Tennis elbow, medically known as lateral epicondylitis, is a condition characterized by pain and tenderness on the outer part of the elbow joint. It results from overuse and repetitive strain on the forearm muscles and the tendons that connect them to the bony prominence on the outside of the elbow. Sleep often proves difficult for those with this condition because unconscious movements and poor positioning throughout the night can aggravate the already irritated tendons. The lack of movement during prolonged rest can also lead to stiffness and increased pain perception. Addressing how the arm is positioned and supported during sleep is a primary step in managing this nocturnal discomfort and promoting healing.
Optimizing Sleeping Positions
The most beneficial sleeping posture for managing tennis elbow pain is generally on the back, or supine position, as it naturally keeps the arms in a neutral, relaxed state. Sleeping on your back prevents direct pressure from being placed on the affected elbow and minimizes the likelihood of the arm twisting or folding into a stressful angle. This position also allows for easy elevation of the arm, which can assist in reducing any potential nocturnal swelling.
If sleeping on your back is not comfortable, lie on the side opposite the injured elbow. Actively prevent rolling onto the affected side, which compresses the inflamed area and restricts blood flow. To maintain proper alignment, place a supportive pillow directly under the affected arm, running its length from the shoulder down to the hand.
The affected arm should be kept relatively straight or only slightly bent at the elbow to avoid hyperextension or excessive flexion. Pillows are important, acting as a physical barrier to prevent the arm from falling off the bed or rotating inward, which pulls on the wrist extensors. Place pillows strategically alongside the torso and under the forearm to cradle the arm in a neutral, comfortable position.
It is advisable to avoid sleeping on the stomach, as this position often forces the elbow and wrist into awkward, stressful twists and bends. Similarly, avoid resting the affected arm curled up under the head or torso, which is a common action that hyper-flexes the elbow and puts strain on the tendons. Studies suggest that keeping the arm down and uncompressed during the night is strongly correlated with subjective improvement in symptoms.
Utilizing Nighttime Support Devices
External support devices are designed to keep the elbow joint stabilized and in a neutral position, countering the effects of unconscious movement during sleep. One common option is a specific nighttime elbow splint or soft support, which is often bulkier than a daytime brace but specifically designed to prevent extreme flexion or extension. These devices typically incorporate a gentle splinting mechanism to limit the range of motion, protecting the healing tendons from strain.
The function of a nighttime splint is to ensure the elbow remains in a slightly bent, resting posture, reducing tension on the forearm muscles and tendon attachments. Unlike daytime braces that apply counterforce pressure, a dedicated night support focuses on positional stabilization. The device should fit snugly enough to stay in place but must not be overly tight, which could impede circulation.
Some individuals find relief by wearing their typical counterforce brace, worn just below the elbow, but it should be worn loosely to avoid undue compression. If choosing a compression sleeve, select one made from breathable materials to prevent skin irritation and overheating. The goal of any overnight device is gentle stabilization, ensuring the joint is protected without causing new discomfort.
Pre-Sleep Pain Management Routine
Establishing a routine in the hour before sleep can significantly prepare the injured arm for a restful night. Applying ice (cryotherapy) to the painful area for 10 to 15 minutes before getting into bed is a recommended step. The cold application helps to temporarily numb the area and reduce local inflammation that may have built up throughout the day.
Some people find that using a warm compress (thermotherapy) for a similar duration helps relax tight forearm muscles, though ice is preferred for acute tendon inflammation. If using heat, ensure it is a gentle warmth, and never apply it directly over any significant swelling. The choice between ice and heat often depends on individual preference.
Incorporating gentle, non-strenuous stretches for the wrist extensors can also help relieve residual tension before attempting to sleep. Simple stretches, such as gently extending the wrist with the elbow straight, should be held briefly and performed without causing a sharp increase in pain. The routine should focus on relaxation and reducing muscle tightness, not on building strength or endurance.
It is important to avoid activities that require heavy gripping, lifting, or repetitive wrist movement in the final hours leading up to bedtime. These actions can re-aggravate the tendons, negating the benefits of any pre-sleep pain management efforts. Minimizing all strain on the affected arm before bed helps ensure the tendons are as relaxed as possible when you finally lie down.