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Shoulder Pain at Night

Learn what causes shoulder pain from sleeping and effective ways to find relief

shoulder pain at night

Shoulder pain after sleeping is one of the most common symptoms for patients with shoulder conditions such as shoulder impingement, bursitis, tendinitis, rotator cuff tears, frozen shoulder, and arthritis.

Other shoulder pain conditions at night may also include poor posture, overexertion, ageing, or repetitive work injuries.

Read on to learn more about what may be causing your shoulder pain at night as well as the best ways to find relief.

Here is everything you’ll learn from this post about shoulder pain and relief at night:

  1. What are the causes of shoulder pain at night?
  2. Why does my shoulder pain get worse at night?
  3. How should you sleep if your shoulder hurts?
  4. 5 simple exercises to help shoulder pain at night
  5. When to seek treatment for shoulder pain?

What are the causes of shoulder pain at night?

There are many of causes of shoulder pain that result from a variety of shoulder conditions. The most common causes include shoulder impingement, bursitis, tendon damage (tendinopathy or tendinitis) or rotator cuff tears and arthritis (which can affect a few areas of the shoulder).

Unfortunately several of these common sources of shoulder problems cause increased pain at night or during periods of rest. It certainly makes it difficult to get a good night’s sleep when your shoulder is in pain.

shoulder pain from sleeping

Shoulder impingement

Shoulder impingement is when there is a reduced space in the shoulder between the rotator cuff tendons and a bone above these tendons. This bone is called the acromion and it is a part of the scapula or shoulder blade.

There are a few causes for this condition.

Most commonly, it is due to an altered shape of the acromion or a spur (extra bone) forming under the acromion. This extra bone reduces the space for the tendons to move and can cause direct injury to the tendons. There is a normal fluid filled sac called a bursa which sits between the acromion and rotator cuff tendons. The bursa helps buffer the tendons and forms a lubricating pillow to assist in making smooth movement, protecting the tendons from damage.

Some people are born or develop an abnormal shaped acromion as they age. Acromions that are flat create more room for the tendons and bursa to move. Unfortunately, some people have a curved or hooked acromion that reduces that space, causing shoulder problems.

When the space is reduced due to a spur or an abnormal shaped acromion, the bursa becomes compressed, aggravated and irritated. This angry and inflamed tissue causes the majority of the shoulder pain.

Movement of the shoulder further aggravates the bursa and tendons. Eventually the extra bone rubs on the tendon potentially causing a tear. This invariably causes further shoulder pain and dysfunction.

Gravity and your arm’s weight can pull the space apart when upright which can alleviate the pain temporarily. Unfortunately, this space compresses once you lie down and try to sleep which can lead to a restless night grappling with pain.

Bursitis

The bursa is a normal structure within the shoulder that helps lubricate the joint and buffers the tendon from damage from the overlying bone.

Once irritated the bursa becomes inflamed. Inflammation causes the bursa to over react and develop cells (cytokines) that incite pain. It’s your body’s way of telling you that something is wrong.

Shoulder bursitis commonly presents with the following symptoms:

  • Gradual onset of your shoulder symptoms over weeks or months
  • Pain on the outside of your shoulder
  • Pain may spread down your arm towards the elbow or wrist
  • Pain made worse when lying on your affected shoulder
  • Pain made worse when using your arm above your head
  • Painful arc of movement – shoulder pain felt between 60–90 degrees of the arm moving up and outwards
  • When your arm is by your side there is minimal pain and above 90 degrees relief of pain
  • Shoulder pain with activities such as washing hair, reaching up to a high shelf in the cupboard

shoulder pain after sleeping

Often the problem causes a vicious cycle of further pain and shoulder problems; the more the bursa gets inflamed and tightens up the space, the more irritated it gets and hence enlarges even more, leading to even more pain and discomfort.

While sleeping or lying directly on the side of shoulder, the bursa can be compressed without the help of gravity.

Tendon damage (tendinopathy or tendinitis) or tear (rotator cuff tears)

Rotator cuff tendons that surround the shoulder joint help stabilise the joint and gives it the ability to move and have power. Their integrity and form is vital to maintain movement, strength and power.

