Nighttime shoulder pain can significantly disrupt sleep and daily function. This discomfort often intensifies when lying down. Understanding its various reasons can help address the issue effectively and improve sleep quality.
Common Shoulder Conditions
Several musculoskeletal conditions are often associated with shoulder pain that worsens at night. These involve inflammation or structural changes within the shoulder joint and its surrounding tissues. Pressure or static positions during sleep can exacerbate discomfort.
Rotator cuff tendinitis and tears involve inflammation or damage to the group of tendons and muscles that stabilize the shoulder joint and enable arm movement. When these tendons are inflamed or torn, lying on the affected side can compress the damaged tissue, increasing pain. Gravity can also pull on the tendons while lying down, contributing to discomfort.
Bursitis refers to the inflammation of bursae, which are small, fluid-filled sacs that cushion the bones, tendons, and muscles around the shoulder. Specifically, subacromial bursitis, affecting the bursa beneath the acromion, can cause pain, especially when pressure is applied, such as when lying on it. Inflammation in the bursa can increase when the body is at rest.
Shoulder impingement syndrome occurs when tendons or bursae in the shoulder are compressed during arm movements. This compression can lead to irritation and pain that may intensify at night, particularly if sleeping positions reduce the space around the affected structures. Inflammation can worsen when the area is compressed during sleep.
Osteoarthritis of the shoulder is a degenerative joint disease where the cartilage that cushions the joint surfaces wears down over time. As this condition progresses, any movement of the shoulder can become painful, and this pain often feels worse at night after a day of use.
Adhesive capsulitis, commonly known as frozen shoulder, is characterized by stiffness and pain in the shoulder joint. The pain associated with frozen shoulder often worsens at night, making it difficult to find a comfortable sleeping position. Inflammation can intensify during rest.
Biceps tendinitis involves inflammation of the biceps tendon, which extends through the shoulder joint. This condition causes pain in the front of the shoulder, and the discomfort can be more noticeable at night or when performing overhead movements. Pain can also radiate down the arm.
Nerve Issues and Referred Pain
Pain felt in the shoulder at night is not always due to a direct problem within the shoulder joint itself. Nerve compression, particularly from the neck, can manifest as shoulder pain. This phenomenon is known as referred pain.
Cervical radiculopathy, resulting from a pinched nerve in the neck, can cause pain that radiates down the arm and into the shoulder. The position of the head and neck during sleep can aggravate this nerve compression, leading to increased shoulder discomfort. This pain may also be accompanied by numbness or tingling in the arm or hand.
While less common for persistent shoulder pain, referred pain can also originate from internal organs like the diaphragm, heart, or gallbladder. However, these instances typically present with other distinct symptoms, and shoulder pain is usually not the primary complaint.
When to Consult a Doctor
Consult a doctor if nighttime shoulder pain becomes persistent or concerning. A medical evaluation is recommended if the pain is severe, progressively worsening, or significantly interferes with sleep.
Also seek medical attention if the pain develops following a specific injury, such as a fall. Other concerning symptoms include:
Weakness or numbness in the arm or hand.
Noticeable loss of motion in the shoulder.
Pain that does not improve with home remedies.
Swelling, redness, tenderness, or warmth around the shoulder joint.
Strategies for Relief
Several practical measures can help manage nighttime shoulder pain and improve sleep comfort. These strategies focus on reducing pressure and inflammation around the affected shoulder.
Optimizing sleeping position is a primary step to alleviate discomfort. Avoid sleeping directly on the painful shoulder. Sleeping on the back can distribute weight more evenly, or sleeping on the non-painful side while hugging a pillow can prevent excessive slumping of the affected shoulder. Using a pillow under the affected arm or elbow can help maintain a neutral shoulder position.
Over-the-counter pain relievers can help reduce pain and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, or acetaminophen, are common options. Consult a pharmacist or doctor for appropriate use and dosage, especially for prolonged periods. Topical pain-relief gels or creams are also available.
Applying ice or heat therapy can provide relief. Ice packs can help reduce swelling and numb sharp pain; apply for 15-20 minutes, several times daily. Heat therapy can relax tense muscles and soothe stiffness; apply using a heating pad or warm compress for similar durations.
Gentle stretches may help improve shoulder mobility and reduce stiffness. Examples include pendulum swings or cross-body arm stretches. Perform stretches slowly and within a comfortable range of motion, stopping if pain increases. Consult a healthcare professional before starting any exercise regimen.
Pillow support can also make a difference. Placing a pillow under the arm when sleeping on the back, or between the arms when side-sleeping, can help support the shoulder and keep it in a relaxed, neutral alignment. Specialized pillows designed for shoulder pain or side sleepers can provide tailored support to alleviate pressure.