Shoulder Pain at Night: Causes and What to Do

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Written by Jill Zwarensteyn, Senior Editor

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In This Article

We’ll explain reasons why your shoulder pain may be bothering you at bedtime, some steps to improve pain and when to see a doctor about it.

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Getting a peaceful night of rest when your shoulder hurts isn’t exactly a walk in the park, especially if you’re used to resting on your side. I know, it’s a popular position, too! 

Likewise, waking up in the morning with a rush of pain in your upper arm could make it harder to get through the day.

The good news is there are ways to help manage shoulder pain at night. We’ll examine some of the most common causes of shoulder pain, along with some at-home and professional treatment options.

Then, explore our picks for the best mattresses for shoulder pain.

Can Side Sleeping Cause Shoulder Pain?

When you rest on your side, your body weight accumulates in a small area, including the hips and shoulders. Experts with the Cleveland Shoulder Institute say the pressure of this weight could lead to soreness, particularly if there is an underlying condition in that part of the body.⁸

If you are a regular side sleeper and have noticed you wake up with discomfort in your arm, it may be time to invest in a new bed that prioritizes pressure relief with quality-made comfort layers. Furthermore, you can add more plush comfort to your sleep space with other helpful products such as a top rated mattress topper or quality bed pad.

Want to know more? See our full guide to the best mattress for shoulder pain.

Your Mattress and Shoulder Pain

Can Your Mattress Cause Shoulder Pain?

While many top-quality mattresses are designed with comfort layers to help with pressure against the shoulders, if your bed is older or is not a good match for your sleep style and body type, this could lead to painful pressure buildup.

For example, if you’re a very lightweight sleeper under 130 pounds, beds will tend to feel harder to you than people who carry more weight because you don’t sink into them as much. By purchasing a mattress that is too firm for your body type, you could wind up exacerbating pain in this area.

How a New Mattress Can Help With Shoulder Pain

• Pressure relief –  A new mattress appropriate for your sleep style and body type may help with shoulder pain by providing better pressure relief in this area. Memory foam is popular for this because it’s exceptional at contouring and cradling the sleeper’s body. Many well-made beds feature either an all-foam construction that includes memory foam or a combination hybrid with memory foam and coils.

• Firmness – While searching for a new bed, pay attention to the firmness of the mattress. A bed’s firmness is rated on a scale of 1-10. Most beds will fall in the medium/medium-firm range between 5 and 7. If you have shoulder pain, though, it might help to skew on the lower end of this.

• Trial period – A good trial period is also going to be important here. If you find the bed does not provide adequate pressure relief for your shoulders, you can return it to the company and receive a refund.

Read More: Best Mattress for 2024.

How to Relieve Shoulder Pain at Night

1. Adjust Your Sleep Position

If you are a side sleeper who regularly rests on the left shoulder and are now experiencing pain on that side, you will need to adjust how you sleep. One option is to rest on the side that does not have shoulder pain. Often, taking weight and pressure off of the affected area should provide relief.

2. Try Support Pillows

Good pillows could help you feel more comfortable. According to St. Kila Osteopathy, you should place the pillow under the elbow of the sore arm.⁹ The shoulder joint’s ball and socket are more supported by lifting the elbow, reducing stress in the affected area.

If you plan to sleep on the opposite shoulder, grab a pillow to hug in front of you. Hugging a pillow should prevent the shoulder in pain from moving too far forward and compressing other parts of the upper arm area. Additionally, this should keep the joint in a stable position.⁹

Another tip for resting on the opposite side is to place a second pillow behind you. A second pillow should help prevent you from falling into an uncomfortable position while you are asleep, which could cause you to wake up with even more soreness in the morning.

Find Out More: How to Properly Sleep on Your Side

3. Avoid Certain Exercies

If you have pain in your shoulder, there are specific exercises to avoid that could exacerbate pain in the shoulders, such as throwing a ball overhead, swimming, and certain weightlifting moves..¹⁰  

According to Rolling Hills Medical, you should avoid the following weight-lifting maneuvers while the shoulder heals:¹⁰

• Lifting weights above the head
• Pulldowns behind the neck
• Upright row
• Shoulder press behind the neck
• Bench (tricep) dips

Even though there may be days when your shoulder does not hurt as much, you should still check in with your doctor before attempting any of these activities. You may feel fine, but it is best to consult with a healthcare professional to avoid worsening anything.

