By Reuben Gobezie, M.D.
Can the way you sleep cause shoulder pain?
If shoulder pain is keeping you from sleeping at night, there is no doubt you are frustrated and want to find a way to stop it. When a patient tells me they have shoulder pain at night, they will often ask if it’s because they tend to sleep on their side.
Prolonged pressure on the shoulder from sleeping on your side can become painful, especially if there is an underlying condition in the shoulder joint or upper arm. Pain at night is not normal and it’s certainly a red flag that something needs to be addressed.
For side sleepers, this is commonly bursitis. Bursitis is an inflammation of the bursa, which is a fluid-filled pad that provides a cushion to the bones of the joint. When injured, fluid in the bursa increases and this swelling can be painful.
Other conditions that could lead to shoulder pain at night include biceps tendinitis, rotator cuff injuries or overuse injuries from a specific activity or shoulder motion that you make repetitively. Racquet and ball-throwing sports are common culprits, but any repetitive shoulder motion can cause an overuse injury.
Biceps tendinitis is usually the result of long-term overuse and deterioration of the biceps tendon that connects muscles and bones in the shoulder joint. Tendons may also get less flexible as we age, and more prone to injury. Tendinopathy is often part of the aging process. Biceps tendinopathy can give sharp pains in the arm with certain motions, like reaching behind yourself.
Rotator cuff injuries usually involve a tear in these tendons. The rotator cuff includes four muscles that come together as tendons and connect your humerus bone to the shoulder blade. The cuff provides shoulder stability and enables movement. Damage to any one of the four muscles could result in inflammation and swelling and general shoulder pain. Rotator cuff tears are common and may result from a fall or lifting something too heavy, too fast. But most tears occur as the tendons wear down over time.
Self Help
One of the first and easiest things you can do to try to relieve pain is to carefully stretch the shoulder before you go to bed. Stretching can increase the range of motion of the shoulder joint and lessen the pain. The following are simple motions can increase flexibility:
- Shrug shoulders up and down
- Roll the shoulders in a backward motion
- Do a wall stretch (stand close to a wall and walk your fingers up as high as you can and hold)
Some things you can try at home to reduce the pain and inflammation include:
- Take anti-inflammatory medications such as ibuprofen, naproxen or acetaminophen
- Sleep in a recliner
- Apply ice or heat
- Wear a compression sleeve
- Take a break from activities that may have contributed to overuse of the shoulder
If the shoulder pain doesn’t go away or worsens, see an orthopedic specialist. It’s important to properly diagnose your condition to ensure you’re getting the best treatment. A specialist will evaluate your X-ray or MRI and determine a care plan.
Non-surgical treatments may include activity modifications, physical therapy and/or a cortisone shot to ease the pain. If there is no improvement in your strength or the injury worsens over time, surgery may be the best option to restore function and alleviate pain.
Dr. Reuben Gobezie is the founding director of The Cleveland Shoulder Institute and Regen Orthopedics (844-SHOULDR).
