They say that time heals all wounds, but whoever said that never tried sleeping with shoulder pain.
For those suffering from shoulder pain or rotator cuff injuries, it can seem nearly impossible to get comfortable at night and find a sleeping position that isn’t painful.
And unlike other injuries, those having to do with this part of the body can take ages to heal. Some people may never get complete relief and must find creative ways to ease their nighttime shoulder soreness.
Though at times it may seem hopeless and frustrating, there are things you can do to help with the pain and potentially promote healing. The effectiveness of the tips provided in this article will depend on the cause of your pain, as well as other factors like your age and overall health. However, we’ve done a lot of research in this area, and we believe that you’ll find at least a few of these tips very helpful.
Causes of Deltoid Muscle / Rotator Cuff Pain
Four muscles make up the rotator cuff, and often the source of shoulder pain is a tear in one of the rotator cuff muscles. This type of problem is relatively common, with approximately two million people in the United States seeking medical treatment for it.
Tears can occur to do a sudden injury like a fall, or they can happen over time from repetitive motion or degeneration. It is critical to rest when damage is present. Neglecting treatment or continuing to stress this area can result in the tear becoming even larger.
Not having correct posture can result in strain and uneven pressure on bones, muscles, and ligaments. For people who have forward head posture, the risk of having shoulder pain increases.
Forward head posture is when you look down too often instead of keeping your head level. The increase in smartphone use is one of the predominant reasons for forward head posture.
Picture your shoulder like a ball within a socket. There’s a 360-degree range of motion so you can do all kinds of things with this part of your body! The danger is injury or soreness due to overexertion.
You don’t have to be a professional athlete to suffer from overexertion. Even a marathon fence-painting extravaganza or overdoing it playing tennis with the neighbors could cause enough strain to make you regret that last set for weeks or months.
Repetitive Work Injuries
If your profession is physical, you’re at a higher risk for a rotator cuff injury or pain. Construction works are notorious for having this type of pain. Athletes also tend to suffer from repetitive work injuries.
However, it doesn’t have to be dramatic or full-motion movements that cause repetitive work injuries. Anything done over and over again can have the same effect. A barista lifting and moving cups of coffee all day could also create a repetitive work injury.
The fluid in that lubricates our joints decreases as grow older, diminishing our mobility. Further, cartilage degenerates over time, and muscles lose their elasticity as we age.
While we can slow down the process with healthy choices and an active lifestyle, the inevitable march of time will always win in the end. These types of injuries and the pain associated with them are most common in individuals over the age of 40.
Osteoarthritis is often associated in older people, but young people can experience it, too. Degeneration from age or injury can lead to osteoarthritis. There’s also a genetic component, so if your parents had it, you’re more likely to get it as well.
Frozen shoulder has nothing to do with being cold. It is, however, a condition associated with the joint being frozen stiff. Also known as adhesive capsulitis, it is characterized by the immobility of the joint.
Often, the condition begins subtly but gets worse over time. It can heal on its own over the course of two to three years, but for those who don’t wish to wait that long, there are solutions like stretching, physical therapy, and possibly cortisone injections from your doctor.
The mobility of this joint makes dislocation a common injury. The humerus (upper arm bone) gets pushed out of the socket. The first step is to have it put back in place by a trained medical professional and then immobilized for healing.
The healing process can take from 12 to 16 weeks, and surgery is sometimes required.
Tendinosis is a form of chronic tendinitis that results from tears at the cellular level rather than in the tendons themselves. While tendonitis is associated with inflammation, tendinosis sufferers don’t show inflammation, making these two conditions markedly different.
Inflammation in the shoulder’s rotator cuff is often due to repetitive motion or constant “micro-traumas.” People often complain of both clicking and continuous pain when they have tendonitis.
How to Relieve Shoulder Pain at Night
In cases where the pain is particularly severe, you may want to sleep in a semi-reclined position, either in a reclining chair or an adjustable bed. However, this sleeping position isn’t ideal for the long-term.
If you’re dealing with chronic pain or you expect it take a significant amount of time to recover from an injury, you’ll be better off finding a position that you can tolerate.
Here are some options to try:
- Sleep on the side that doesn’t have the shoulder pain. Often taking weight and pressure off of the affected area will provide relief.
- Sleep on the side that has the shoulder pain. In rare cases, putting pressure on the hurt side could diminish the pain. It’s kind of like putting pressure on a wound to compress it and ease the sharpness of the feeling.
