Why Does Your Shoulder Hurt When You Sleep on Your Side?

Shoulders will often hurt when you sleep on your side. Here at Easy Orthopedics in Colorado Springs we frequently see those with shoulder pain that bother them at night. 

Shoulder pain when sleeping on your side is a common issue, and it can be caused by a variety of factors. Here are some possible reasons for this pain:

1. Pressure on the Shoulder Joint

• What happens: Sleeping on your side places direct pressure on the shoulder joint, which can lead to discomfort, especially if you’re sleeping for long periods in that position.
• Why it hurts: Prolonged pressure on the bony structures and soft tissues (like muscles and ligaments) can cause irritation and pain, particularly if there’s an existing issue with the shoulder.

2. Rotator Cuff Issues

• What happens: The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Sleeping on your side, especially if your arm is unsupported, can strain or aggravate the rotator cuff muscles and tendons.
• Possible causes:
  • Tendonitis: Inflammation of the rotator cuff tendons.
  • Rotator cuff tears: A tear in the tendons or muscles of the rotator cuff can cause pain when sleeping on the affected side.
  • Bursitis: Inflammation of the bursa (fluid-filled sacs that cushion the joint) can occur with side sleeping, especially if there is excessive friction or pressure.

3. Shoulder Impingement Syndrome

• What happens: This condition occurs when the tendons of the rotator cuff get pinched between the bones of the shoulder.
• Why it hurts: Sleeping on the side can put pressure on the tendons, causing pain, especially if there’s already an underlying impingement.

4. Poor Sleeping Posture

• What happens: If you sleep with your shoulder hunched forward or in an awkward angle, it can strain the muscles and ligaments.
• Why it hurts: Poor alignment of the shoulder during sleep can cause muscle tension, leading to pain upon waking.

5. Shoulder Osteoarthritis

• What happens: Osteoarthritis (degeneration of the cartilage) in the shoulder joint can cause stiffness and pain, particularly when weight is placed on the shoulder while sleeping.
• Why it hurts: Sleeping on the side with osteoarthritis can exacerbate joint stiffness and irritation, leading to increased pain and discomfort.

6. Referred Pain from the Neck or Spine

• What happens: Nerve issues or muscle tension in the neck or upper spine can cause pain that radiates to the shoulder.
• Why it hurts: Sleeping on your side can exacerbate nerve compression or tension in the neck, causing referred pain in the shoulder area.

7. Frozen Shoulder (Adhesive Capsulitis)

• What happens: Frozen shoulder is characterized by stiffness and pain in the shoulder joint, often affecting those with limited mobility.
• Why it hurts: Sleeping on the affected side can trigger pain due to limited range of motion and stiffness in the shoulder capsule.

How to Reduce Shoulder Pain While Sleeping

• Proper Pillow Position: Use a supportive pillow that keeps your head and neck aligned with your spine.
• Body Pillow: Use a body pillow to support your arm and reduce pressure on the shoulder.
• Sleeping on the Opposite Side: Try sleeping on the opposite side or on your back to reduce pressure on the painful shoulder.
• Adjust Sleeping Posture: Avoid sleeping with your arm overhead or with excessive weight on the shoulder.
• Ice or Heat: Apply a cold compress before bed to reduce inflammation, or use heat to relax the muscles.
• Gentle Stretches: Perform shoulder stretches during the day to improve flexibility and reduce stiffness at night.

 

How do I stop my shoulders from hurting when I sleep on my side?

To stop your shoulders from hurting when you sleep on your side, it’s important to address the pressure on the shoulder joint and optimize your sleeping posture. Here are some strategies that can help:

1. Use Proper Pillows and Sleep Support

• Support your neck and spine: Ensure your pillow keeps your head and neck aligned with your spine. A pillow that’s too high or too low can strain your neck and shoulders.
• Body pillow: Place a body pillow in front of you or between your knees to support your arm and reduce shoulder pressure. This can also help you maintain a better sleeping posture.
• Pillow under the shoulder: Use a small pillow or cushion under your top arm to prevent it from sagging down and creating additional strain on the shoulder joint.

2. Adjust Your Sleeping Position

• Avoid sleeping with your arm overhead: Sleeping with your arm stretched out or above your head can put strain on your shoulder and rotator cuff muscles. Keep your arm closer to your body to reduce pressure.
• Alternate sides: Try to switch sides during the night if possible to avoid prolonged pressure on the same shoulder.
• Sleep on your back: If you find it difficult to sleep on your side without shoulder pain, consider training yourself to sleep on your back, which can relieve pressure from your shoulders.

3. Use Heat and Cold Therapy

• Cold therapy: Apply an ice pack or cold compress to your shoulder before bed to reduce inflammation and pain, especially if you’re dealing with an injury or inflammation.
• Heat therapy: Use a warm compress or heating pad to relax tight muscles and improve blood circulation before sleeping. This is especially helpful if muscle tension is contributing to your shoulder pain.

4. Stretch and Strengthen Your Shoulders

• Stretching exercises: Gentle stretching before bed can help reduce muscle tightness and improve flexibility in your shoulder muscles and joints.
  • Example: Try a doorway stretch, where you place your arms on a door frame and gently lean forward to stretch the chest and shoulders.
• Strengthening exercises: Incorporating shoulder strengthening exercises into your routine can prevent overuse injuries and improve the stability of your shoulder joint.
  • Example: Wall push-ups, rotator cuff exercises, or resistance band exercises to strengthen the muscles around the shoulder joint.

5. Maintain Proper Posture During the Day

• Avoid slouching: Good posture during the day supports proper alignment of your shoulders and reduces the strain that can lead to pain at night.
• Adjust your workstation: Ensure that your computer screen is at eye level and your chair supports good posture to avoid unnecessary shoulder tension.

