Shoulder Sleep: A Guide To Better Resting Positions

Sleeping on your side can be a comfortable position for many, but it can also cause shoulder pain. This is because sleeping on your side puts additional stress on your shoulder, which bears the weight of your torso. This can lead to various conditions such as shoulder impingement, tendinitis, bursitis, and osteoarthritis.

To prevent or alleviate shoulder pain from side sleeping, you can try adjusting your sleeping position, using thicker pillows, or sleeping with a body pillow. Additionally, strengthening and repairing the shoulder through exercises and managing pain through medication or hot/cold packs can help. Improving your sleep hygiene and maintaining good posture during the day and while sleeping are also important for reducing shoulder pain.

Shoulder pain causes: rotator cuff injuries, bursitis, osteoarthritis, impingement, and tendinitis

Sleeping on your side can put additional stress on your shoulder, which may explain why you are experiencing pain when sleeping on one shoulder. This is because when you sleep on your side, your shoulder bears a lot of the weight of your torso.

There are several conditions that can cause shoulder pain, including:

Rotator cuff injuries

The rotator cuff is a collection of tendons surrounding your shoulder joint, attaching the end of your upper arm bone to your shoulder blade and helping to secure it in the socket. Rotator cuff injuries occur when the tendons become inflamed and irritated (tendinitis) or even partially or completely torn. This can be due to injury, such as falling with an outstretched arm, or participating in sports that frequently use the shoulder joint, such as baseball or tennis. It can also be caused by regularly performing activities that require lifting or overhead use of your arms, such as construction work or painting.

Symptoms of rotator cuff injuries

• A dull ache or pain deep in your shoulder
• Pain that gets worse when performing movements that involve lifting, throwing, or reaching behind your back
• Stiffness or loss of range of motion
• Disrupted sleep if you roll onto the affected shoulder

Treatment for rotator cuff injuries

• Rest and ice the affected shoulder
• Over-the-counter (OTC) anti-inflammatories, such as ibuprofen or aspirin
• Physical therapy to improve strength and range of motion in the shoulder
• Corticosteroid injections for pain and inflammation
• In severe cases or those that don't respond to conservative treatment, surgery may be required

Bursitis

Bursae are small, fluid-filled sacs that cushion the tissues around your joints and are found all over your body. Bursitis occurs when a bursa becomes inflamed, and the shoulder is one of the most common locations for this condition. It is often caused by an injury affecting the shoulder or repetitive actions that overwork the joint, but sometimes the cause may be unknown.

Symptoms of bursitis

• Localized aching or tenderness in the affected shoulder
• Pain that gets worse with movement
• Pain when pressure is applied, such as when lying down
• Stiffness in the affected shoulder
• Swelling and redness

Treatment for bursitis

• Resting the shoulder
• OTC anti-inflammatories for pain and inflammation
• Physical therapy exercises
• Corticosteroid injections
• In severe cases, surgery may be required to drain or remove the affected bursa

Osteoarthritis of the shoulder

Osteoarthritis occurs when cartilage, which cushions your bones, begins to break down. It can affect various joints throughout the body, including the shoulder. This condition can occur naturally with age or due to previous injuries affecting the shoulder joint, such as a rotator cuff tear or a dislocated shoulder.

Symptoms of osteoarthritis of the shoulder

• Pain, initially worse when moving the shoulder but can eventually occur at rest or while sleeping
• Stiffness or loss of range of motion
• Grinding or clicking sounds when moving the shoulder

Treatment for osteoarthritis of the shoulder

• Oral or topical pain relievers
• Specific physical therapy exercises for arthritis in the shoulder
• Corticosteroid injections for inflammation
• Surgery may be recommended if non-surgical treatments don't help relieve pain

Shoulder impingement syndrome

Shoulder impingement syndrome occurs when the soft tissues around the rotator cuff catch or rub on nearby tissue or bone as you move your arm. This can be caused by swelling of the surrounding tendons (tendinitis), inflammation of the surrounding bursa (bursitis), the presence of bone spurs, or a bone in the shoulder joint that is curved or hooked instead of flat.

Symptoms of shoulder impingement syndrome

• Pain located on the top or outer part of the shoulder
• Pain that becomes worse when lifting the arm, especially above the head
• Pain that worsens at night and affects sleep, particularly when rolling onto the affected shoulder
• A feeling of weakness in the affected shoulder or arm

Treatment for shoulder impingement syndrome

• Rest, pain relief with OTC anti-inflammatories, and gentle shoulder exercises
• Corticosteroid injections for pain and swelling
• Surgery to widen the area around the rotator cuff if other treatments are ineffective

Sleeping on your side can cause shoulder pain

Additionally, sleeping on your side can cause or exacerbate specific shoulder conditions, such as:

• Rotator cuff injuries: Sleeping on the affected side can irritate and inflame the tendons of the rotator cuff, causing pain and reduced range of motion.
• Shoulder bursitis: The bursae are fluid-filled sacs that cushion the joints. Sleeping on your side can irritate and inflame these sacs in the shoulder, causing increased pain and stiffness.
• Osteoarthritis: Prolonged side sleeping can cause cartilage breakdown in the shoulder, leading to stiffness, painful clicking, and pain with movement.
• Shoulder impingement: This occurs when the tissues around the rotator cuff rub or grind against nearby tissue or bone. Sleeping on the affected side can worsen symptoms, causing pain and weakness in the shoulder.