- Sleep on your back. We’ve seen reports that warn against this, but not in any regularity or with solid reasoning. Lying on your back helps to evenly distribute your weight. If the shoulder pain is near the front, this position also keeps the pressure off. However, if the rotator cuff pain is on the back side of the joint, then this could make the situation worse.
Maintaining a routine sleep schedule is helpful in providing relief and ensuring you get the proper amount of rest. While it can be more challenging to fall asleep when you’re in pain, not getting enough sleep can result in irritability, slower healing times and sleep deprivation.
Make an effort to go to bed at the same time each night. It may help to do something relaxing right before bed like drink a cup of herbal tea or take a warm, muscle-relaxing bath.
Stretching has proven to be helpful for all types of muscle and joint stiffness and soreness.
When adopting a new stretching regime, go slow. You should feel the stretches, but they shouldn’t be overly painful. If the feeling of mild strain escalates to something that feels more like pain, ease up on the stretch to prevent further injury.
We recommend holding each stretch for 30 seconds up to one minute. Remember to take slow, deep breaths while stretching. Breathe in through the nose and either exhale through the nose or out of the mouth.
Begin seated in a neutral position. Then retract your chin backward. Then go back to neutral. You’ll feel a contraction in the back of your neck. Each time you retract, you’ll feel a tightening sensation in the front of the neck muscles and a corresponding stretch at the base of the head.
This exercise is particularly useful for opening up the shoulders. Start seated, either cross-legged or on your heels. Extend both arms out in front of you. They should be parallel to the floor, palms facing down. Keeping your arms straight, cross your right arm underneath your left at the elbow area. Slowly, wrap your hands around each other. Touch your palms together. Allow your elbows to drop down and keep your eyes on your fingers in front of you.
You’ll feel a refreshing stretch in the upper part of your back and between your shoulder blades. After about six to eight breaths, raise your shoulders slightly and feel the stretch move to the middle of your back.
Supposedly, this stretch got its name because the position your body is in at the end of the stretch resembles the shape of a cow’s face, so don’t take this name personally.
To begin, sit with your legs stretched out in front of you. Then, bend your knees, drawing your feet closer to your body. Slide your right leg under your left, bringing your right foot back toward your left hip. The next step is drawing your left foot to your right hip, stacking your left knee directly on top of your right. It is like a modified cross-legged position.
If this seated position is uncomfortable, you can modify it by sitting on your heels.
The next step is to raise your left arm into the air, bend it at the elbow and reach down along your head down your back. At the same time, reach behind you with your right arm, and bend it up at the elbow so that your right forearm is against your spine and that same hand is resting between your shoulder blades.
Then, interlock the fingers of each hand together, but only if that range of motion is available to you. If your fingers can’t quite reach other, use a strap, belt or towel, gripping it with each hand. Finally, bend forward, bringing your chest down to your knees. Repeat the pose on the other side after holding for 30 seconds to one minute.
Standing Wall Stretch
Begin by facing a wall, standing about 12 inches away from it. Raise your arms above your head and place the palms flat against the wall. Hinge forward slightly, bending at the knees.
Shoulder Blade Stretch
Stand with your feet hip-width distance apart. Raise your arms above your head and face the palms to touch. Then slowly twist to the right, feeling a deep stretch in the back of your right shoulder. Hold for a few breaths and switch sides.
Begin by lying face down on your stomach. Place your right hand on the floor near your chest and push yourself up slightly. Shift your left arm underneath your chest, and then rest your weight back down. Do this gently, especially if you’re putting weight on a sore shoulder. Hold for a handful of breaths and then switch sides.
Triangle pose helps strengthen the neck muscles. Since these muscles are connected to the shoulders, strengthening them can help with pain and prevent further injury.
To begin, stand up with your legs wide apart. Stretch your arms out to each side. They should be parallel to the floor. Rotate your right foot to the front of the room and face the same direction as your head. Slowly hinge forward toward the front the room. Keep your arms in the same outward stretched position, and you’ll notice that your right hand will drop to meet your right ankle.
Depending on what is comfortable, you can choose to look up or down.
Need more info? Check out our guide for bedtime stretches.
For some people with shoulder pain, the act of lying down is sheer agony. You may find it more comfortable to sleep in a reclined position. One option is to prop yourself up with a myriad of pillows so that you remain semi-seated while you’re asleep.
Or, trying to sleep in an actual recliner or invest in an adjustable bed that allows you to switch positions whenever it’s convenient.