6. Adjust Your Sleeping Surface

• Firm mattress: A mattress that is too soft can cause your body to sink, increasing pressure on your shoulder. A medium-firm mattress may offer better support and reduce shoulder pain.
• Consider a mattress topper: If you prefer a softer surface, a supportive mattress topper can help distribute pressure more evenly across your body.

7. Try Orthopedic or Memory Foam Pillows

• Memory foam pillows: These pillows conform to your body shape and can help alleviate pressure points on your shoulder by providing support tailored to your specific contours.

8. Avoid Tight or Stiff Clothing

• Ensure that your pajamas or sleepwear are loose and comfortable, as tight clothing can restrict movement and increase shoulder strain.

9. Over-the-Counter Pain Relief (if necessary)

• If shoulder pain is persistent, you can try over-the-counter anti-inflammatory medications, like ibuprofen or naproxen, to reduce pain and inflammation, but only for short-term relief.

10. Consult a Doctor or Physical Therapist

• If your shoulder pain continues despite these adjustments, or if you experience weakness, numbness, or tingling, it may be worth seeking professional advice. A doctor or physical therapist can assess your shoulder health and provide specific exercises or treatments to help alleviate the pain.

 

How to fix shoulder impingement?

Shoulder impingement, also known as rotator cuff impingement, occurs when the tendons of the rotator cuff muscles are irritated or compressed as they pass through the shoulder joint. The goal of treatment is to reduce inflammation, improve flexibility, and strengthen the shoulder muscles to prevent further impingement. Here are several ways to fix shoulder impingement:

1. Rest and Modify Activities

• Rest the shoulder: Avoid activities that involve overhead lifting, reaching, or repetitive movements that aggravate the condition.
• Modify your routine: If possible, adjust activities to avoid positions or motions that trigger pain, such as lifting objects overhead or heavy pushing.

2. Ice and Heat Therapy

• Ice packs: Apply ice to the shoulder for 15-20 minutes every 2-3 hours to reduce inflammation, especially during the acute phase or when the pain flares up.
• Heat packs: After the acute pain has subsided, you can apply heat to relax the muscles and increase blood flow to the area. Use a warm compress or heating pad before exercises or stretches.

3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• Ibuprofen or naproxen can help reduce pain and swelling. Use as directed, and avoid long-term use without consulting a doctor, as prolonged NSAID use can lead to side effects.

4. Shoulder Exercises and Physical Therapy

Strengthening and stretching exercises can relieve impingement by improving shoulder stability and flexibility. Physical therapy is often the most effective treatment to address the condition.

• Strengthening the rotator cuff: Exercises that target the rotator cuff muscles can improve their function and prevent further irritation. Examples:
  • External rotation: Hold a resistance band with your elbow bent at 90 degrees. Rotate your forearm outward, keeping your elbow tucked in. Repeat for 10-15 reps.
  • Internal rotation: Using a resistance band or cable machine, pull the band inward across your body while keeping your elbow bent at 90 degrees.
• Strengthening the scapular muscles: These muscles help stabilize the shoulder and prevent impingement.
  • Scapular squeezes: Sit or stand with your arms by your sides. Squeeze your shoulder blades together and hold for 5-10 seconds, then relax. Repeat 10-15 times.
• Stretching: Stretching the shoulder and chest muscles can improve range of motion and prevent tightness that contributes to impingement.
  • Cross-body stretch: Bring one arm across your chest and use the opposite hand to gently pull your arm closer to your chest, holding for 20-30 seconds.
• Posterior capsule stretch: Reach one arm overhead, bend the elbow, and use the opposite hand to gently push the elbow downward to stretch the back of the shoulder.
• Passive stretches: In some cases, gentle passive stretches using a towel or band can help improve flexibility.

5. Corticosteroid Injections

• If pain and inflammation are persistent, a corticosteroid injection into the shoulder joint may provide significant relief. This can help reduce inflammation around the tendons and offer temporary relief while you focus on rehabilitation exercises.

6. Correct Posture and Ergonomics

• Posture correction: Poor posture can contribute to shoulder impingement by causing the shoulder blade to sit improperly. Focus on keeping your shoulders back and down to prevent rounding your upper back.
• Workplace ergonomics: If you sit at a desk or work in a position that stresses the shoulder, adjust your workspace to maintain good posture and minimize strain on the shoulder joint.

7. Avoid Overhead Activities

• Avoid repetitive overhead activities that can exacerbate impingement, such as lifting weights above your head or reaching in awkward positions for extended periods.

8. Surgery (if necessary)

• When conservative treatments fail: If the pain persists despite physical therapy and other treatments, or if there’s significant damage to the rotator cuff or other shoulder structures, surgery may be required. Options may include:
  • Arthroscopic subacromial decompression: This procedure removes bone spurs or inflamed tissue that are pressing on the rotator cuff.
  • Rotator cuff repair: If the rotator cuff tendon is torn, surgery may be needed to repair the tear.

9. Prevention

• Regular exercise: Maintain shoulder strength and flexibility through regular exercise to prevent recurrence of impingement.
• Proper warm-up: Always warm up before engaging in activities that involve the shoulder, such as sports or weightlifting.
• Gradual increase in activity: Avoid suddenly increasing the intensity or duration of physical activities, especially those that involve overhead movements.

When to See a Doctor

• If symptoms don’t improve with rest, ice, and exercises.
• If you have persistent or severe pain, weakness, or limited range of motion in the shoulder.
• If you experience sharp pain, especially with overhead activities.

• If there’s no improvement after treatment.

I hope we were able to answer some of your questions about why your shoulder may hurt if you sleep on your side. If you would like us to evaluate you, and are in the Colorado area, contact us below to make an appointment at Easy Orthopedics.