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If the pain is between his shoulder shoulders intensive treatment Shoulder arthroscopy Shoulder pain blades it is probably from GERD (reflux into his esophogus). Maybe by the morning the reflux has irritated his esophogus enough to cause the terrible pain (I get it often and it is really bad). Now it is bad enough that the food or liquid hits the irritated spot and causes the same pain. He needs to see a gastroenterologist and have a endoscopy to have a true diagnosis, but needs to take care of it as it can cause Barrett's esophogus (pre cancer).
Thank you,
AMF