Ice Compression Wrap
These wraps are like ice packs designed especially for the shoulder. They work by icing the shoulder, and they have a strap system that holds the pack in place. Depending on the model you get, there may be an option to pump air into the wrap, to allow for more pressure and compression. The air pressure also ensures that the cold gel pack covers the entire surface area of your sore body parts.
There are plenty of medications to help with inflammation like Advil or Aleve, but please consult with your physician before taking anything because there are documented side effects. If you’re looking for a more natural solution, the tart cherry juice is known for its effectiveness.
Shoulder Support Pillow/System
A shoulder support system is kind of a like a pillow, but the manufacturer is quick to point out that you still need a regular cushion. The “system” works by having a slotted area for your arm and shoulder area. The idea behind this genius invention is that side sleepers have nowhere comfortable to rest their arm, and now they do!
With this system, the body is elevated with a slot to place the arm and shoulder to avoid any unnecessary weight. This thing that is not a pillow (even though it looks exactly like one) is a must-try.
Check Out Our Guide: Best Pillows for Side Sleepers
Yoga is a helpful practice for just about everyone, not just people with shoulder pain at night. It involves full-body stretching as well as building strength in the neck and back muscles that surround the area.
If you have pain, some of the standard poses could be a challenge, but if you ease in to them, you’re likely to find that yoga helps increase the strength and health of your shoulders, too!
Want to read more? Here are our favorite yoga poses for better sleep.
If your pain is acute and persistent, your body may need help with healing. Physical therapy and chiropractic are both helpful strategies, and either a physical therapist or chiropractor can recommend an optimal treatment plan.
There is also the option to get medical injections, either PRP (plasma-rich protein) or cortisone injections. Both of these injections can ease the pain, but the PRP injections also aid in healing. Medications are also available.
This route is usually reserved as a last result for extreme injuries or in older people who aren’t as likely to heal from the pain on their own. However, surgery also carries its own risks, especially in older populations.
Signs to Watch Out For
Excessive Stiffness and Swelling
If your shoulder or rotator cuff is so stiff or swollen that you can’t move it, you should consider seeking out professional medical attention. Often, symptoms get worse before they improve, so a visit to the doctor may be in order.
Whether it’s frozen shoulder or you simply can’t move, immobility could be a sign of something more serious. Again, consult with your doctor to rule out anything sinister.
Fever or Chills
Fevers and chills are often symptoms of an infection. It could be unrelated to your shoulder pain, but we recommend being better safe than sorry.
Constant for More Than 4 Days or Intermittently for 2 Weeks
A mild case of overexertion will heal on its own, but long-lasting pain could be a sign of a more serious injury. If it’s a tear, remember that it can get larger or become chronic if not treated properly.
Perhaps the pain is affecting your appetite, and you’ve lost a few pounds. Or, maybe your recent weight loss is an indicator of an underlying condition.
Excessive Night Sweats
Unless it’s a hundred degrees in your bedroom or you’re going through menopause, sweating excessively at night shouldn’t be a common occurrence. Keep in mind that sweating is a way for the body to release toxins, so if you’re waking up in a puddle of your own sweat, it might be time to get your shoulder examined.
Frequently Asked Questions
Why do I have shoulder pain at night only?
There are a few reasons for this phenomenon:
- During the day, you move around more. As you settle in for the evening, movements slow, decreasing blood flow and replacing it with stiffness and soreness.
- Lying down shifts the balance of weight on the shoulder. You may find that you can get through the day perfectly okay but lying down in bed is a whole other story.
- You have less to distract you. Your workday may have been incredibly hectic with not a moment to dwell on anything you might actually need, like food, water or a bathroom break. But when you’re in bed and alone with your thoughts, the lack of distractions could cause you to focus more on pain.
Can I sleep on my side with shoulder soreness?
It's wise to avoid sleeping on your injured side. While sometimes putting pressure on the shoulder can help bring temporary relief, it's typically better to let it heal without interference.
Sleeping on your back is usually a good position for shoulder pain because gravity assists in pulling the humerus back into the joint where it belongs.
However, keep in mind it's always best to consult a professional when necessary.
How can I sleep better after a rotator cuff surgery?
One of the most comfortable ways to sleep after a rotator cuff surgery is by sitting up. This position may entail lying in bed surrounded by pillows or literally sitting up in a recliner.
Hopefully, after reading this guide, the nights of tossing and turning to find a comfortable sleeping position are finally over. In addition to having some tips and tools to battle shoulder pain, having a better understanding of what’s causing it in the first place could potentially speed up your healing and prevent recurring injuries.