<s>[INST] I have had really bad pain in my arms from my elbow to my shoulder for over three months now. It hurts constantly and even wakes me up several times in the night. It is getting worse instead of better. I do quite a bit of lifting at work sometimes up to 40 pounds and I only weight 105 myself. I am 47 years old and have no other health issues. [/INST] Hi, thank you for providing the brief history of you. A thorough clinical examination is advised. As this injury looks more of the muscular called as the bicep ital tendonitis. Due to heavy work and sudden movements the Pain can arise. Taking a therapeutic ultrasound therapy and TENS therapy should help reduce pain. Post this exercises to strengthen the muscles and shoulder girdle should solve the matter. In my clinical practice most cases with sucChatDoctorplaints are referred to physical therapy, and they respond well. Regards Jay In Chat Doctor.  </s>