Have you ever spent hours and hours of the night tossing and turning, but can’t seem to turn your brain off and get to sleep? Even worse, if you have a joint injury that’s causing some pain, the lack of distractions while you’re laying in bed inevitably leads to the pain getting worse.
Shoulder pain can lead to sleepless nights and grumpy days, especially if you normally sleep on your side or front. Not only does the pain itself make it difficult to sleep but having to sleep in an unnatural position makes it even harder.
Poor sleep can worsen your mood for the following day, and can also impact your energy levels and make it difficult to concentrate. It can worsen your immune system and prolong your recovery from joint conditions, so it’s important to get a good amount of rest.
So, how do you sleep while you’re suffering from shoulder pain?
How to Sleep with Shoulder Pain
Working out how to manage your sleep while suffering from shoulder pain depends on your what your normal sleeping pattern is, the severity of your pain, and the cause of your shoulder pain.
You can control your sleeping pattern by managing three aspects that affect the sleep-pain cycle:
- Pain levels
Managing Your Pain Levels
During the day your brain does a good job of distracting you from the pain. By focusing on whatever is going on in your daily activities, you can push the pain to the back of your mind – but at night this no longer works! Sometimes it can feel almost impossible to sleep with shoulder pain – which is why using painkillers to numb the pain is a great first step to getting you to sleep.
Here are some tips on how to manage your pain levels at night using painkillers:
- Timing is Everything – If you’re not careful about when you take your medications, you could find your painkillers wearing off just as you’re trying to sleep. Even worse, you could already have reached your maximum daily dose of painkillers and be forced to try to sleep without them. Time your medication so that you take it around 30 minutes to an hour before bed.
- Save the Stronger Stuff – Generally, we recommend taking the lowest dose of painkillers that manages your pain, as opiates and other strong pain medication can have side effects and become addictive at larger doses. If you’re weaning down your pain meds, save the strongest dose for night-time – that way, you don’t have to worry about drowsiness and your night pain will be more manageable.
- Hot or Cold Packs – If you’re suffering from an inflammatory condition such as bursitis or frozen shoulder, use an ice pack (or frozen peas) just before you head to sleep. If it’s a muscular ache that’s preventing you from sleeping, try a hot water bottle.
Sorting Your Sleeping Position
Choosing a comfortable sleeping position while you have shoulder pain can be especially difficult if you’re a side-sleeper, but even those who sleep on their front or back will usually have their arm in a position which causes discomfort. So, how do you manage?
If you normally sleep on your back with your arms at your side, this position can add additional pressure to your shoulder joint.
Place the affected arm across your stomach with your elbow bent and place a pillow underneath. This lifts your arm to help reduce the pressure on your shoulder.
If you’re a side sleeper, your sleeping position while suffering from shoulder pain will depend on whether you’re lying on the side with shoulder pain or not.
When lying on the non-affected side, place one pillow just in front of your chest, and another pillow on top of that so that it goes under your affected arm. This will raise your arm and reduce pressure on the shoulder joint.
Ideally you should avoid lying on the affected side, but you can try to relieve some of the pressure using pillows. Take a flat pillow and lay it underneath you at waist height, while leaving some space between this pillow and the pillow your head is lying on. This gives you a channel between the pillows to place the affected arm and helps to alleviate the pressure.
Sorry front sleepers – this isn’t a good position for when you’re recovering from a shoulder injury! If you’re a front sleeper, you’re going to have to get used to sleeping in another position.
Sleep Hygiene and Lifestyle Changes
With a world so full of distractions, it’s no wonder that sleep hygiene has become such a big topic. It’s easy to find yourself scrolling through your phone until late at night, and then struggling to doze off. Luckily, sleep hygiene is one of the easiest ways to get your sleep cycle back in order and make it easier to sleep with shoulder pain.
When it comes to sleep, our brains love routine. Your body’s internal clock regulates your sleep cycle by producing melatonin before you go to bed and cortisol when you wake up. If you find yourself out of sync with your normal routine, your body clock won’t trigger your sleep cycle at the right time – so it’s important that you get to bed and wake up at the same time each day (yes – even weekends!).
You may also need some help to wind down before you go to sleep. Late-night working and bedtime phone use will leave your brain overstimulated and make it difficult to get to sleep. Put down your phone at least 30 minutes before bed and try to avoid doing any work late into the evening.
You can also take part in relaxing activities which get your brain in the right mood to sleep:
- Read a book
- Take a bath
- Meditate, or spend a few minutes focusing on your breathing
- Do some yoga or gentle stretches
In the daytime, you should avoid caffeine and nicotine, as these will stay in your system for at least 4-6 hours. You should also avoid taking any daytime naps. There’s a misconception that alcohol helps with sleep, and while it might make you drowsy, alcohol worsens the quality of sleep and will make your daytime sleepiness worse.
