Waking up with shoulder pain in the middle of the night may be caused by other systemic diseases such as frozen shoulder, rotator cuff injury or cholecystitis. 1. Frozen shoulder: this disease is a chronic inflammation of the ligaments, ligaments, bursa and other soft tissues around the shoulder joint, which is often manifested as pain and limitation of activities in the shoulder joint, mostly aggravated at night, and may be related to factors such as cold and pressure at night. 2. Rotator cuff injury: this disease is mostly caused by trauma and chronic strain injury, which is one of the main causes of periapical pain and often affects the abduction function of the upper limb. The pain is aggravated at night due to cold stimulation or inadvertent lifting of the upper limb during sleep. 3. Other systemic diseases: due to the pain of internal organs with the characteristics of involving pain, certain diseases can cause shoulder pain when occurring at night, such as acute myocardial infarction can cause left shoulder pain, cholecystitis can cause right shoulder pain. If shoulder pain wakes people up at night, you should consult a doctor in a timely manner, under the guidance of the doctor to improve the relevant examinations to further clarify the cause and targeted treatment, do not use painkillers, so as not to delay the condition.