4. Stretch Exercises

While you should take it easy and avoid moves that can aggravate the area, never moving your upper arm is not ideal since the muscles could stiffen up. Harvard Health suggests practicing the following stretches two or three times a week to help maintain flexibility and minimize pain:¹¹

Check with your doctor before doing any of these exercises, and do not attempt to over-stretch because you risk pulling a muscle. Instead, ease into the stretch and only extend as far as you can comfortably.

Seated Stretch

To begin, sit in a chair facing forward with your feet planted on the ground. Place the left hand on the right shoulder, and then cup the elbow with the right hand. From there, roll the shoulders down and back.

Lightly pull the left elbow across the chest while extending the left arm. You should feel the stretch in your left shoulder.

Hold for 20-30 seconds, and then do the same thing on the other side. Repeat this stretch two to four times on both sides.

Seated Triceps Stretch

While seated in a chair, place the right hand on the right shoulder. Then, hold the right elbow with the left hand. Make sure to keep the shoulders down and back as you lift the right elbow toward the ceiling as high as it can go.

You should feel a stretch throughout the right upper arm and shoulder. Hold this position for 10-30 seconds and repeat on the left side. Do two to four reps of this on the right and left sides.

Seated Chest Stretch

You will also begin this exercise seated in a chair. However, for this one, you will need to turn your body to sit facing the side. Also, make sure the chair you use does not have armrests.

To begin, roll the shoulders down and back, and then clasp your hands behind you. Intertwine the fingers and have the palms of the hands facing you. Slowly lift the hands toward the ceiling.

This move should stretch the chest and front of the shoulders. Do two to four reps while holding for 10-30 seconds.

Need more info? Check out our guide for bedtime stretches.

5. Ice or Heat

Whether you use ice or heat will depend on why your shoulder hurts in the first place.¹²

• Injuries: Short-term injuries last less than six weeks, and they should be treated with ice to help reduce swelling, inflammation, and pain. However, if the injury lasts longer than six weeks, heat is acceptable to use. Since heat increases blood flow, this should loosen up stiff muscles and joints to help with range of motion.¹²

• Arthritis: If your shoulder pain is caused by arthritis, Cleveland Clinic recommends using moist heat such as a warm bath or shower. However, they add that the water should be warm but not too hot (between 92 and 100 degrees Fahrenheit).¹²

• Muscle strain: To treat a strained muscle, begin with ice to decrease inflammation. Once that is resolved, switch to heat.¹²

Learn More: Cold Plunge Benefits and Best Cold Plunge Tubs

• Tendonitis: For tendonitis, use ice to help with the inflammation. Tendonosis, the chronic version of tendonitis, can benefit from both ice and heat. First, use ice to tackle the inflamed area, and then switch to heat to alleviate stiffness.¹²

According to the Cleveland Clinic, a good rule of thumb is to leave ice or heat on for 20 minutes and then 20 minutes off.¹² 

Learn More: Best Home Sauna, Best Infrared Sauna, and Best Portable Sauna

5. Pain Relief Medications

Common over-the-counter medications can be used to treat shoulder soreness.¹³ Acetaminophen and ibuprofen are two forms of over-the-counter pain medications. Tylenol is a well-known acetaminophen, and Advil and Motrin are popular ibuprofen brands. While acetaminophen can help treat achiness, it does not reduce inflammation.

When taking medications, always follow the dosage directions and consult with your doctor if you are pregnant or have another serious health condition. Also, if you are taking any other medications, you should check with your doctor to ensure any pain relief drugs won’t affect them.

6. Physical Therapy

Even after trying out these different treatment options on your own, you may find that your body needs extra help to heal itself. In this case, physical therapy could be a beneficial choice and a less-invasive alternative to surgery.¹⁴

Physical therapists offer a structured and personalized treatment program to help you on the road to recovery. According to Ortho Bethesda, the following methods are examples of ways a physical therapist may try to help your pain:¹⁴

• Ice or heat therapy – A physical therapist may use ice, heat, or a combination of the two.
• Hands-on therapy – In this case, the physical therapist uses their hands to relax the shoulder and apply pressure to the tissue to improve mobility.
• Stretching – A therapist may also help stretch the shoulder and surrounding areas, such as the neck and spine.
• Strengthening exercises – A therapist can guide you through specific strengthening exercises designed to help improve your recovery and reduce your risk of a repetitive injury.
• Joint mobilization – For this treatment, the therapist focuses on stretching the joint capsule.
• Therapeutic ultrasound – A therapeutic ultrasound uses deep heating to improve circulation and flexibility in the muscles, tendons, and other soft tissue.
• Electrical stimulation – Electrical stimulation is designed to strengthen the muscles. This treatment may also be used to decrease inflammation or provide medication.
• Athletic taping – The physical therapist may use athletic tape to help limit movement.
• Kinesiology taping – Conversely, kinesiology taping fosters movement safely to improve circulation.

