Shoulder Pain When Sleeping: Causes and Better Positions

You finally drift off, roll over, and a deep ache in your shoulder wakes you up. You shift, punch the pillow, and try again. By morning you've slept in pieces, and the shoulder still hurts. Night pain is one of the most common reasons people finally get a sore shoulder checked.

Why does my shoulder hurt when I sleep on it?

Lying on your side puts your body weight on the shoulder underneath. If the tendons or the fluid-filled sac (bursa) in that shoulder are already irritated, the pressure makes them ache. Lying still for hours also means less movement and less blood flow, so stiffness builds.

Night pain is a hallmark of several common shoulder problems. According to Mayo Clinic¹, rotator cuff pain is often a dull ache deep in the shoulder that can disturb sleep. Orthopedic surgeons note that rotator cuff tear pain often shows up at rest and at night. It's often worst when you lie on the affected shoulder².

Learn more about the causes we see most in our guide to shoulder pain.

What causes shoulder pain at night?

The most common causes are rotator cuff problems, impingement, frozen shoulder, and arthritis. Bursitis can also flare when you lie on it. Each tends to feel a little different.

Rotator cuff irritation

The rotator cuff is a group of muscles and tendons that hold your upper arm in the shoulder socket. According to AAOS², most tears come from gradual wear over time. Risk climbs after age 40. Jobs and sports with repeated overhead reaching add to it. See our guide to rotator cuff pain.

Shoulder impingement

Impingement happens when tissues at the top of the shoulder get pinched as you raise your arm. NHS guidance³ says the pain may be worse at night while sleeping. It usually improves over a few weeks or months. Learn why shoulder impingement makes reaching overhead hurt.

Frozen shoulder

Frozen shoulder causes pain and stiffness that build slowly. According to Mayo Clinic⁴, the pain is often worse at night and can interrupt sleep. It moves through stages and usually improves within one to three years. See frozen shoulder stages.

Pain that starts in your neck

An irritated nerve in your neck can send pain into the shoulder. That pain usually doesn't change much when you move your arm. If your arm or hand goes numb at night, read why your arm goes numb when you sleep.

Does sleeping on your side cause shoulder pain?

Not clearly. Sleeping on a sore shoulder can make existing pain worse, but research hasn't shown that side sleeping causes shoulder problems. The evidence is limited and mixed.

A 2018 study of 761 workers looked at preferred sleep positions and shoulder pain⁵. It found no clear link between any position and shoulder pain or rotator cuff problems. Positions with the arms overhead, which researchers expected to be the worst, were actually linked to less pain. The study only captured one point in time, so it can't show cause and effect. People in pain may simply change how they sleep.

The practical takeaway is simple. There's no single "right" position for everyone. The best position is the one that keeps pressure off your sore shoulder and lets you sleep.

What is the best sleeping position for shoulder pain?

For most people, sleeping on your back or on your pain-free side works best. Healthline's medically reviewed guidance suggests avoiding the sore shoulder and using a pillow to keep from rolling onto it⁶. Small adjustments with pillows you already own can make either position more comfortable.

On your back

• Rest your sore arm on a pillow at your side or across your stomach.
• Keep your elbow slightly away from your body rather than pinned tight.
• A thin pillow under the elbow can keep the shoulder from sagging backward.

On your pain-free side

• Hug a pillow in front of your chest.
• Rest your sore arm on top of it, so it doesn't drop forward across your body.
• Keep your head pillow at a height that holds your neck level.

Positions to try avoiding for now

• Lying directly on the sore shoulder.
• Tucking the sore arm under your pillow or your head.
• Sleeping with the sore arm stretched far overhead, if that position hurts.

A pillow tucked behind your back can stop you from rolling onto the painful side. Many people find they only need these changes for a few weeks while the shoulder calms down. Your doctor can suggest positions that fit your pain.

What else helps shoulder pain at night?

Keep the shoulder gently moving during the day. NHS guidance⁷ says not to stop using your shoulder completely, because that can slow recovery. Avoid the activities that clearly make it worse, but don't hold your arm still.

A few other habits may help:

• Use cold or heat before bed. NHS guidance⁷ suggests a wrapped cold pack or a wrapped hot water bottle for up to 20 minutes.
• Ease off late-day strain. Heavy lifting or long overhead tasks in the evening can leave the shoulder sore at bedtime.
• Watch your daytime posture. NHS advice⁷ includes sitting tall with your shoulders relaxed, and resting your arm on a cushion in your lap.
• Give it time. NHS guidance⁷ says pain often starts to ease within about two weeks, though full recovery can take six months or longer.

Winter adds its own strain here in Milwaukee. A long afternoon of shoveling can leave a shoulder aching by bedtime.

When should you see a doctor about shoulder pain at night?

Shoulder or arm pain can also be a sign of a heart attack. If it comes with chest pressure, shortness of breath, a cold sweat, or nausea, call 911⁸. Learn more about left shoulder pain and your heart.

Find out what's behind your shoulder pain

Night after night of broken sleep wears on everything. You're tired at work, short with your family, and nervous about rolling over. You've tried three pillows and two positions, and you still don't know what's actually wrong.

We're here to help you find out. Chiropractic Company has cared for Greater Milwaukee since 1982, with 400,000+ patients, 1,400+ five-star Google reviews, and 20+ neighborhood clinics. We look for the cause of your pain, not just the symptoms. Your doctor checks your shoulder, neck, and upper back, with X-rays if your exam calls for them. Your care is designed around your condition, your medical history, your daily routine, and your goals. You choose your care, and you see the same doctor as it continues.

Care is natural and drug-free. Treatment begins at your second visit, or the same day in acute cases if your doctor decides it's appropriate. Shoulder care often centers on exercise, and some plans add physical therapy at our Menomonee Falls, Waukesha, and West Allis North clinics. See more about shoulder pain care.

We're in-network with most insurance companies and accept Medicare. Eligible new patients can start with the $29 new-patient special, which includes a consultation, an exam, and X-rays if needed. *See offer terms.

Visit one of our 20+ neighborhood clinics across Greater Milwaukee: Milwaukee East, Milwaukee North, Milwaukee Third Ward, Shorewood, Glendale, Mequon, Cedarburg, Grafton, Germantown, Brookfield, Menomonee Falls, Waukesha, Oconomowoc, New Berlin, West Allis, West Allis North, Greenfield, Hales Corners, Franklin, Muskego, and Cudahy.

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