Calcific tendonitis is a common orthopedic condition involving the accumulation of calcium deposits within the tendons, most frequently affecting the rotator cuff in the shoulder. This build-up causes inflammation and significant discomfort, which often severely disrupts sleep. The pain experienced can be sharp and intense, particularly during the resorptive phase when the body attempts to break down the calcium crystals. Finding ways to manage this nocturnal pain is paramount to recovery. This guide explores the reasons for increased pain at night and offers practical strategies to improve comfort and sleep quality.
Understanding Nocturnal Pain Triggers
For many people with calcific tendonitis, the discomfort seems to intensify after lying down for the night. This increase in pain is related to a combination of physiological and positional factors affecting the shoulder joint. One explanation involves the body’s natural inflammatory cycle, which is partly regulated by the hormone cortisol. Cortisol levels typically decrease during the night, which can lower the body’s natural pain threshold and make existing inflammation feel more pronounced.
The reduced movement and prolonged stillness of the shoulder during sleep can also contribute to stiffness and discomfort. When the shoulder is inactive for hours, it may experience a reduction in blood flow, which can aggravate the already inflamed tendon tissue. Furthermore, certain sleeping postures can create direct mechanical pressure on the affected rotator cuff tendon, compressing the inflamed area and spiking pain levels. This combination of hormonal changes, reduced movement, and external pressure explains why the night can be the most challenging time for those dealing with calcific tendonitis.
Positional Strategies for Comfort
The optimal sleeping position for people with calcific tendonitis is typically on the back. When sleeping on your back, it is helpful to place a pillow or a folded towel under the arm of the affected shoulder. This slight elevation helps maintain the arm’s alignment with the body and prevents the shoulder from dropping into a position that strains the rotator cuff.
If you prefer to sleep on your side, avoid sleeping directly on the affected shoulder, as this puts substantial pressure on the inflamed tendons. Instead, shift to the unaffected side and use a pillow to create a supportive “nest” for the affected arm. This involves hugging a pillow to your chest and resting the affected arm on top of it, which keeps the shoulder joint slightly abducted. This practice helps to reduce downward strain and prevents the shoulder from rolling forward.
For individuals struggling to remain in the back or unaffected side positions, a wedge pillow can be a beneficial solution. Sleeping in an elevated, reclined position uses gravity to reduce pressure on the joint capsule and may help prevent accidental rolling onto the painful side. Using a wedge or a substantial backrest pillow can help stabilize the torso and keep the shoulder in a more comfortable, slightly angled position throughout the night.
Pre-Sleep Pain Reduction Routine
Establishing a consistent routine in the hour before bed can prepare the shoulder for rest. Cold therapy is effective; applying an ice pack for 15 to 20 minutes before lying down can help reduce inflammation and lower the local skin temperature. The ice pack should always be wrapped in a thin towel to prevent direct contact with the skin and avoid ice burn.
Timing pain medication is important. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to manage the inflammation associated with calcific tendonitis. Taking an NSAID approximately 30 to 60 minutes before bedtime can ensure the medication reaches peak effectiveness during the initial hours of sleep when pain often begins to worsen. Before incorporating any new medication into your routine, it is advisable to consult with a healthcare professional.
A gentle, non-strenuous range-of-motion exercise can also be incorporated to prevent the shoulder from stiffening. Performing simple pendulum stretches or light, pain-free movements may improve circulation and reduce tension in the muscles surrounding the joint. This activity should be brief and stopped immediately if any sharp pain occurs, as the goal is relaxation and limbering, not therapeutic stretching or strengthening.