Your physical therapist may have you continue certain exercises at home once your program is complete. In addition, they may show you how to modify certain activities to prevent future problems and discuss ways to support your body while at work.

7. Surgery

If all of the above treatments are unsuccessful, you may need surgery. Different surgery options are available depending on the cause of the pain and what is needed. 

According to Dr. Pamela Mehta, an orthopedic surgeon in San Jose, California, “surgery for shoulder pain depends on the cause.”

She adds, “Severe arthritis can be treated with shoulder replacement surgery – this has a prolonged recovery period of several months and will certainly impact your sleep as your arm will be in a sling for the initial phase of recovery.”

“Shoulder impingement is usually treated arthroscopically with a procedure called subacromial decompression. Recovery can take 3-6 months.”

Lastly, Dr. Mehta explains, “Frozen shoulder and shoulder bursitis are also treated with arthroscopy. You’ll be in a sling for 2-6 weeks and won’t be able to sleep on that shoulder for 6+ weeks.”

When to Talk With Your Doctor about Shoulder Pain

If you experience any of the following symptoms with your shoulder pain, contact your healthcare provider to schedule an office visit.¹⁵

• Swelling
• Redness
• Tenderness and warmth around the joint

When to Seek Immediate Medical Attention

If you have a shoulder injury and exhibit any symptoms below, immediately ask for a ride to urgent care or the emergency room.¹⁵

• Joint appears deformed
• Unable to move joint or arm
• Intense pain
• Sudden swelling

Final Word of Advice

Shoulder pain is no joke, especially if you’re used to sleeping on the side that hurts. While it helps to avoid sleeping on that shoulder, sometimes, switching sides might not be enough to solve the problem. Injections, physical therapy, pain relief medications, and even surgery may be needed to relieve the pain. 

One of the best things you can do for yourself and your shoulder pain is to get the right mattress that supports the area without creating pressure buildup.

Jill Zwarensteyn

Senior Editor

About Author

Jill Zwarensteyn is the senior editor for Sleep Advisor and a certified sleep science coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.

Combination Sleeper

References:

1. “Shoulder Pain: 11 Common Conditions and Causes”. Cleveland Clinic. 2022.
2. Williams, Christopher H., Jamal, Zohaib., Sternard, Britni T. “Bursitis”. StatPearls. Last modified July 24, 2023.
3. “Tendonitis”. Cleveland Clinic. Last modified July 18, 2023.
4. “Arthritis of the Shoulder”. Hospital for Special Surgery. Webpage accessed July 26, 2024.
5. “Frozen shoulder”. Mayo Clinic. Last modified August 19, 2022. 
6. “Dislocated shoulder”. Mayo Clinic. Last modified August 23, 2022.
7. “Dislocated Shoulder”. Cleveland Clinic. Last modified May 11, 2024.
8. “Shoulder Pain from Sleeping on Your Side”. Cleveland Shoulder Institute. Webpage accessed July 26, 2024. 
9. “Best Sleeping Position for Shoulder Pain”. St Kilda Osteopathy. Webpage accessed July 26, 2024.
10. “Shoulder Injury Exercises 101: Shoulder Tendonitis Exercises To Avoid & Rotator Cuff Exercises To Avoid”. Rolling Hills Medical. Webpage accessed July 26, 2024.
11. “Ouch! Shoulder pain and how to treat it”. Harvard Health. 2022.
12. “Here’s How to Choose Between Using Ice or Heat for Pain”. Cleveland Clinic. 2020.
13. “What’s the Difference Between Tylenol, Advil and Aleve?”. Hospital for Special Surgery. Last modified May 9, 2022. 
14. “Best Physical Therapy Methods for Treating Shoulder Pain and Injuries”. Ortho Bethesda. Webpage accessed July 26, 2024.
15. “Shoulder pain”. Mayo Clinic. Last modified August 31, 2023.