Do you struggle to fall asleep at night because of shoulder pain or are you just wondering whether your shoulder pain stems from sleeping on the side?
Sleep-related shoulder pain is pretty common and it has several possible causes. In this article, we’ll cover all the causes in detail as well as provide you with information on the best potential treatments for relieving shoulder pain and how to prevent it.
Can Sleeping on Your Side Hurt Your Shoulder?
Sleeping on the side shouldn’t directly cause shoulder pain, but it may make certain underlying injuries worse.
However, simply put, when you sleep on your side, your shoulder takes on extra pressure. A study on shoulder pain in association with sleeping positions found that 67% of participants had shoulder pain on the side they sleep on.
Another study, even though it suggests a causal correlation between sleeping on the side and shoulder pain, doesn’t manage to prove it.
Given the plethora of other potential causes of shoulder pain, you simply can’t know for sure whether the sleeping position is your only culprit. That’s the bad news. The good news is that if sleeping on your side does indeed cause shoulder pain, you can solve it rather easily.
Let’s go over the common causes first.
Causes of Shoulder Pain
Simply put, our shoulders are not meant to carry the weight of our whole bodies, and, to an extent, that’s what happens when sleeping on the side. But, as we said, shoulder pain could also occur as a result of various injuries or conditions.
Rotator Cuff Injury (RCI)
Rotator cuff injury is the most common and prominent cause of shoulder pain. The collection of tendons that surrounds our shoulder joints is called a rotator cuff. It attaches the shoulder blade end of the upper arm bone within the shallow socket of the shoulder. This way, the shoulder remains in the socket without restricting your arm movements.
Through overuse or overextension of shoulder muscles during sports, inflammation can occur, and further aggravating it can cause RCI.
But, even seemingly negligible day-to-day activities that require overhead use of your arms like painting and construction can also cause this issue.
If a rotator cuff injury is left untreated, it may severely restrict its function and the range of motion it has. If torn, partial rotator cuff tears can progress to full-blown tears.
- Loss of range of motion or stiffness.
- Pain that gets worse when you perform activities like throwing, lifting, or reaching behind your back.
- Dull ache deep in the shoulder.
- Pain while sleeping on the side.
A “frozen shoulder” or adhesive capsulitis occurs when joint tissue gets progressively thicker and thicker, ultimately limiting your range of motion due to the development of scar tissue.
While it’s not exactly known what causes this condition, underuse or complete immobilization (due to a severe injury) of the shoulder can cause a “frozen shoulder.” It’s also known to happen in patients recovering from certain medical conditions like stroke, heart disease, thyroid disease, or Parkinson’s disease.
Shoulder Impingement Syndrome
This condition occurs when the shoulder joints trap nearby tissue or a bone. It can occur due to a muscular imbalance of the shoulder, swelling of the surrounding tendons, or the presence of bone spurs.
- Pain while sleeping on the affected side.
- A feeling of weakness in the affected arm or shoulder.
- Persistent pain in the shoulder.
Bursitis is a condition that occurs due to the inflammation of the bursae. Bursae are fluid-filled tiny sacs that cushion the tissues around the joints.
Moreover, it can occur because of an injury or a repetitive action that overburdens your shoulder. To treat shoulder bursitis, resting the shoulder and taking over-the-counter anti-inflammatory medicines are recommended. In worst-case scenarios, surgery might be necessary, but make sure to contact your physician before panicking.
The symptoms of shoulder bursitis are the following:
- Swelling & redness.
- Stiffness of the affected area.
- Tenderness or localized aching in the shoulder.
- Pain when pressure is applied on that area.
Osteoarthritis happens when the cartilage between the bones starts to break down. The cartilage cushions the joints, among other things. This condition may also affect various parts of the body.
- Stiffness or loss of range of motion.
- Clicking or grinding sound that results when you move your shoulder.
- Pain that occurs during rest or sleeping.
What Can I Do to Alleviate Shoulder Pain While Sleeping?
First, find out the exact cause of your shoulder pain and treat it accordingly. If you think that the pain stems from sleeping on the side, make sure to change sleeping positions for a couple of days, and see if it subsides. Other than that, we’ll suggest several methods below.
If you have a more severe condition, please consult your physician for a correct diagnosis before trying out any of them.
Exercise Your Shoulder
Home exercises and physical therapy helps to gradually increase the endurance of shoulder muscles. This way, the range of mobility and strength of your shoulders will increase.
The type of exercise to treat shoulder pain largely depends on the underlying cause. Here are some strengthening exercises that you can apply:
- Upper Extremity Strengthening
This exercise consists of lifting light weights. You have to lie on your left side, keep the weight in your right hand, and raise the forearm while keeping your elbow near your side.