Tendon damage occurs from a few causes ranging from trauma or an injury, to slower processes involved in increasing age and wear and tear. The most common cause is repeated microtrauma to the rotator cuff tendons rather than a specific one of trauma. Rotator cuff surgery and recovery may be required to alleviate pain and get back a full range of motion.

Shoulder tendonitis (or tendinitis) is an inflammation injury to the tendons. Because inflammation is not always present in injuries to the shoulder tendons, this group of injuries are medically known as a rotator cuff tendinopathy or tendinopathies. Once this progresses, the tendon will fail and cause a tear.

Shoulder tendonitis commonly has the following symptoms:

  • Shoulder popping or clicking and/or an arc of shoulder pain when your arm is about shoulder height
  • Pain when lying on the sore shoulder or lifting with a straight arm
  • Shoulder pain or clicking when moving your hand behind your back or head
  • Anterior shoulder pain and upper arm pain (potentially as far as your elbow)
  • As your shoulder tendonitis deteriorates, your shoulder pain may even be present when resting and often worsens at night after using the shoulder all day.

shoulder pain from sleeping on side

Shoulder arthritis

Wear and tear of the shoulder that affects the cartilage lining of the shoulder joint is called arthritis. This progressive condition causes shoulder pain and is often worse at night after a day of use. The chances of you suffering shoulder arthritis are increased if your shoulder has been overworked or injured. It can be a result of years of sports that involve heavy use of the shoulder including AFL football, cricket, and tennis.

Arthritis can affect the main joint of the shoulder (gleno-humeral joint) or the AC joint (acromio-clavicular joint).

The acromio-clavicular joint (AC joint) is the intersection between the end of the collar bone and the end of the shoulder blade. The joint often gets earlier wear and tear from ageing and can suffer an AC joint injury and arthritis due to an injury from a fall or as result of playing sports that involve arm elevation. Arthritis from this area presents with pain on top of the shoulder and is often worsened by sleep when your arm is crossed over your chest or when lying directly onto your shoulder.

Other shoulder pain conditions that lead to discomfort at night include poor posture, sports & work injuries, ageing, overuse, and overexertion.

Why does my shoulder pain get worse at night?

Shoulder pain at night is a very common problem and can be both disruptive and frustrating. The most common cause of night pain in your shoulder is due to a process we call rotator cuff tendinosis and shoulder bursitis.

While there is no exact science as to why your shoulder pain is worse at night, some factors may be sleeping on your side, direct pressure on your shoulder, and/or your mattress. Certainly, using your shoulder during the day means that the bursa is more inflamed and the rotator cuff tendon is over worked by the end of the day, hence the symptoms worsening by night time. Other factors may be unrelieved tension of pressure and stress.

During the day, the weight of the arm and gravity help to increase the space in your shoulder to reduce pressure and compression on the bursa and rotator cuff tendons. However, at night and during sleep, this is no longer the case as gravity is eliminated while lying flat. The muscles are also relaxed while sleeping and aren’t activated to centre the ball within the socket so this also reduces the space.

Direct pressure when sleeping directly on the painful side exacerbates the problem, especially when this occurs for an extended period of time while in deep sleep. Pressure for prolonged periods throughout the night puts direct compression on the subacromial joint space and compresses this inflamed tissue and bursa.

Uncontrolled movements of the arm or sleeping with your arm across your chest or above your head for extended periods (abnormal positions) are other factors that may contribute to more pain at night and after sleeping.

shoulder pain sleeping

How should you sleep if your shoulder hurts?

Going to sleep with shoulder pain is difficult and certainly if you wake due to shoulder pain, falling back asleep can be very troublesome.

Resting your shoulder during day may reduce the inflammation, reducing the pain enough that you can sleep.

Taking tablets that help reduce pain and inflammation (analgesics and anti-inflammatories) can also assist in reducing pain during the night. Taking the tablets well before night time is advisable to allow enough time for them to work.

If you wake up with a shoulder that hurts after directly lying on the shoulder, try sleeping on the opposite side. It might sound obvious but it isn’t as easy as it sounds given you often don’t control your movements when in deep sleep. Try placing a pillow behind you to stop you rolling over while sleeping on your affected shoulder and changing sides with your bed partner depending on which shoulder is involved. Sleeping propped up on a few pillows or on a special bed that has you a bit upright might also stop you rolling over onto the painful shoulder.

