-inflammatory medications are helpful; however, the extent of the underlying problem really needs to be evaluated. Those interventions may not be effective for really controlling or improving your pain. I know the "go to your provider" answer is not the most popular answer, but sometimes it is necessary. I hope you understand. If you have any additional questions or concerns, please let me know. Lisa

Customer: replied 7 years ago.
I thought rotator cuff problems were enhanced by raising the arm up.
I have no problem raising my arm up during the day when I have no pain. And my problem in the night is not related to raising my arms - I can not lie with my arm next to my body without pain and this makes it difficult to lie on my sides.
Does this still sound like rotator cuff?
Expert:  Lisa, MSN, FNP-BC, CCRN replied 7 years ago.
It actually does still sound suspicious for rotator cuff related problems. There are different degrees and types of rotator cuff disorders and injuries. I am most suspicious of some rotator cuff related tendonitis. It is possible to have some tendonitis without limited overhead range of motion. You may also want to see if you have any pain when you reach into your back pocket, like putting a wallet in a back pocket or putting on a coat. There are actually 3 different tendons throughout the rotator cuff area. As people age, particularly those over 60, it's normal for these tendons to thin, making them more susceptible to irritation and inflammation. Personally, I am still suspicious of that rotator cuff. I think your provider will want to image it (MRI not Xray). At any rate, I hope this helps. Lisa
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