Experiencing shoulder pain at night can significantly disrupt sleep and daily life. Understanding the potential reasons behind this discomfort is a crucial first step toward finding effective relief and improving sleep quality.
How Sleep Habits Contribute to Shoulder Pain
The way an individual sleeps can directly influence shoulder comfort. Sleeping positions that place direct pressure on the shoulder, such as lying on the affected side, can aggravate existing pain. This sustained pressure can compress the shoulder joint and surrounding soft tissues, leading to increased pain.
Sleeping on the stomach, especially with an arm overhead, can also strain the shoulder joint and surrounding muscles. Using a pillow between the arms when side-sleeping can help keep the shoulders in a more neutral position.
The quality and type of mattress and pillows also play a role in supporting the shoulder. A mattress that is either too soft or too firm may not provide adequate support, causing the body to sink improperly or creating pressure points on the shoulder. A medium-firm mattress often balances support and pressure relief for many individuals.
Medical Conditions Causing Nighttime Shoulder Pain
Beyond sleep habits, several medical conditions commonly cause or worsen shoulder pain at night. These conditions involve inflammation, structural damage, or nerve irritation within or around the shoulder joint. The reduced movement during sleep can allow inflammatory mediators to accumulate, intensifying pain.
Rotator cuff injuries are a frequent cause of nighttime shoulder pain. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and enable arm movement. Inflammation (tendinitis), impingement, or tears in these tendons can lead to a dull ache that often worsens when lying down, particularly on the affected side.
Bursitis, the inflammation of the bursae—small fluid-filled sacs that cushion joints—is another common culprit. When the bursa in the shoulder becomes inflamed, even mild pressure from lying on that side can cause significant pain. Inflammation tends to increase when the body is at rest, making bursitis pain more pronounced at night.
Osteoarthritis, a degenerative joint disease where cartilage breaks down, can also cause shoulder pain that is worse at night. As the cartilage thins, bones may rub against each other, leading to inflammation and pain. This discomfort can intensify when resting, making it difficult to sleep.
Adhesive capsulitis, commonly known as frozen shoulder, causes stiffness and pain in the shoulder joint. The joint capsule thickens and tightens, restricting movement. Pain often increases at night, especially in the “freezing” stage, as the shoulder capsule can tighten further when still.
Sometimes, shoulder pain at night can be referred pain, meaning it originates from another area but is felt in the shoulder. Issues in the neck, such as pinched nerves, can radiate pain to the shoulder. In rare instances, pain in the left shoulder, especially if accompanied by chest pain, shortness of breath, or arm numbness, could indicate a heart condition.
When to Consult a Doctor
While many cases of nighttime shoulder pain are manageable with home care, certain symptoms warrant professional medical attention. Persistent pain that does not improve with conservative measures or worsens over time should be evaluated by a healthcare provider.
Sudden, severe shoulder pain, especially if it occurs without a clear injury, is a reason to seek immediate medical advice. Other warning signs include pain accompanied by significant swelling, redness, or warmth around the joint. An inability to move the arm, notable weakness, or new numbness or tingling sensations in the arm or hand also indicate a need for professional evaluation.
If shoulder pain is interfering significantly with daily activities, work, or sleep quality, a doctor can help identify the underlying cause. They can provide an accurate diagnosis and recommend appropriate treatment strategies.
Home Strategies for Relief and Prevention
Adjusting sleep positions is a practical first step for managing nighttime shoulder pain. Sleeping on the back can reduce direct pressure on the shoulders. Placing a small pillow under each arm can provide additional support and keep the arms from hanging, which might contribute to discomfort.
For side sleepers, lying on the non-painful side is often recommended. Hugging a pillow in front of the body or placing one between the knees can help support the sore shoulder and maintain spinal alignment. Some individuals find sleeping in a semi-reclined position, such as in a recliner, reduces pressure on the shoulder.
Applying ice or heat to the shoulder can help manage pain and inflammation. Ice is generally recommended for acute pain, swelling, and inflammation, typically for 15-20 minutes at a time, particularly before bed. Heat therapy, such as a warm compress, can relax muscles and improve blood flow for chronic stiffness or soreness.
Over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can reduce inflammation and pain. Acetaminophen can also help with pain relief. Consult a healthcare provider before regular use of these medications, especially if you have underlying health conditions.
Gentle stretching or light exercises, if they do not aggravate the pain, can help improve shoulder mobility and reduce tension. Examples include shoulder rolls, arm circles, and cross-body stretches. These should be performed mindfully, avoiding movements that cause increased discomfort.