Doing some light stretching might also help to relieve shoulder pain. It may relax some of the tight muscles around the shoulder and also allowing the space to open up in the shoulder enough so that the pain reduces and you can try to get back to sleep.

shoulder pain while sleeping relief

5 simple exercises to help shoulder pain at night

  1. Standing wall stretchstanding wall stretch for shoulder pain while sleepingPlace both hands on a wall so they form a 90-degree angle to you body. Walk feet backwards until the arms straighten and then bow, hinging forward at the hips. Do not push on the wall, and do not allow your arms to raise up too high in order to avoid shoulder impingement. Keep shoulder blades set back and avoid scrunching shoulders around the neck.
  2. Shoulder rollsshoulder rolls for shoulder pain after sleepingFrom a position of proper alignment, roll shoulders up, then back, then down in a fluid motion. Repeat this movement about a dozen times, then reverse it, rolling forward another dozen times.
  3. Shoulder rotationshoulder rotation for shoulder pain sleeping on sideWith your back to a wall, allow the shoulder blade (scapula) to rest in a neutral position and bring both elbows out to 90 degrees (so the side of your biceps are in contact with the wall). Without moving the position of your elbows turn right arm upward, so the back of the right hand touches the wall, and left arm downward so the left palm touches the wall (or they come as close as possible). Slowly switch (right arm up, left arm down, then reverse it with left arm up and right arm down) for about 30 seconds, trying to keep arms at 90 degrees throughout.
  4. Cow face armscow face arms for shoulder pain sleepingBegin by kneeling on the floor, sitting your hips back onto your heels. Hold a towel in your right hand. Reach you right arm straight up, bend your elbow to let you right hand and towel fall behind your head. Take your left arm behind your back, bending you elbow to reach your left hand up your back. Grab hold of the other side of the towel with your left hand and use the towel to walk your hands towards one another. If you hands come all the way to touch, you can let go of the towel and interlace your fingers. Try to hold this for 30 seconds to one minute and then switch sides.
  5. Thread the needlethread the needle for shoulder pain at nightStart on all fours on the floor. Lift the left hand off the ground and thread the left arm through the space between the right arm and right leg, letting the back of the left hand arm slide along the ground. Allow the upper body (thoracic spine) to naturally rotate toward the right but keep hips level. Stop pushing the arm to the right at the point where your hips begin to open to the right. This may mean less of a range of motion than what you could do if continued to open.

When to seek treatment for shoulder pain?

Living with shoulder pain, especially if it wakes you up at night or makes sleep difficult, is challenging. If your shoulder pain persists for a period of a few weeks or worsens it is recommended to seek consultation and treatment.

More worrying signs that may present with pain include weakness, loss of movement or instability. These additional symptoms warrant more expedient investigation.

The first step would be to see your family doctor who will ask you specific questions and examine your shoulder to narrow the diagnosis as well as order specific tests to help work out what is wrong with your shoulder.

Getting plain X-rays are very useful to check that you don’t have arthritis, spurs or other bone issues that may be causing your night pain. Additional investigations to assess the soft tissues, including the rotator cuff tendons and the bursa, might include an ultrasound scan or an MRI (magnetic resonance imaging) scan.

Depending on what is found during these consultations your doctor might suggest an injection into your shoulder with corticosteroid to help reduce inflammation and pain and a period of rest. Seeing your physiotherapist for exercises to help settle the symptoms and then strengthen your shoulder is also a good option. If your symptoms persist despite these treatments, or if they worsen, your family doctor may suggest a review with a specialist shoulder orthopaedic surgeon for further treatment options.

Surgical options to help alleviate the pain and improve your shoulder function depend on the diagnosis. Most of this surgery can be performed using keyhole or arthroscopic methods. They include removing the inflamed bursa, removing bone spurs and reattaching torn rotator cuff tendons. If your shoulder pain is from a condition called adhesive capsulitis (frozen shoulder), your shoulder surgeon can release tight and inflamed structures (ligaments and capsule) in your shoulder that cause the pain and stiffness. Lastly, if your pain is due to severe arthritis, a shoulder replacement might be a good option to treat your pain and improve your shoulder range of motion and power.

Shoulder exercise photos provided by ActiveCare Physical Therapy

51 Comments

  1. Willie WILLIAMS

    I have pain in both shoulders and neck that worsened at night. I will try the exercises.