The better sleep you get, the less pain you’ll experience throughout the day and at night – so sleep hygiene can really make a difference to your night-time shoulder pain.
Condition-Specific Techniques to Manage Shoulder Pain
There are many potential causes of shoulder pain, all of which will impact your sleep:
- Frozen Shoulder
- Bicep Tendonitis
- Rotator Cuff Tears
- Recent Shoulder Surgery
Sleeping while your arm is in a sling can cause additional discomfort. We will discuss how to sleep with shoulder pain due to specific conditions such as bursitis, frozen shoulder, and shoulder impingement below.
How to Sleep with Bicep Tendonitis
Bicep Tendonitis causes pain and tenderness at the top of your arm, so your shoulder pain will worsen if you try to sleep on your front or side. To get to sleep with bicep tendonitis, it’s best to sleep either on your back, or on the non-affected side – using the sleeping positions above.
You can also incorporate gentle shoulder stretches into your night-time routine, making sure that you don’t push yourself too hard. Keep it gentle and do some of these stretches as part of your daily wind-down.
How do you Sleep with Shoulder Bursitis?
Shoulder bursitis is caused by irritation of the fluid-filled sac (bursa) around your shoulder and will ache even worse at night. To sleep with shoulder bursitis, try taking a non-steroidal anti-inflammatory medication before bed to help settle the inflammation in your shoulder (check this with your doctor first).
When sleeping with shoulder bursitis, you should avoid sleeping on your front or side. Sleeping on your back is best for this condition, though if you simply cannot get to sleep on your back you can try the side-sleeping positions above.
How to Sleep with Frozen Shoulder
When trying to sleep with a frozen shoulder, you will have additional difficulty as your shoulder movement is severely reduced. You will struggle to lift your arm above your head if you sleep on your front and attempting to get your arm into this position will worsen the problem.
To sleep with a frozen shoulder, try sleeping on your back or the non-affected side. You can place some pillows under the affected arm to help alleviate some of the pressure. You can also take some painkillers about an hour before bedtime to help with some of the associated pain.
How to Sleep with Shoulder Impingement
When you’re suffering from shoulder impingement, certain positions will cause additional pain. Side-sleeping in the normal position may be possible for you depending on the severity of your condition, even on the affected side.
If you’re suffering from minor pain while sleeping on the side affected by shoulder impingement, try using pillows to relieve some of the pressure on your shoulder. If you’re still experiencing pain, you’ll have to try sleeping on your back. Sleeping on your front is likely to cause pain for all forms of shoulder impingement, so try to stick to your back or side.
Shoulder impingement is commonly associated with rotator cuff problems, and in this case you need to avoid causing further damage to your rotator cuff. To sleep with a rotator cuff injury, stick to sleeping either on your back, or on your non-affected side.
How to Sleep with Shoulder Pain on Both Sides
When both of your shoulders are hurting, it’s even harder to find a comfortable sleeping position. Most of the sleeping positions put some level of pressure on your shoulders, so you need to use pillows and padding to take some pressure off. To achieve this, keep your arm slightly away from your body using the sleeping positions we discussed above.
If you only have minor pain in your shoulders, but back or side sleeping is making it worse, this is one of the only situations where I would recommend trying out sleeping on your front. You can put a pillow under your hips to align your body and take some pressure off your shoulders.
Still struggling to sleep with shoulder pain despite this? You can either try switching from side to side to prevent the pressure from building up or talk to your doctor about increasing the pain relief medications you take at night.
Sleeping with a Shoulder Sling
If you’ve had shoulder surgery and need to have your shoulder in a sling, you may find most sleeping positions uncomfortable.
If you’re sleeping on your back, the extra weight from your shoulder sling will put pressure on your shoulder and increase the pain. To prevent this, place a pillow underneath the whole of your affected arm, including the shoulder. This lifts the shoulder and prevents gravity from pulling on the joint and causing pain.
For side sleepers, you’ll need to sleep on the non-affected side to avoid causing damage to your shoulder. Place plenty of pillows (you’ll need at least 2 folded pillows!) underneath the arm that’s in a sling. Make sure that this arm is well supported, and gravity isn’t trying to pull on your joint.
How to Sleep After Shoulder Surgery With a Recliner Chair
Once you’ve reached a stage where you no longer need to wear a sling, you may still feel uncomfortable sleeping in your normal position. While you can try some of the advice in the sleeping position section, if you have a recliner chair you can use this to have a more comfortable sleep.
In your recliner chair, sleep upright and find a comfortable position where you can keep your arms at your side. This helps to reduce post-op pain and inflammation, and will give you a more comfortable sleep. If you normally have your recliner chair in a room with a TV, make sure to keep the TV off! Using screens late at night affects your chances of a good and restful sleep – try to stay away from screens for at least an hour before bedtime.