You use your shoulders throughout the day for everything from reaching into a cabinet and carrying groceries to swinging a golf club, working in the yard, or picking up a grandchild. Yet sometimes an aching shoulder becomes much more noticeable at night.
The pain may start when you lie down, wake you after you have been sleeping for several hours, or suddenly bother you when you roll onto one side. You may find yourself rearranging pillows or changing positions trying to get comfortable and wondering why your shoulder seems to hurt more at night than it does during the day.
At Carolina Rehab and Physical Medicine Center, we do not look only at where you hurt. We want to understand what may be contributing to your pain and how the way you move could be affecting your shoulder.
Changing your sleeping position may help you get more comfortable tonight. But when shoulder pain at night keeps returning, it is worth looking beyond your pillow.
Why Shoulder Pain Can Be Worse at Night
There is not one explanation for nighttime shoulder pain.
Lying directly on a painful shoulder places pressure on tissues that may already be irritated. The position of your arm can also aggravate an uncomfortable shoulder even when you sleep on your back or opposite side.
What happens during the day can provide important clues, too. Does your shoulder hurt when you reach overhead or behind your back? Have you noticed weakness when lifting something? Does turning your neck change the pain? Have you recently increased your activity or repeatedly used your arm for work, sports, home projects, or exercise?
Your sleeping position may be aggravating a problem that is already there.
Common Reasons Your Shoulder May Hurt While You Sleep
Nighttime shoulder pain is a symptom, not a diagnosis. Several different problems can cause similar complaints.
Rotator cuff problems can cause pain when lifting or reaching with your arm and can become particularly uncomfortable at night. The rotator cuff is a group of muscles and tendons that helps stabilize your shoulder and allows you to lift and rotate your arm.
Shoulder impingement or bursitis can make certain arm movements painful and may become more uncomfortable when you lie on the affected shoulder.
Arthritis can cause shoulder pain, stiffness, and decreased range of motion. The shoulder may feel particularly stiff after it has been in one position for a while.
Frozen shoulder is a condition in which the tissue surrounding the shoulder joint becomes thick and tight, gradually making the shoulder painful and increasingly difficult to move. Everyday movements such as reaching overhead or behind your back can become difficult. Nighttime pain can be particularly troublesome, especially during the earlier stages.
Why Does My Shoulder Hurt When I Sleep on My Side?
If you are a side sleeper, you may already know what happens. You roll onto the painful shoulder and wake up.
Putting your body weight directly over an irritated shoulder can increase pressure on sensitive tissues. If the shoulder is already irritated or not moving as it should, lying on that side may make your symptoms more noticeable.
For the time being, try sleeping on the opposite side and supporting the painful arm with a pillow in front of you. If you sleep on your back, placing a pillow beneath the affected arm may help keep the shoulder supported in a more comfortable position.
These changes can make sleeping easier, but they do not necessarily address why your shoulder is hurting.
If you have to build a pillow fortress around yourself every night just to keep your shoulder comfortable, we want to know why.
At Carolina Rehab, We Look at How You Move
When you come to Carolina Rehab with shoulder pain, we want to understand more than where it hurts. We look at how your shoulder is moving, what activities are difficult or painful, and how your symptoms are affecting everyday activities and sleep. Because shoulder pain does not always originate in the shoulder itself, we may also consider whether your neck, upper back, or the way you are moving could be contributing to your symptoms.
Based on what we find, we can develop an appropriate treatment plan. Your care may incorporate therapeutic exercises, chiropractic care, soft-tissue techniques, or other treatments available in our multidisciplinary practice.
Once we have a better understanding of the problem, we can determine an appropriate treatment plan. Depending on what we find, your care may incorporate therapeutic exercises, chiropractic care, soft-tissue techniques, or other treatments available in our multidisciplinary practice.
When Should You Have Nighttime Shoulder Pain Checked?
A sore shoulder after an unusually active day may improve on its own. Recurring pain is different.
Consider having your shoulder evaluated if:
- Pain regularly wakes you from sleep
- Shoulder pain is getting worse instead of better
- You are having difficulty raising or moving your arm
- Your arm or shoulder feels noticeably weaker
- You have numbness or tingling in your arm or hand
- Your shoulder is becoming increasingly stiff
- The pain began after a fall or other injury
- You are changing the way you use your arm because of the pain
One important exception: Sudden shoulder or arm discomfort accompanied by chest pressure or tightness, shortness of breath, unusual sweating, dizziness, or nausea can signal a medical emergency. Seek emergency medical attention rather than assuming the discomfort is simply a shoulder problem.
Get Back to Sleeping and Moving Comfortably
Losing sleep because your shoulder hurts is frustrating enough. When that same shoulder begins affecting how you reach, lift, work, exercise, or enjoy your normal activities, it can start changing much more than your nights.
At Carolina Rehab and Physical Medicine Center in Little River, our goal is to determine what is contributing to your pain and help restore better movement and function. Our team can evaluate how your shoulder and surrounding areas are working and determine an appropriate treatment plan for you.
If shoulder pain is keeping you awake at night or interfering with your day, contact Carolina Rehab and Physical Medicine Center to schedule an evaluation with Dr. Strickland.