  2. Vijay Kaser

    My age is 71 years, Left shoulder pain after injury on 20-7-18 .Can not move left hand as right. No pain during day in simple activities. After sleeping , feel mild pain after 2 hours, get relief by malish by oil or balm.What to do ?

    1. Mavata Wandile

      I have neck pain shoulder pain tricept pain doctor inject be six five time in muscles but i cant have direction ti sleep i am in pain just now . I drink my medication and sleeping pain bu still awake in pain . I dont know what to do now plse assit me

    2. Kwena

      I am feeling hell pain on my left shoulder and it’s bad in the night. Must I consult doctor or what can I do, please assist

      1. S

        Consult a doctor. It’s better.

  3. Sue

    This information is so helpful thanks I have pulled a tendon and it’s so painful all the symptoms I have you have explained

    1. Max

      Tramadol is awesome.

      1. Ms Rachel Marsh

        What dose of tramadol are u on? Cause im on it but doesn’t help a lot at night when it’s at it’s worse. I’m on 200.

  4. Susie Reynolds

    My pain consultant suggested I take tramadol as I take flecaine for my heart condition- not sure what to do as t seems to be a drug with many side effects and I need to be able to drive and look after my husband who’s had a stroke

    1. Michelle

      Tramadol is very strong drug with severe side effects. I found it affected my vision and i had a constant fuzziness in my head. I stopped taking it after 2 weeks. It was prescribed for severe back pain

      1. Angie walsh

        Not too strong of a drug at all but it can b very addicting:(

      2. Annmari

        Tramadol does absolutely nothing for my pain. Gas no side effects at all. I find it interesting that so many people have any reaction to this medication.

        I gave been using Arnica Cream and it helps greatly. I bought it on Amazon.

    2. Eva Schultz

      I think tramadol with ibuprofen it only works with both. Over the years my dosage had increased to the highest amount 400 mg but then i take a break by lowering the dosage by weaning and them starting over again. I don’t like taking the hard stuff.

  5. Sue Chach

    After stupidly swapping 2 mattresses and bases..queen size upstairs to downstairs I have torn muscles on both shoulders . Hence there is no relief for sleeping. Have been on antiinflammatory meds…….relief but not healing. I’m in my 10th week of pain and little sleep. Such a long road and so frustrating

    1. Same wth me, worse is i got muscle stiffness at the back… slowly getting longer sleeping time. But its about 8 weeks now.

  6. rahul

    the Exercises reduced my pain significantly. Thanks a tone

    1. Tracy

      I have suffered since October 2018 no sleep hurt all night every night…One cortisone shot in January 2019 helped doctor decided not to give me a second one because I was doing so much better…the same night it came back worse than ever…I have muscle relaxers but that is not a cure… I am so miserable my neck and shoulder hurt during the day as well not much strength in my hand… I am scared of getting hook d on pain pills seeking a little relief

      1. Cheryl

        Hi Tracy which muscle relaxer do you use please.
        Our dates coincide completely too 🙁

      2. Teri

        This makes me want to cry… this is a concern that is more than necessary, and is the story behind sooooo many opiate addicts today! In my case I was only 13 when I became addicted and had no clue I was even taking narcotics! Actually didn’t even know there was such a thing, thought narcotic (addiction threat) drugs meant marijuana & cocaine! No one told me anything, thought I was dying when I was having withdrawals, even had me on a home heart monitor for a week! It was only after SEVERAL dr visits that a nurse (and a temp float filling in at that #NursesAreTheRealDrs…LOL or they oughta be) noticed I’d been prescribed (so not kidding) a bottle of 200 Vicodin just prior to this for a collar bone fracture! I was a gymnast training for the Olympics, got hurt often. Guess the dr figured I was used to it? Please. NOBODY has justification for prescribing 200 pills, and IMO no da** 13-yr old needs Vicodin unless maybe a single dose at the time of injury! I took it for 3 weeks, as prescribed or less, stopped when I wasn’t in pain anymore. That’s all it takes! Happy to report I’m now 45 and 100% clean & sober 13 years in Sept. But if u notice, that means ages 13-32, 19 YEARS of my life trampled by addiction. Why? BECAUSE OUR HEALTHCARE SYSTEM IS AWFUL!! Sorry, ranted on forever there! In ur spec situation, it’s the common problem where you’re stuck w/o a choice – pain starts, u go see ur dr, he sends u to physical therapy. You report it’s still hurting, rx for drugs, maybe an xray. Next time cortisone shots which work for a minute and u think it’s the answer… not for long! Works less each time, pain worsens. You go back to ur PCP and if u even get the same dr, it’s been so long, they start this whole thing over again! They must, insurance will not pay otherwise!(I worked in med field 25 yrs, billing for 15) GEEZZ, if they’d have done a *%!€~ MRI in the 1st place, they’d have seen the problem, done surgery to correct it… while you were still young! JUST SAYIN!!! But we know the deal…100 visits, specialists, therapy, prescriptions for YEARS – permanently for those who give up trying or don’t know any better – WAY MORE $$$$ Thx for listening, sorry so much word vomit!

