Can the Way You Sleep Cause Pain in Your Shoulders?

September 01, 2022

Illustration of a man experiencing shoulder pain upon awakening

If shoulder pain is keeping you from sleeping at night, you’re likely frustrated and want to find a way to solve it.

“One of the most frequent complaints that I hear from patients with pain in their shoulder is that they have difficulty sleeping,” says Jared Levin, MD, an orthopedic sports medicine physician and shoulder surgeon at University Hospitals. “This is true for a wide range of shoulder problems. While people find a way to adapt during the day, going a long time without a restful night’s sleep certainly can wear you down.”

Fortunately, pain at night is a problem you can do something about and many options exist.

Common Causes of Shoulder Pain at Night

Prolonged pressure on the shoulder from sleeping on your side can become painful especially if there is an underlying condition in the shoulder joint or upper arm.

For side sleepers, this pain is commonly caused by bursitis. Bursitis is an inflammation of the bursa, which is a fluid-filled pad that provides a cushion to the bones of the joint. When injured, fluid in the bursa increases and this swelling can be painful.

Other conditions that could lead to shoulder pain at night include biceps tendonitis, rotator cuff injuries or overuse injuries from a specific activity or shoulder motion that you make repetitively. Racquet and ball throwing sports are some of the main culprits, but any repetitive shoulder motion can cause an overuse injury.

Biceps tendonitis is usually the result of long-term overuse and deterioration of the biceps tendon that connects muscles and bones in the shoulder joint. Tendons may also get less flexible as we age, and more prone to injury. Tendinopathy is often part of the aging process. Biceps tendinopathy can create sharp pains in the arm with certain motions like reaching behind you.
Rotator cuff injuries usually involve a tear in these tendons. The rotator cuff includes four muscles that come together as tendons and connect your humerus bone to the shoulder blade. The cuff provides shoulder stability and enables movement. Damage to any one of the four muscles could result in inflammation and swelling and general pain in the shoulder. Rotator cuff tears are a very common problem and may result from a fall or lifting something too heavy, too fast. But most tears occur as the tendons wear down over time.

Importance of Stretching

One of the first and easiest things you can do to try to relieve the pain is to carefully stretch the shoulder before you go to bed. Stretching can increase the range of motion of the shoulder joint and lessen the pain. Some very simple motions can make a world of difference in increasing your flexibility:

Shoulder shrug up and down
Rolling the shoulders in a backwards motion
Wall stretch stand close to a wall and walk your fingers up as high as you can and hold

Before You See the Doctor

Some things you can try at home to reduce the pain and inflammation include:

Taking anti-inflammatory medications such as ibuprofen, naproxen or acetaminophen
Sleeping in a recliner
Applying ice or heat
Wearing a compression sleeve
Taking a break from any activities that may contribute to overuse of the shoulder

If the shoulder pain doesn’t go away or worsens, see an orthopedic specialist. It’s important to properly diagnose your condition to ensure you’re getting the best treatment. A specialist will evaluate your shoulder with an X-ray or MRI and determine a care plan.

Non-surgical treatments may include activity modifications, physical therapy and/or a cortisone shot to ease the pain. If there is no improvement in your strength or the injury worsens over time, surgery may be the best option to restore function and alleviate pain.