Trying to sleep with shoulder pain can feel like a torturous cycle. The nagging aches alone can make it hard to drift off. Once you finally do get to sleep, your sleeping position could worsen your shoulder pain overnight, leading to more stiffness and discomfort the following day.
Nearly 70% of people will have shoulder pain at some point in their lives. The most common cause of shoulder pain is rotator cuff tendinitis or bursitis, which is when the rotator cuff tendons get trapped under the shoulder bones, causing inflammation or damage.
Beyond cuff tendinitis, shoulder pain can also stem from injury and a wide range of other conditions. Rheumatoid arthritis, for example, can cause swelling in the shoulder joints, which leads to pain and stiffness. Likewise, osteoarthritis can cause the smooth outer covering of bones to wear away, causing the bones in the joints of the shoulder to rub together — ouch! Shoulder pain can also follow laparoscopic surgery, although the reasons why aren’t entirely clear.
Other causes of shoulder pain include:
- bone spurs
- frozen shoulder
- poor posture
- overuse of nearby tendons (like the bicep muscles)
- calcific tendonitis
- spinal issues
- avascular necrosis
- thoracic outlet syndrome
But regardless of the cause, there are ways to sleep better with this type of discomfort. If side-sleeping is the cause of your shoulder pain, that might simply mean learning to sleep on your back. If your shoulder pain stems from another common cause, such as arthritis, tendon inflammation, or an injury, stretches and lifestyle tweaks could be all that it takes to help you sleep more soundly.
Read on for more strategies for pain-free sleep.
Switch positions if you have shoulder pain from sleeping
In a small study, researchers found that 67% of patients slept on their painful side rather than their pain-free side. Thankfully, shoulder pain that occurs after sleeping, or gets worse during sleep, can usually be remedied by switching up your sleep position.
Sleep on your non-injured side
Your sleeping position can either be the key to finding shoulder pain relief or an active contributor to your discomfort. More than half of us sleep on our sides — a position that puts added weight and pressure on the shoulder.
“People will typically avoid sleeping on the affected shoulder, as the pressure can make pain worse in most situations,” says Dr. Russell S. Petrie, an orthopedic surgeon at the Hoag Orthopedic Institute who specializes in shoulders.
In addition to sleeping on your non-injured side, you might also consider investing in a new pillow to support your preferred sleeping position.
Side sleepers often do well with a firm pillow that is plush enough to fill the space between their bed and head, which helps keep the upper body in proper alignment.
Sleep on your back
Better yet, commit to sleeping in a more shoulder-friendly position; that’s a more reliable solution than switching which side you sleep on. Jean Pradel, a licensed physical therapist and owner of Physical Therapy Now Miramar in Florida, says the best sleeping position for shoulder pain is on your back, with your bent elbow supported by a small pillow or rolled towel underneath, and your hand draped on a pillow atop your abdomen.
“This is the best sleeping position because it puts the least amount of stress on the rotator cuff and supporting structures,” he explains.
Upgrade your bed setup to prevent shoulder pain while sleeping
If you find yourself waking up each morning with shoulder pain worse than the night before, it might be time to change your sleep setup.
Elevate your body with an adjustable-base bed
Got some room in your budget? Consider making a few key upgrades to your bed to help you sleep better. Petrie suggests investing in an adjustable bed that allows you to sleep with your head elevated, which helps reduce stress on the shoulders. While costly, this upgrade may be worth the splurge if you have chronic shoulder pain that makes it hard to catch Zzz’s.
Invest in a wedge or backrest pillow
If you have acute shoulder pain that’s likely to go away in the coming weeks or months, you might want to consider picking up a wedge pillow or plush backrest pillow, which can keep you upright during your recovery, says Pradel.
“As you improve, you can get a smaller (pillow) so you are less upright and eventually, you can fully lie down. It’s important to note that a shoulder injury should only last months, not years, so these accommodations should only be temporary, not permanent,” he adds.
Stretch out shoulder stiffness in the morning
Lying in one position all night long can cause you to wake up with shoulders that feel especially stiff and sore. Incorporating some gentle stretches into your morning routine can boost blood flow to your muscles and joints. It can also reduce pain in your body during the day — potentially making it easier to sleep at night, too.
Shoulder stretches and exercises can also help if you have bad posture and poor shoulder strength. Repetitive motion from work duties or day-to-day responsibilities can also increase your risk for shoulder pain. Strong shoulder muscles help support your rotator cuff and can also reduce the risk of shoulder pain caused by shoulder impingement syndrome, osteoarthritis symptoms, and rotator cuff injuries.
Looking for specific exercises that can help loosen up stiff shoulders? Start with these stretches:
While stretching can be beneficial for many people, certain moves may not be safe for some conditions or injuries that cause shoulder pain, such as recurrent dislocations. Be sure to check in with a doctor, physical therapist, or other healthcare professional before trying shoulder exercises. And if a movement causes more pain, stop doing it.
Explore other ways to relieve shoulder pain
If adjusting your sleep position, bed setup, and stretching routine hasn’t alleviated your shoulder pain, try these strategies.
- Hot and cold therapy: Place an ice pack on your shoulder for 15 minutes a few times during the day. Before bed, use a heating pad to soothe stiffness and pain in your shoulders.
- Acupuncture: While further study on acupuncture is needed, some limited research shows that it can offer short-term improvements to shoulder pain and function.
- Proper posture: Maintaining good posture throughout the day can help keep your shoulder muscles and tendons in the correct position. Poor posture can reduce back and shoulder strength, affecting your spine.
- Over-the-counter pain relievers: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can reduce inflammation — and in turn, help ease pain. Take these medications as directed on the bottle, or per your doctor’s instructions.
Get a diagnosis and treatment, especially for chronic shoulder pain
Shoulder pain (and the sleep problems it can cause) aren’t something you just have to live with. Many treatments can help alleviate shoulder pain, depending on what’s causing it.
“Shoulder pain is an indication that something is wrong. If you are living with shoulder pain, you should go seek professional medical care as soon as possible,” says Pradel.
Over-the-counter and prescription medication can reduce inflammation and pain. A doctor may also recommend that you receive steroid injections to relieve shoulder pain, especially if your injury or condition causes symptoms of inflammation or swelling. In most cases, physical therapy can be a helpful way to improve your shoulder function, strength, flexibility, and range of motion.
If your shoulder pain isn’t alleviated with injections or physical therapy, or seems to be getting worse, your doctor may suggest surgery to repair torn tissue or get rid of scar tissue. If you have serious damage to your shoulder joint, bone, or cartilage, reconstruction or replacement surgery could be an option worth discussing with your physician.
Fortunately, these procedures aren’t necessary for most people with shoulder pain. However, if you do need surgery, a wedge or backrest pillow will come in handy during your recovery period, as you may need to sleep upright in a chair to avoid the risk of sleeping on your shoulder.
Make sleep part of your overall shoulder pain treatment
Sleep deprivation can make chronic pain feel even worse, which, in turn, can lead to more sleep disruptions. Breaking the cycle requires facing both problems head-on. This could mean:
- upgrading to an adjustable bed, which can keep your upper body elevated
- finding the right pillows; wedge and backrest pillows are great options for recovering from a shoulder injury
- adjusting your sleep position to avoid putting pressure on your sore side
- doing shoulder stretches in the morning to work through stiffness
If you’re not sure what’s causing your shoulder pain, talk to a healthcare professional to get a diagnosis. That way, you can work toward a treatment that provides pain relief — and pain-free sleep.