Elbow tendonitis, commonly known as tennis elbow (lateral epicondylitis) or golfer’s elbow (medial epicondylitis), involves irritation and inflammation of the tendons around the elbow joint. This condition frequently causes significant discomfort that intensifies at night, making it difficult to maintain continuous rest and hindering natural healing processes. This guide provides actionable steps to adjust your routine and posture to achieve nighttime pain relief and promote recovery.
Optimal Sleeping Positions for Relief
The most effective strategy for managing elbow tendonitis at night is to adopt a sleeping position that places the least amount of strain on the forearm tendons. Sleeping on your back (supine position) is generally ideal because it allows the arm to rest in a naturally neutral posture. When lying on your back, place a small, soft pillow underneath the affected arm, extending from the elbow down to the hand, for gentle elevation and support.
This arrangement helps maintain a neutral alignment where the elbow is slightly bent, approximately 10 to 20 degrees. This prevents the arm from either locking straight or bending too tightly. Keeping the arm supported minimizes the risk of unconscious movements that could stretch or compress the irritated tendons, ensuring the forearm muscles remain relaxed.
If you prefer side sleeping, always lie on your unaffected side to avoid placing direct body weight pressure on the painful elbow. Use a body pillow or a stack of pillows to support the affected arm directly in front of your body. This support prevents the arm from falling across your body or being pulled into an awkward position.
Using Nighttime Braces and Supports
Specific external devices can provide stabilization during sleep, preventing movements that aggravate the tendon. Nighttime splints or braces are designed to hold the elbow or wrist in a fixed, neutral position, limiting the muscle contractions that pull on the inflamed tendon attachment points.
These supports differ from the compression sleeves sometimes worn during the day, as their primary function is to restrict motion rather than apply pressure. When using a brace, ensure the fit is snug enough to prevent unwanted joint movement but loose enough to maintain unimpeded circulation. If the brace causes numbness, tingling, or increased pain, it is too tight and should be adjusted immediately.
Some specialized splints target the wrist, preventing the flexion or extension that can strain the forearm muscles connected to the elbow. By stabilizing the wrist, these devices reduce the mechanical tension transmitted up the forearm to the lateral or medial epicondyle. Consulting with a physical therapist can help determine the most appropriate type of brace to wear overnight based on the location and severity of your tendonitis.
Pre-Sleep Pain Management Routine
Establishing a routine 30 to 60 minutes before bed can significantly improve sleep quality by calming the tendon and surrounding tissues. Cold therapy is an effective pre-sleep treatment, as applying ice helps reduce inflammation and temporarily numb pain signals. Apply a wrapped ice pack to the painful area on the elbow for about 10 to 15 minutes to achieve localized cooling without damaging the skin.
For systemic pain relief, consider taking an over-the-counter non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, about an hour before sleep. Timing the medication this way allows the peak anti-inflammatory and pain-relieving effects to coincide with your initial hours of sleep. Always adhere to the recommended dosage and consult a healthcare provider if you plan to use NSAIDs for more than ten consecutive days.
A short session of gentle stretching or self-massage can also help relax the forearm muscles before lying down. Simple stretches that lightly extend the wrist and fingers, lengthening the forearm extensors, can relieve residual tension. These movements should be slow and controlled, stopping immediately if any sharp pain is felt, as the goal is relaxation, not intense exercise.
Positions and Actions That Worsen Pain
The most damaging habit is sleeping directly on the affected arm, which subjects the compromised tendon to sustained, direct pressure from your body weight. This pressure can compress the tissue and restrict blood flow, leading to increased pain and stiffness upon waking.
Avoid tucking the affected arm under the head or pillow, as this often forces the elbow into hyperflexion, or extreme bending. Hyperflexion puts excessive tension on the tendons and can aggravate the condition throughout the night. Similarly, letting the arm dangle off the edge of the bed can cause the elbow to hyperextend, or straighten too much, also straining the joint.
Unconscious clenching or gripping of the hand during sleep can also exacerbate symptoms, as these actions activate the forearm muscles connected to the elbow. Any position that results in the forearm being twisted, such as sleeping on the stomach with the head turned to one side, should also be avoided. These twisting motions place rotational stress on the inflamed tendon and can delay healing.