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Do you have shoulder pain when sleeping at night?
Have you tried changing positions, switching mattresses and pillows only to find yourself staring at the ceiling each night with pain, praying to get a few hours of sleep?
Shoulder pain is a common condition that can be chronic and disabling if not addressed. The pain and limitations that often accompany shoulder pain can have a large impact on a person's quality of life, their families, and their ability to sleep/function. Shoulder pain is in the top 3 most common injuries seen by a physical therapist and in my experience top 2 alongside low back pain.
Before we get into specifics about best techniques to aid sleeping when suffering from shoulder pain and exercises to help, let's talk about best practices for sleep as that may be a big part of the problem.
Sleep: Try the 10-3-2-1 rule
There are various factors that influence sleeping positions, such as age, BMI, pain and different health conditions. For example sleeping on your side with hip bursitis may be painful, or sleeping on your stomach when overweight may be uncomfortable.
There may be sleeping positions that can be practical or advantageous for certain populations or injuries but the truth is we move a lot during our sleep. The Study published by Koninck et. al shows that 3 yr olds -45 yr olds change positions 19-45 x per night with more changing of position occurring in younger individuals. Why do I bring this up? Because even though you may hear pillow/mattress ads promising you perfect neck or spine alignment during sleep, or social media post demonstrating how to wedge pillows or comforters to give you the best sleeping results, truth is even if you wake up in the same position you fell asleep in, it's almost impossible to guarantee your spine, shoulders and neck stay “neutral or straight” during sleep.
Now that brings up the next point, do certain sleep positions cause pain? According to the research there hasn't been any association found with sleeping position and shoulder/ spinal symptoms, this includes sleeping on your stomach with your arms overhead which is viewed by many as not the most advantageous position for your shoulders (many of these studies use small sample sizes).
Can certain positions cause pain in certain individuals? Sure, as mentioned above if you have outside hip pain, sleeping on the painful side may be uncomfortable (Btw i know this is about your shoulder but if you do have outside hip pain try putting a pillow in between your legs when sleeping, it may help).
If I went through all the different types of shoulder injuries or surgeries, we would be here all day. So let's simplify things and chat about the different sleeping positions and the pros and cons to sleeping in that position and the steps you can use to help mitigate most shoulder pain with sleeping.
Sleeping on your back with your hands supporting the back of your head may be uncomfortable after a shoulder injury due to the position the shoulders are in, not necessarily because you are sleeping on your back. This position may increase a feeling of pressure or a pinchy sensation in your shoulders and may cause the arms to go numb since there is a bundle of nerves deep in your shoulders that may be compressed. If sleeping on your back is your preferred position, try bringing your arms down by your side, if the weight of gravity is pulling on your shoulders when laying on your back put pillow underneath your arm to help support them and prevent that pulling sensation on the shoulders
Laying on your non painful side can lead to the injured shoulder to drag or hang in front of us in an internally rotated position. That can cause some shoulder irritation with gravity weighing it down. Using a pillow between the arms longitudinally can help decrease that stress on the shoulder.
Sleeping on the painful side may put a lot of pressure on your shoulder joint, muscles, tendons, nerves and blood vessels. Ideally you will change position naturally as mentioned above. If you always sleep on that side, you can try to create a gap for the shoulder or wedge yourself so you're sleeping at a 45 degree angle or wall. This puts more pressure on shoulder blade than tip of your shoulder joint.
If you just went through shoulder surgery requiring you to have your shoulder in a sling, most sleeping positions can be uncomfortable.
If you’re sleeping on your back, the extra weight from your shoulder sling can put pressure on your shoulder and increase the pain. To mitigate this issue, try placing a pillow underneath the affected arm, including the shoulder. This lifts the shoulder and prevents gravity from dragging it down which may alleviate shoulder pain.
For side sleepers, try to sleep on the non-affected side to avoid putting increased pressure on your shoulder. Use all of the pillows!!! Start with 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 shoulder joint.
Naturally some people gravitate to their recliner to sleep post surgery, as this to the patient feels more comfortable than sleeping in their bed.
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 mentioned above, if you have a recliner chair you can use this to have a more comfortable sleep.
In your recliner chair, you can try sleeping upright and finding a comfortable position where you can keep your arms by your side. This helps to reduce post-op pain and may give you a more comfortable sleep.
Falling asleep in a comfortable pain free position and getting even a couple of hours of sleep can make a world of difference
I must preface this by saying that you should consult with a medical professional before trying these exercises as not all exercises are appropriate for everyone even if diagnosed with the same injury. We all have unique bodies, with different demands from our everyday lives and there is no one cookie cutter way to treat shoulder pain.
At RehabSpot, your well-being is our priority. If you have any questions, concerns, or would like to schedule an appointment, our friendly team is here to help you. Get in touch with us using the following contact information