  7. Patrick

    I have had increasing shoulder pain for almost a year. In the past few weeks, it has been so bad that I have not been able to sleep. I have done these exercises for only two days and the relief is unbelievable. I actually slept last night. Thank you for publishing these in an easy to understand manner. I am grateful.

    1. Dan

      Which exercises worked? I am in such pain, more so at night…no sleep, intense pain. Thanks, Dan 307.250.7911 after 1pm. Email not going thru

  8. Kirelos

    I get that shoulder pain that radiates down to my fingers. This pain is dull aching as if there is some bone fractures going from my shoulder down to my elbow. It goes by as very subtle while awake and manifests while sleeping .. it has been a few days and it is unbearable by now

  9. Carolyn Speechley

    I had shoulder surgery when i was 24 and crushed my collarbone. In turn i had parr if my collarbone removed. Now 20 years later i suffer from aching pain in my shoulder throughout the day and night, i have nothing holding up my shoulder and if i lift anything heavy my shoulder goes limp for 24 hrs and constant pain. How can I fix this.

    1. Have that didn’t know till today it’s called frozen shoulder. He said for some reason sometimes it happens after neck surgery. I had my neck fused in 2018. I seen the bone doctor July of 2019 pain is awful especially at night

  10. Subahsh Chaurasia

    my wife suffering frozen shoulder pain during sleep at night pain increased.
    Please suggest suitable medicine.

  11. My shoulder joint pain increases after I wake up from sleep , so what to do

    1. Eileen

      I just do a few arm exercises with my arms and I find it gives me relief and I go back to sleep.

  12. I have suddenly gotten terrible shoulder pain in the front of my left shoulder recently. Although this pain is weird, it comes in the morning until around 10ish and then comes back when I try to go to bed at night. I am 12 years old and the pain is getting worse by day. Should i be consulting a doctor? Do you have any tips to help me? How can I fix this??

    1. Anakin.

      You may want to consult your parents and see if your family has medical problems like that. Also check to see if you’re sleeping on your shoulder I’m slightly heavy and I hurt my shoulder by sleeping on it.

  13. Harold moore

    I have shoulder pain goes down to hand arm goes numb or asleep

    1. Erik Richards

      I suffer the same symptoms. ..the Dr gave me an injection of cortisol + pain killers (Andone)…It hasn’t helped much…but maybe I’m being impatient because the cortisol injection takes 3 to 4 weeks to have any effect. .I can’t sleep at night. ..I don’t understand why this is happening as I’ve never had any problems with my left shoulder. .this started after I had 2 vaccination shots 1 for flu and 1 for pneumonia. ..

  14. Jorge lucero

    After reading all the stories I found that my symptoms are typical.I tried all the exercises including different types of yoga, pain medications internal and external as well as all the topical rubs. Occasionally there is some minor relief.
    I’m considering radiofrequency ablation, has anyone else tried this treatment?

    1. Ezerie Olivia

      I am suffering from severe shouder pain that radiates to the fingers for about 13 weeks now after a hard job that involved the long use of my arm muscles. Pain wakes me up at night. I’ve taken analgesics and massages with some balms as well as some antiinflammatory drugs yet little relief. Need to know what more to do

    2. Vicki Wilson

      I Had Radiofrequency Ablation on my lower back. I have severe facet joint arthritis there. It sure helped me. I’ve had pain there for many years. I’ve taken all different kinds of pain meds, muscle relaxers and anti inflamatories. This procedure brought real pain relief for me. Try it if your Dr recommends it. Good Luck!

