There are several possibilities and the most common cause might be heart attack,rotator cuff tear and frozen shoulder.
1. Common heart attack signs and symptoms include:
- Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
- Nausea, indigestion, heartburn or abdominal pain
- Lightheadedness or sudden dizziness
To improve your heart health, take the following steps:
- Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help.
- Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications.
- Get regular medical checkups. Some of the major risk factors for heart attack — high blood cholesterol, high blood pressure and diabetes — cause no symptoms early on.
- Exercise. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack. Walking 30 minutes a day, five days a week can improve your health.
- Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes.
- Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure.
- Manage diabetes. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes.
- If you drink alcohol, do so in moderation. That means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger.
You can also take some medication to control your disease under the guidance of your doctor.
Medications given to treat a heart attack might include:
- Aspirin. The 911 operator might tell you to take aspirin, or emergency medical personnel might give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
- Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart.
- Antiplatelet agents. Emergency room doctors may give you other drugs known as platelet aggregation inhibitors to help prevent new clots and keep existing clots from getting larger.
- Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given intravenously or by an injection under your skin.
- Pain relievers. You might be given a pain reliever, such as morphine.
- Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels.
2. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.
The pain associated with a rotator cuff injury may:
- Be described as a dull ache deep in the shoulder
- Disturb sleep, particularly if you lie on the affected shoulder
- Make it difficult to comb your hair or reach behind your back
- Be accompanied by arm weakness
Conservative treatments — such as rest, ice and physical therapy — sometimes are all that's needed to recover from a rotator cuff injury. If your injury is severe and involves a complete tear of the muscle or tendon, you might need surgery.
3. Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.
- Freezing stage. Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.
- Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.
- Thawing stage. The range of motion in your shoulder begins to improve.
For some people, the pain worsens at night, sometimes disrupting sleep.
Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely.