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Understanding and Managing Nighttime Shoulder Pain

March 3, 2024

Understanding and Managing Nighttime Shoulder Pain

As a physical therapist specializing in shoulder conditions, one of the most common complaints I hear from patients is about shoulder pain that worsens at night. Nighttime shoulder pain can not only disrupt sleep but also significantly impact the quality of life. In this blog, we'll explore the causes of this pain, its implications, and effective strategies for management and relief.

What Causes Nighttime Shoulder Pain?

Nighttime shoulder pain can stem from various sources, and understanding these is key to effective management.

  1. Rotator Cuff Injuries:
    • Rotator cuff tendinitis or tears are common culprits. Lying on the affected shoulder can compress the rotator cuff structures, exacerbating pain.
  2. Bursitis:
    • Inflammation of the bursa, a fluid-filled sac that reduces friction in the shoulder joint, can cause significant discomfort, particularly when pressure is applied.
  3. Osteoarthritis:
    • Wear and tear of the shoulder joint, or osteoarthritis, can lead to pain, especially after repetitive use throughout the day.
  4. Referred Pain:
    • Sometimes, the pain originates from other areas like the neck or spine but is felt in the shoulder.
  5. Frozen Shoulder:
    • Adhesive capsulitis, or frozen shoulder, can cause persistent pain, worsening at night.

Why Does Shoulder Pain Worsen at Night?

Several factors contribute to the intensification of shoulder pain at night:

  1. Positioning:
    • Lying down can increase pressure on the shoulder, especially for side sleepers.
  2. Reduced Distraction:
    • The lack of daytime distractions can make the individual more aware of the pain.
  3. Circulation Changes:
    • Changes in circulation and fluid distribution when lying down can increase inflammation and pain.
  1. Reduced Gravitational pull on the shoulder joint:


  • When standing gravity pulls the shoulder down which provides space for the rotator cuff muscles and tendons, nerves, etc. When we lay down this space decreases and can compress the tissues and nerves causing pain.

Managing Nighttime Shoulder Pain:

  1. Proper Sleeping Position:
    • Avoid sleeping on the affected side. Try sleeping on your back or the non-affected side with a pillow for support.
  2. Pillows and Supports:
    • Using a specially designed shoulder pillow or a regular pillow to support the arm can reduce stress on the shoulder.
  3. Pain Relief Before Bed:
    • Over-the-counter pain medications or anti-inflammatory drugs can be helpful. Always consult with a healthcare provider before starting any medication.
  4. Gentle Stretching:
    • Light stretching exercises before bed can alleviate tension in the shoulder.
  5. Heat Therapy:
    • Applying heat to the shoulder can reduce pain and stiffness. This can be done through heating pads or warm showers.

Exercises to Alleviate Nighttime Shoulder Pain:

  1. Pendulum Stretch:
    • Lean over slightly and let the affected arm hang down. Gently swing the arm in small circles.
  2. Doorway Stretch:
    • Stand in a doorway with your arms on the door frame and gently lean forward to stretch the front of the shoulder.
  3. Towel Stretch:
    • Hold a towel behind your back and gently pull upwards with the unaffected arm.

When to Seek Professional Help:

If your nighttime shoulder pain persists despite home management, it's crucial to seek professional advice. Persistent pain could indicate a more serious underlying condition that requires medical attention.

Lifestyle Modifications:

  1. Daily Activity Adjustments:
    • Modify your daily activities to reduce stress on the shoulder. Avoid overhead lifting and repetitive movements that exacerbate pain.
  2. Stress Management:
    • Stress can tighten the muscles, worsening pain. Techniques like meditation or yoga can help.

Nighttime shoulder pain can be a challenging condition, but with the right strategies, it can be managed effectively. Remember, the key to relief is a combination of proper sleep positioning, pain management, gentle exercises, and, when necessary, professional intervention. Don't let shoulder pain disrupt your night; take steps today to ensure a pain-free, restful sleep.

Get some Free Help with shoulder pain at our FREE Shoulder Pain Relief Workshop.  Learn more and register at: Free Shoulder Pain Workshop (thesuperiortherapy.com)


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