Daniel G. Schwartz MD

Shoulder Pain from Sleeping

Waking up with severe shoulder pain really isn’t the best way to kick start your day. It can be quite alarming to find yourself waking up with shoulder pain from sleeping that wasn’t there before, especially when you go to bed fully intending to get a solid 7 hours of sleep and waking up feeling nice and refreshed.

So, what just happened and what can you do about it?

The human shoulder is notoriously injury-prone making pain a very common injury, but that’s not very reassuring when you went to bed the night before feeling just fine and woke up to find a mysterious and painful shoulder problem.

Fortunately, for most people who claim their shoulder hurts after sleeping, the reasons why it occurred are relatively clear, and the pain is treatable – enabling you to get back on track and take the necessary steps to prevent shoulder pain after sleeping happening again.

Types of Shoulder Pain

It’s no fun at all to wake with severe shoulder pain; the good news however, is for many people the pain may subside during waking hours, allowing you some time to treat the underlying problem.

First, you’re going to want to identify the type of shoulder pain you’re having, so take a look through the different types of shoulder pain and see which one closely resembles what you may be experiencing.

  • Rotator Cuff Tendinitis – This is probably the most common type of shoulder injury and can cause severe pain after waking up. Rotator cuff tendinitis occurs when the rotator cuff tendons break down over time.
  • Frozen Shoulder – Usually before the freezing occurs, there’s excruciating pain – Followed by an inability to move the joint due to extreme stiffness.
  • Spinal Stiffness – The thoracic spine is meant to be held erect, and often is not due to our everyday lives, constantly hunching over our phones and computers creating a fixed bending position. This poor posture (along with the normal effects of aging) makes us far more prone to shoulder injuries, which often act up in the morning.
  • Altered Mechanics – Conditions such as scapular dyskinesis and old sprains or soft tissue injuries can cause us to modify the muscles we use and can lead to overuse and stretching pain from muscles not used to heavy load.
  • Radiating Pain – Sometimes it’s not actually a problem in the shoulder, neck and back pain is the underlying problem and can radiate to the shoulder, leading patients to think that the issue is the shoulder when it’s not.

To able to identify which type of shoulder pain you’re dealing with, it’s advised to seek out a medical centre to get a proper diagnosis and treatment plan for your shoulder.

Shoulder Pain Causes

If you are experiencing shoulder pain you’re going to want to know what could be cause, here are some the of common culprits:

  • Repetitive movements
  • Medical conditions like arthritis and bursitis
  • Either sleeping on your arm, or the same side every night (This pressures and pinches tendons deep in the shoulder, causing them to become chafed or inflamed)
  • Poor shoulder mechanics (A weakness or limited range of motion in the back or ribs can cause overcompensation with the shoulder)

Most of these injuries all relate to the rotator cuff, a ball-and-socket joint that’s stabilized with a cuff of muscles and tendons. Just like any muscle group, injury can be caused from sudden trauma, like an accident, dislocation or fall, or from chronic overuse.

Shoulder Pain at Night

Some people experience shoulder pain at night only or claim to get shoulder pain when lying down.

Shoulder pain at night is typically caused by bursitis, which occurs when the rotator cuff is torn or frayed, irritating the bursa. The bursa is a fluid-filled pad that provides a cushion to the bones of the shoulder joint. When injured, the fluid in the bursa increases and causes swelling which can be very painful.

There’s a reason people experience shoulder pain at night or while resting and not so much during the day. During the day, the shoulder is being actively used whilst in a vertical position, and when tendons are engaged they are pulled downward by gravity, allowing space for the muscle groups in the shoulder. The additional space allows for increased blood flow and oxygen which helps to alleviate any stiffness and pain that may be present otherwise.

However, when you lay down at night often in a horizontal position – Any effect of gravity is removed, and your shoulders are allowed to relax. The lack of movement and relaxed muscles allow the fluids in your joints to settle and decrease the blood flow, which causes the joints to become inflamed creating excruciating pain.

Shoulder Pain at Night Relief

Things you can use before seeing a doctor.

  • Anti-inflammatory medications (Ibuprofen, naproxen or acetaminophen)
  • Sleep in a recliner
  • Apply ice or heat
  • Wear a compression sleeve
  • Discontinue activities that may be contributing to shoulder pain.

Why do Shoulders Hurt When You Sleep?

The position you sleep is the main contributor to shoulder pain while sleeping, with the most common complaint from patients saying they are experiencing shoulder pain from sleeping on your side.

Here are some ways to relieve shoulder pain from sleeping:

  • Switch your sleeping position – This one may seem obvious, but if you are experiencing shoulder pain from sleeping on the side try sleeping on your back or the other side, just not your stomach.
  • Don’t sleep with your elbow over your head or arm underneath your pillow – This can lead to weakness in the arm by squeezing the tendons.
  • Switch to using a cervical support pillow or tear drop shaped pillow which is specifically designed to support the neck during side-sleeping
  • Buy a new mattress – If you’ve had yours for years it can be putting your muscles under unnecessary pressure, caused by a mattresses tendency to sag in the middle over time.

If still, your shoulder hurts when sleeping it’s best to see an experienced shoulder practitioner – Whether in physiotherapy, acupuncture, chiropractic, sports medicine, arthritis or osteopath. This depends on your condition and will determine the route you will need to take. They will be able to further recommend a course of action to relieve shoulder pain while sleeping.

They may recommend exercises to do or even clinical treatments.

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