A man in his 40s, identified as Mr. A, who works for a company and habitually sleeps on his right side, often felt a heavy sensation in his right shoulder when going to bed. However, he dismissed it as mere fatigue and did not pay much attention to it.
Recently, however, the number of nights he lost sleep due to shoulder pain increased, and on particularly bad days, even routine actions such as washing his hair or putting on clothes became difficult. Eventually, after visiting an orthopedic clinic, Mr. A was diagnosed with inflammation in his right rotator cuff.
The rotator cuff is composed of four muscles and tendons (supraspinatus, infraspinatus, teres minor, and subscapularis) that surround the shoulder joint and assist with the movement of the shoulder and arm. It plays a crucial role in both the stability and mobility of the shoulder.
Like Mr. A, the habit of sleeping on one side for an extended period can place continuous pressure on the shoulder, causing micro-injuries to the tendons. As a result, not only the rotator cuff but also surrounding tissues that make up the shoulder, such as the bursa and joint capsule, may develop inflammation or sustain damage. In particular, lying on the side concentrates body weight on the shoulder, which can repeatedly cause pressure-related injuries to specific areas.
Inflammation of the rotator cuff can also occur in cases where the arm is used excessively and repeatedly, such as in tennis, baseball, swimming, or cleaning. It can also result from sudden trauma or impact to the shoulder, from impingement due to structural abnormalities of the shoulder bone, or from aging and degenerative changes in the tendons.
When inflammation occurs, pain typically appears in the front or side of the shoulder and intensifies when lifting the arm. The pain often worsens at night, disrupting sleep. Patients may feel restricted when rotating or lifting the arm, and sometimes a clicking or grinding sound can be heard in the shoulder.
If these symptoms are ignored and left untreated, the inflammation can become chronic, leading to persistent pain. Actions such as washing hair or putting on clothes may become difficult, and sleep disturbances can significantly reduce overall quality of life.
If the inflammation persists, the tendons may gradually weaken, potentially progressing to a partial or complete tear, in which case surgical treatment may be necessary. Conversely, if one tries to avoid pain by limiting shoulder use, muscle atrophy and joint stiffness can occur, reducing the range of motion and possibly leading to adhesive capsulitis (frozen shoulder), which requires caution.
To assess the condition of the rotator cuff, doctors check for pain responses when lifting the arm and perform rotational strength tests. Imaging studies such as X-rays, ultrasound, and MRI are used to precisely diagnose the structure of the shoulder and the condition of the tendons. Treatment typically begins with conservative measures focused on pain control and rehabilitation, such as rest, hot or cold therapy, medication, and physical therapy. If symptoms are severe enough to interfere with daily life or a tear is suspected, surgery may be considered.
Lee Jimin, Director of the Joint Center at Daedong Hospital and an orthopedic specialist, emphasized, "Shoulder disorders are often thought to be caused only by aging or sports injuries, but as in Mr. A's case, everyday behaviors such as repeated postures or sleep habits can also be the cause. The shoulder is anatomically thin and delicate, and repeated pressure from certain postures can cause inflammation. If left untreated, this can progress to structural damage and chronic problems, so it is important to see an orthopedic specialist early if abnormal symptoms appear."
For rotator cuff health, it is important to thoroughly stretch the shoulders before exercising and to consistently perform strength training exercises to build up the muscles around the shoulder. Avoid staying in the same position for long periods, and when lifting heavy objects, keep your elbows close to your body to minimize strain on the shoulder.
When performing tasks that require repetitive arm use, take breaks to protect the shoulder. If shoulder pain occurs during daily life, do not overexert yourself and seek medical attention immediately to prevent chronic problems and tears.
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