You can adjust it according to your comfort level and don’t forget to switch sides.
- Rotator Cuff Strengthening
For this exercise, you have to take a resistance band and loop it around the knob of any closed door. Afterward, grab the other end of the band.
Then, pull the band downward across your stomach while keeping your elbow at a 90-degree angle. Repeat the exercise at least 5-10 times and switch sides.
Apply Heat & Ice
Another helpful way of treating shoulder pain is to apply heat or ice to the affected area. The application of ice/heat will depend upon the kind of symptoms you are experiencing. Here are some valuable tips:
- Moist heat helps to lessen the stiffness of joints and relax muscles.
- In tendonitis, ice helps numb pain and reduce inflammation.
- For strains, heat helps to reduce stiffness after the inflammation has gone down.
There are various over-the-counter medicines available that can be used for treating most types of shoulder pain. These medicines include ibuprofen, nonsteroidal anti-inflammatories, and acetaminophen. Shockwave therapy is also helpful in reducing pain in some cases.
If none of the above treatment methods don’t help, depending on the severity of your injury, the doctor may recommend surgery.
For instance, in osteoarthritis, the surgeon replaces the affected joint with an artificial implant. Other surgeries for shoulder impingement include RCI surgery or bursectomy.
Ways to Prevent Shoulder Pain
Other than alternating your sleeping position, here are the steps you can take to prevent shoulder pain.
Enhance Sleep Hygiene
Believe it or not, general physical pain can get worse when you don’t get enough sleep. When you are sleep-deprived, two various kinds of proteins are produced in the body, namely C-reactive protein and interleukin. The elevated level of these proteins makes your body feel more pain.
Sleep hygiene is a series of steps that promotes a good night’s sleep by regulating your circadian rhythm. Here are some tips to improve sleep hygiene:
- Create a noise-free sleep environment.
- Avoid consuming stimulants like coffee or tea before bedtime.
- Don’t take long naps (more than 30 minutes) during the day.
- Form a relaxing bedtime routine. It could be anything like sipping a calming, warm drink, a soothing bath, light meditation/yoga, reading a book, or even writing down your thoughts. Anything goes and it’s entirely up to you – just make sure to stick to it.
Change the Mattress
The quality of your mattress also matters. If the mattress is too soft or too hard, it can make shoulder pain worse.
Research on the effects of an adapted mattress proved that using a medium-firm mattress helps to lessen musculoskeletal pain.
The Best Sleeping Position for Shoulder Pain
You should sleep in the position that’s most comfortable for you. This is yet another thing that’s entirely subjective, but we can give you some tips on what works for a lot of people.
For most people, the best way to relieve shoulder pain is to sleep on your back while providing adequate support to your lower legs, back, and neck. Sleeping on your stomach could also be helpful, but some people find it uncomfortable, and you may end up with back pain. If you prefer to sleep on your back, use a softer mattress to provide it with proper support.
Use The Right Pillow
Using the right pillow is also essential, and it may help reduce the pain if used in the right way. Changing the pillow once it loses shape or after every 18 months is also advised.
- A firm and thick pillow works best for side sleepers.
- Stomach sleepers need a “skinny” pillow.
- A thin pillow that is thick at the bottom and cradles the neck is good for back sleepers.
Best Pillow Positioning for Shoulder Pain
While pillow positioning may not be what you first think of when tackling shoulder pain, anecdotally, it’s been known to help. Here are some specific pillow configurations and angles that help with some types of shoulder pain.
Sleeping on the Back With a Pillow Under the Armpits
The best sleeping position for shoulder pain is sleeping on the back. This way, your shoulder remains stress-free and your spine is aligned correctly. However, some people do notice soreness or stiffness in the shoulders even when sleeping on their back. If you’re one, place a pillow under your armpit beneath the affected shoulder.
Sleeping on the Side With a Pillow Under the Armpits
As we said, side sleepers should avoid sleeping on the affected shoulder, but if you simply can’t get used to another position, try sleeping on the other shoulder. Moreover, you should place one pillow under your affected shoulder’s armpit.
When you sleep on your side, extra pressure is exerted on your shoulder, which may in turn cause pain or irritation. While there’s no direct causal correlation between sleeping on the side and shoulder pain, sleeping on the side may aggravate underlying injuries.
There are various causes of shoulder pain, with the most common ones being bursitis, osteoarthritis, and rotator cuff injury. Always make sure to contact your physician before undergoing any therapy or exercises. Staying active and OTC painkillers are a good solution in most cases.