  15. JR

    Try taping your shoulder with sports tape. YouTube has great video showing you how to do this. Gave me tremendous relief

  16. laura watts

    I have been having physio on my shoulder since 28th November but the trouble is they never x rayed my shoulder or mri scan and doing all this exercises and nothing seems to be working pain at night time is so bad and I get pins and needle in my hand and a sharp pain down my arm I am on 500mg codein and neoproxin nd ompersal and doesn’t seem to work the pain killers

  17. Brian Nkandu

    I have a shoulder and upper arm pain severe at night thanks for the information received here I will try to do it.

  18. Yogesh

    I have pain in left shoulder.when I wake up in morning the shoulder pain Start when I move my arms it’s hurting how can I fix it

  19. Joe

    IHave sharp hot firing pain within the flared area…pain across from shoulder bone to necker do to made changes in life style…..no heavy lifting…move daughters clothes closet hanger lower level tightness down to arm wrist sometimes… Use less my left arm…practice on use right less over active movement with left side….have tried this already makes a big differ…for the best. I also feel keep away from sugar and carbs will help very much……went to doc got a steroid shot and light suggestion exercise…n

  20. Lori Jackson

    Had an accident 8/7/1987 I’ve had therapy which caused my condition(frozen shoulder) to worsen what types of exercises are best for me. Mind you any type of exercise I do, I’m not able to use arm. It’s my right arm.

  21. Polly

    Dull but strong ache all day every day, very distracting. Goes from shoulder down scapula in my back, and down my arm to my elbow and sometimes even to my hand. It feels a lot like carpal tunnel compression pain. I can’t sleep more than a few hours. Pain medication does very little. Prescription anti-inflammatory not doing much for the pain after two days, no significant help from OTCs even at double the recommended dose. The only thing that has provided a small amount of relief is icing.

  22. Chris

    I have pain in both shoulders towards the back every nite. It’s only when I go to sleep on my side but I can’t sleep on my back

  23. John Stratako

    I have two torn muscles in my right shoulder, and rotators cuff. The pain is intense at night, and I am waiting for surgery. Ironically, my left shoulder feels like my arm is falling out of the socket just like my right shoulder feels every night. Constant burning pain, no matter how I lay down in bed! Sleep seems to elude me. It only has getting worse. Don’t know what to do anymore. I am on anti- inflammatory medication, and painkillers, but they are not doing anything for me at night. I’m seeing the doctor, and going to ask for more help!

    I don’t remember when I slept well. The only thing I know is pain. And yet nobody seems to believe the levels of pain I am in.

    1. robert stone

      I’ve been dealing with shoulder pain for several months. At the age of 58(eight years ago) I took up the concert harp. Not sure if that, my age, are the cause. Like this article states, my pain is increased at night. I got a an x ray and the doctor said I have an impingement, but I need to get an MRI for further diagnosis. I took a break from the harp to deal with my condition. Ibuprofen has been best for me. Meloxicam has a residual effect that I don’t like, including not being able to think straight. I prefer not taking drugs. Exercise, I think is helping but the process is slow. I don’t want to quit playing the harp so I am going to do everything i have to, even if it means surgery, if that’s the only way to get better!

  24. Christopher Cammack

    Hi maybe someone can help me diagnose on here. Like everyone else my shoulder bugs me the most at night. So I tried laying on my opposite side and my shoulder that bugs me gets more stiff and more uncomfortable. So I am finding it hard most nights to fall asleep

  25. C.ANDIAPPAN

    SIR I AM 78 DIABETIC 2 UNDER CONTROL. MY PROBLEM SHULDER PAIN… TRIED TABLETS.. HOT WATER …ICE THERAPY..NOW THE PAIN IS AS IF GONE

  26. Jan Overmyer

    Thank you x 1,000,000! This nighttime shoulder pain was wearing me down,. Came across your exercises and, oh my, what a difference. Just started and already I have incredible relief! Who would have thought?

  27. Shoulder rotation exercises are the best part and I truly found relief. Thank you for sharing.

  28. Audrey

    Does magnesium oil help to relieve should pain. ? And can I continue playing tennis ?

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