Shoulder pain at night is a very common issue among chronic pain sufferers. The shoulder is one of the most vulnerable joints as it has such a wide range of motion, which opens it up to various injuries and problems. So, why are you experiencing shoulder pain at night and what can you do to find relief? We discuss five treatment options ranging from shoulder stretches to chiropractic to interventional procedures.
Issues associated with shoulder pain at night
On top of the pain, most people with shoulder pain at night sleep poorly, which has a completely different set of problems associated with it. These can include:
- Increased sensitivity to pain
- Low energy
- Mood disorders
Sleeplessness can become a vicious cycle of decreasing sleep and increased pain, which will only make your condition worse.
Causes of shoulder pain when night
Although many shoulder disorders can cause pain, the most common cause of shoulder pain at night comes from rotator cuff tendinitis. It usually is caused by irritation of the shoulder tendons leading to inflammation and pain. This condition can be caused by many things, including:
- Poor posture
- Repetitive work injuries
Rotator cuff tendinitis is known to affect millions of people in the U.S. each year and is a major cause of shoulder pain when sleeping.
Some of the other causes of shoulder pain at night are:
- Frozen shoulder
- Shoulder dislocation
Why exactly does the pain increase at night even though it might be fine during the day?
Why do I have shoulder pain at night only?
While this nighttime shoulder pain cannot always be explained, a lot of the pain comes down to:
- Being still at night
- Unrelieved tension and stress from the day
- The sleeping position you choose
- Your mattress
During the day, the shoulder is being actively used while you are in a vertical position. The tendons engage and are pulled downward by gravity, which allows space to be made in the muscle groups in the shoulder. This additional space allows for an increase in blood flow and oxygen that alleviates the stiffness and pain that would be present otherwise.
When you lay down to rest or sleep at night, you are generally in a horizontal position. This removes the effect of gravity and allows the shoulder muscles to relax. The lack of movement and the relaxation of the muscles allows the fluids in your joints to settle and decreases the flow of blood, allowing the joint to become inflamed. People also tend to lie on their shoulder while sleeping, which can compress the joint even further, and thereby worsening the inflammation.
How-to relieve shoulder pain at night
If your shoulder pain is worse at night, there are ways to ease your pain.
1. Find a better sleeping position
The first course of action to relieve shoulder pain at night is to find a good sleeping position for you. Tossing and turning at night is normal for most people, but can agitate your shoulder if you land on it wrong. Sleeping on the opposite shoulder can help avoid this pain, but try not to sleep on your back.
If the pain persists, you can always trying wrapping your arm or wearing a sling to assist in preventing movement during sleep. Sleeping with a pillow under your knees can help alleviate any associated back pain.
2. Stick to a sleep schedule
Along with fixing your position while sleeping, always make sure to try to stick to a sleeping schedule. Good sleep hygiene can make all the difference in your sleeping patterns. Having a consistent bedtime ritual that helps wind you down at the end of the day can do wonders in terms of reducing stress and tension, and improving sleep length and quality.
Try something relaxing before bed like a shower and make sure you fall asleep in a dark room with no electronics. Medication can also help you sleep, but be cautious of how often you use them. Constantly requiring sleep aids can be a major sign of a problem and the more you use over-the-counter drugs, the more you will need to be effective. In addition, if you’re using other medications, they may react poorly with the sleep aids.
3. Perform stretches for shoulder pain at night
Exercising a few hours before bed can also be useful as it will increase blood flow throughout the whole body. This can alleviate pain, but also relax you enough to ease sleeping troubles. Try something low impact like a brisk walk or a bike ride, and then allow your body to cool down again before going to bed.
Further, certain shoulder stretches can help you reduce the tension and stress that has built up during the day. Not only are shoulder stretches an easy option, but they take only a few minutes at night. Stretching has huge health benefits like increasing flexibility, range of motion, and blood flow. Another big plus is that they are simple to do in your own home and require no special equipment. Before you go to bed, try these seven shoulder stretches to alleviate some tension and reduce your stress.
Shoulder stretch basics
If you start to feel pain at any time during a stretch, stop immediately. Stretching should be done to the point of mild strain. If you experience pain, you are going too hard and could injure yourself. This is especially true if the pain is sharp or sudden. It is a good idea for chronic pain sufferers to consult a pain doctor before starting too strenuous of a stretching routine as overexertion could exacerbate certain conditions.
For best results, always warm your muscles up a little before stretching. For the following stretches, it is best to do each for approximately 30 seconds to one minute for maximum effect. Also, make sure you are steadily breathing in and out in a controlled manner.
This is a quick stretch that is great if you spend way too much time staring at a computer monitor. Slowly extend your neck outward, making sure your keep your chin parallel with the floor. Then, pull it back in to a neutral position that is straight with your spine, slightly tucking the chin in. Repeat.