To alleviate shoulder pain caused by sleeping on your side, you can try the following:

• Change your sleep position: Sleeping on your back with a pillow for support can minimize pressure on your shoulders and maintain a neutral spine.
• Use pillows: Place a pillow between your arms if sleeping on your side to keep your shoulders in a neutral position, or hug a body pillow for full-body support.
• Choose the right pillow: Use a thinner pillow if sleeping on your back, and a thicker pillow if sleeping on your side, to maintain proper neck and spine alignment.
• Adjust your mattress: A medium-firm mattress can help alleviate shoulder pain by providing a balance of comfort and support.
• Strengthen your shoulders: Regular exercises targeting your shoulder muscles can help prevent pain and improve your posture.
• Apply heat or ice: Use a heating pad or ice pack to reduce pain and inflammation.
• Practice good posture: Sitting and standing with correct posture can help reduce strain on your shoulders, neck, and back.
• Stretch before bed: Gentle stretches before sleep can help relieve tension in your shoulders and neck, improving your range of motion.

A soft mattress may help with shoulder pain

Sleeping on your side can put a lot of pressure on your shoulder, which can lead to shoulder pain. This is especially true if you have an unsupportive mattress.

If you're experiencing shoulder pain, a soft mattress may help. A soft mattress will allow your arm to sink further in, easing the pressure on your shoulder joint.

However, it's important to find a mattress that provides a balance between softness and support. A mattress that is too soft may lack the support needed to maintain proper spinal alignment. On the other hand, a mattress that is too firm can create pressure points, leading to pain and discomfort.

Therefore, if you're experiencing shoulder pain, look for a mattress that is soft enough to cushion your shoulders, while still providing adequate support for your spine. Memory foam, latex, and hybrid mattresses are often good choices for this, as they offer a combination of pressure relief and support.

Additionally, consider using a body pillow to support your arm and shoulder while sleeping on your side. This can help keep your spine aligned and reduce strain on your shoulder.

If you're experiencing persistent shoulder pain, it's recommended to consult with a healthcare professional or physical therapist to address any underlying issues.

Use a pillow to support your shoulder

Using a pillow to support your shoulder is a great way to prevent pain and discomfort while sleeping. Here are some tips on how to use a pillow for better sleep:

• Choose the Right Pillow: Opt for a pillow that provides adequate support for your head and neck, keeping them upright and aligned with your spine. Memory foam, latex, or buckwheat pillows are good options as they contour to your body and provide support. Avoid down, down alternative, and feather pillows, as they may not provide enough support.
• Pillow Positioning: If you're a side sleeper, place a pillow under the armpit of the affected shoulder. You can also try sleeping on your back and placing a pillow in the armpit of the affected side. This helps relieve pressure on the shoulder.
• Arm Position: Avoid sleeping with your arm under the pillow or above your head, especially if you have shoulder pain. Instead, try to sleep with your arms in a downward position to reduce tension on the shoulders.
• Pillow Loft: Consider a higher loft pillow if you're a side sleeper to ensure your ears are lined up with your shoulders. Back sleepers should choose a pillow that keeps their chin and breastbone aligned.
• Pillow Material: Look for pillows with breathable and cooling materials, such as latex, bamboo, or cotton. This is especially important if you tend to sleep hot.
• Adjustability: Pillows with adjustable loft or firmness can be helpful as they allow you to customize the pillow to your preferences and sleeping position.
• Sleep Position: Back sleeping is the ideal position to reduce shoulder pain as it distributes weight evenly and puts less stress on the shoulders. Side sleeping can cause or worsen shoulder pain, so try to sleep on the unaffected side if possible.
• Pillow Care: Remember to replace your pillow every two years or sooner if it shows signs of wear or if it's causing you discomfort. Wash your pillow regularly according to the manufacturer's instructions to maintain hygiene.

Rehabilitation and pain management may be necessary

If you're experiencing shoulder pain from sleeping on one side, rehabilitation and pain management may be necessary. Here are some steps you can take to address the issue:

Consult a Specialist

It is important to consult a specialist, such as an orthopaedic doctor or a pain and rehabilitation specialist, to determine the underlying cause of your shoulder pain. They can provide an accurate diagnosis and recommend an appropriate treatment plan.

Identify the Cause

Shoulder pain can be caused by various factors, including sleeping position, underlying medical conditions, or previous injuries. Identifying the specific cause of your shoulder pain will help in determining the best course of treatment.

Change Your Sleeping Position

Adopting a better sleeping position can significantly reduce shoulder pain. Sleeping on your back is often recommended as it distributes your weight more evenly and reduces pressure on the shoulders. This can be facilitated by using a small pillow between your shoulder blades for added support.

Adjust Your Bedding

Consider changing your mattress to a softer one, as stiff surfaces can force the arm towards the chest when lying on the side, increasing pressure on the shoulder. Additionally, using thicker pillows for your head and extra pillows for support under the knees or lower back can help improve your sleeping posture and reduce shoulder strain.

Strengthen and Repair the Shoulder

If changing your bedding doesn't provide relief, you may need to focus on strengthening and repairing your shoulder. Consult a specialist who can recommend specific exercises or physical therapy to improve the strength and range of motion in your shoulder.

Manage Pain with Medication

Over-the-counter pain relievers and anti-inflammatory medications can help manage shoulder pain and reduce inflammation. Consult your doctor for recommendations on appropriate medications and dosages.

Consider Surgery

In some cases, if conservative treatments are ineffective, surgery may be necessary to address the underlying cause of your shoulder pain. This is usually considered a last resort when other treatments have not provided sufficient relief.

Remember, it is important to seek professional advice to determine the best course of treatment for your specific condition.

Frequently asked questions