Why Does Your Shoulder Hurt More at Night?
Your shoulder might feel manageable throughout the day, only to become noticeably painful when you get into bed.
You shift onto one side.
The pain starts.
You roll over.
It gets worse.
Eventually, you’re trying to find one position that lets you fall asleep without irritating your shoulder.
If you experience shoulder pain at night, it does not necessarily mean the underlying problem has suddenly become worse after dark.
Night-time can simply make shoulder symptoms more noticeable because you are lying in one position for longer, putting pressure on certain tissues and paying more attention to discomfort when there are fewer distractions.
However, persistent night pain can also occur with several shoulder conditions, so the pattern of your symptoms matters.
Why can shoulder pain get worse when you’re in bed?
There are several possible reasons.
Sleeping directly on the painful shoulder:
This is one of the simplest explanations.
When you lie on your side, your body weight places pressure through the shoulder.
If the area is already sensitive after an injury, repetitive activity or another shoulder problem, that pressure may increase discomfort.
You may find that sleeping on the opposite side feels easier, although this can create another problem if your painful arm falls forwards or is left unsupported.
Your shoulder stays still for longer:
During the day, your shoulder is constantly changing position.
You reach for something, walk around, use your arms, drive, work and perform everyday tasks.
At night, you may remain in essentially the same position for hours.
For some people, that lack of movement can make the shoulder feel stiff or uncomfortable.
This can be particularly noticeable when you first wake up or when you turn over in bed.
Your sleeping position may place the arm overhead:
Some people naturally sleep with an arm above their head or tucked underneath a pillow.
Depending on the shoulder and the underlying issue, certain positions may reproduce symptoms.
There is no single sleeping position that is right for everyone.
Instead, notice which positions consistently increase or reduce your symptoms.
Why does my shoulder hurt when I lie on it?
If lying on your shoulder is painful, pressure through the area may be contributing.
The shoulder is a complex region containing the joint itself as well as muscles, tendons and other surrounding tissues.
A painful shoulder can become sensitive to direct pressure, particularly when you remain on it for an extended period.
This does not automatically tell you which structure is responsible.
Shoulder pain can come from different tissues and may sometimes be influenced by the neck or upper back as well.
That is why trying to identify the exact problem from the sleeping position alone can be difficult.
Could what you do during the day be causing night-time shoulder pain?
Sometimes the clue is not in your bedroom.
It is in your day.
Consider someone who spends hours:
- working overhead
- lifting repeatedly
- reaching across a desk
- carrying a child
- playing sport
- using a computer
- performing repetitive manual tasks
The shoulder may cope reasonably well while the person is busy.
By evening, however, the accumulated workload may become more noticeable.
This is particularly relevant if your shoulder pain started after changing your exercise routine, increasing your workload or taking on a new physical activity.
Night-time pain can sometimes be the point at which you notice the effects of the day’s activity, rather than the point at which the problem began.
Why does shoulder pain sometimes wake you up?
Being woken by shoulder pain is worth paying attention to, particularly if it happens regularly.
Pain can interrupt sleep because you roll onto the affected side or because a particular position places the shoulder under uncomfortable pressure.
But persistent pain that repeatedly wakes you should not simply be dismissed as a sleeping-position issue.
The cause could be something relatively straightforward, but an assessment may be appropriate if symptoms are ongoing, worsening or affecting your sleep.
What about frozen shoulder?
Frozen shoulder, also called adhesive capsulitis, is one condition that can cause significant night-time shoulder pain.
People with frozen shoulder commonly experience increasing stiffness as well as pain, with everyday movements such as reaching overhead, putting on a shirt or reaching behind the back becoming more difficult.
Night-time discomfort can be particularly frustrating.
However, not every painful shoulder at night is a frozen shoulder.
Other shoulder conditions can also produce pain during sleep, so an assessment is needed to understand the likely cause.
When should shoulder pain at night be assessed?
Consider getting your shoulder assessed if:
- pain is regularly disturbing your sleep
- symptoms are becoming more frequent or intense
- your shoulder movement is becoming restricted
- you have noticeable weakness
- pain has continued despite reducing aggravating activities
- symptoms began after an injury
- you are struggling with everyday activities such as dressing or reaching
A shoulder that becomes suddenly very painful after an injury, particularly if you cannot use the arm normally, should be assessed promptly.
Don’t assume all night-time shoulder pain is musculoskeletal:
Shoulder-area pain can occasionally be associated with problems outside the muscles and joints.
If shoulder pain occurs with chest pain or pressure, significant shortness of breath, sweating, fainting, severe dizziness or other concerning symptoms, seek urgent medical attention rather than assuming it is a shoulder problem.
Can a chiropractor help with shoulder pain?
Depending on the cause of your symptoms, chiropractic care may be one option for managing some types of musculoskeletal shoulder pain.
An assessment may consider your shoulder movement, strength, neck and upper-back function, previous injuries, daily activities and the movements that reproduce your symptoms.
Treatment and exercise recommendations should be individual.
If your symptoms suggest that another type of healthcare assessment is more appropriate, referral may be recommended.
FAQ
Why does my shoulder hurt more at night?
Night-time shoulder pain may be influenced by sleeping position, pressure on the shoulder, prolonged periods without movement or the physical demands of the day. Different shoulder conditions can also cause night pain.
Why does my shoulder hurt when I sleep on it?
Sleeping directly on a painful shoulder places pressure through the area for an extended period. If the tissues are already sensitive, this may increase discomfort.
Should I sleep on my painful shoulder?
If sleeping directly on the painful shoulder makes your symptoms worse, try another position. Supporting the affected arm with a pillow may also make side sleeping more comfortable.
Is shoulder pain at night a sign of a serious problem?
Not necessarily. Many causes of shoulder pain are musculoskeletal and may not be serious. However, persistent night pain, significant weakness, restricted movement or pain following an injury should be assessed.
Can a chiropractor help with shoulder pain at night?
Depending on the underlying cause, chiropractic care may form part of an individual management plan. An assessment can help determine whether the shoulder, neck, upper back or other factors may be contributing.
If shoulder pain is regularly keeping you awake or making it difficult to get comfortable in bed, an assessment may help you understand what is contributing. Wellbeing Chiropractic with clinics across Melbourne, Sydney and Brisbane. Book an appointment to discuss your symptoms and explore your options based on your history and examination findings.