Sit in a cross-legged position on the ground. Extend your arms in front of you and place your left elbow in the crook of the right arm. Now, bend your elbows back so your hands are touching. Hook one hand over the other so that your palms are facing each other.
For this stretch, you should keep your palms together, elbows lifted in a 90 degree angle, and your hands in front of your face. Try to keep your shoulders relaxed and down. You should feel a powerful stretch in your shoulder blades as well as the lower part of your neck. After this, change arms by placing your right elbow in the crook of your left arm and repeating.
Take your right arm and reach over your shoulder aiming to lay your palm in-between your shoulder blades. Then take your left arm and reach up your back (not over the shoulder) also placing the hand between the shoulder blades. Try to interlock your hands and pull slightly.
If you are having trouble interlocking your hands, you can modify this stretch. Keep a towel or something similar in your top hand, and then grasp it with your bottom hand instead of clasping the hands together. Gently pull with each arm to feel your shoulders start to open up.
Standing wall stretch
While standing tall, reach out and place both of your hands on a wall. Walk your feet back until the arms are straight, but don’t let your arms reach too far above your head. Make sure you keep the shoulder blades open and relaxed downwards during the whole stretch. Also, avoid pushing against the wall and don’t allow your shoulders to press up and into your neck.
Shoulder blade stretch
Start by spreading your feet, so they are shoulder-width apart. Raise your arms above your head as far as possible and bring your palms together. Now, simply twist your waist by bringing one shoulder forward and simultaneously pulling the opposite shoulder back. Hold this stretch and then switch sides.
This stretch begins by lying face down on your stomach. First, place your right hand palm down on the floor like you are starting a pushup. Next, lift your chest slightly and slide your left arm under your chest. Finally, square your chest with the floor and lower on top of your arm. Hold this position and then switch your arms.
If you want a deeper stretch in this position, you can move on to the full dragonfly. This is accomplished by lying on your stomach face-down. Crisscross both arms near the collar bones and straighten your arms out as far as possible. Then, allow your body to drape onto your arms.
Stand your feet hip-width apart. Turn your right foot forward. Turn the left foot so it is perpendicular with the right and raise both arms to shoulder level straight out from the body.Stretch your right arm up and forward, pulling your body up slightly. Then slowly lower the chest forward over the right leg until it is parallel with the ground. Place your hand on your thigh or calf, while avoiding placing it on the knee directly. Try to keep as little weight in your hand as possible, focusing on keeping yourself upright with your core instead. Extend the left arm completely upward towards the ceiling, if it feels comfortable. Finally, turn your head upwards towards the ceiling or down towards the ground for an additional neck stretch.
4. Try yoga poses for neck pain
Since shoulder pain at night is often related to neck pain, trying the following yoga poses for neck pain could also help relieve your pain. This video also demonstrates the triangle shoulder stretch.
5. Talk to a pain doctor about interventional therapies
If these natural treatments don’t work to relieve your shoulder pain at night, it may be time to talk to a pain doctor. They can help diagnose the exact cause of your shoulder pain. If your pain isn’t due to an acute injury or fracture, they may suggest interventional treatments for chronic pain.
These shoulder pain at night treatments include:
- Physical therapy to increase flexibility and reduce pressure on your joint
- Chiropractic care to increase mobility and loosen tension
- A regimen of non-steroidal anti-inflammatory medications
- Joint injections that can relieve nerve irritation
- Surgery, but only for the most severe cases of shoulder pain at night
If more conservative treatments like chiropractic care or physical therapy haven’t worked, a joint injection provides a minimally-invasive treatment that doesn’t require surgery. You can learn more about this approach in the following video (while not a shoulder injection, it does showcase a knee joint injection using a similar approach).
Signs to watch for
It’s always best to consult a medical professional before starting any kind of treatment for shoulder pain. A proper diagnosis is always critical, so you may need an examination and other tests, such as an MRI or X-ray.
Shoulder joint pain can come from many different causes, but they share many similar symptoms such as being tender or warm to the touch. You should always talk to your physician if you are experiencing:
- Excessive stiffness, pain, or swelling in your shoulders
- Difficulty moving your shoulder or performing daily activities due to pain
Some types of shoulder pain such as arthritis can cause permanent damage, which can be mitigated if caught early enough.
If you experience any of the following symptoms, reach out to your doctor immediately:
- You begin to experience a fever or chills
- If severe shoulder pain is constant for more than four days or intermittently for two weeks
- You start losing weight without reason
- You have excessive night sweats
It is important to have these symptoms checked as soon as possible as these can be symptoms of serious conditions that should be treated immediately.
Do you experience increased shoulder pain at night? If you’re ready to learn more about treatment options that could work for you, reach out to one of our pain specialists.