Why Does My Shoulder Hurt When I Sleep? Possible Reasons and What May Help
Waking up with shoulder pain , or finding that your shoulder becomes painful when you lie down, can be frustrating โ especially when it starts affecting your sleep.Shoulder pain can have several possible causes, and symptoms can sometimes feel worse at night. This does not necessarily mean that you are damaging your shoulder while you sleep.
The reason for your symptoms can vary from person to person, so it is not possible to identify the cause from night-time pain alone.
Why might my shoulder hurt when I sleep?
1. Your sleeping position may aggravate your symptoms
If your shoulder is already painful or sensitive, lying directly on that side may make your symptoms more noticeable.
Some people find that changing their sleeping position or supporting the affected arm with a pillow makes them more comfortable.
You could try:
avoiding lying directly on the painful shoulder if this increases your symptoms
supporting your affected arm with a pillow
placing a pillow behind your back if you tend to roll onto the painful side
changing position if staying in one position becomes uncomfortable
There is not necessarily one "perfect" sleeping position for everyone. The aim is to find a position that allows you to sleep as comfortably as possible.
2. Some shoulder problems can be worse at night
Night-time shoulder pain can occur with a number of different shoulder problems.
For example, NHS guidance notes that shoulder impingement can cause pain that is worse at night, while pain associated with frozen shoulder can also disturb sleep.
However, night pain by itself does not tell you exactly what is causing your shoulder symptoms.
Several different shoulder conditions can have similar symptoms, which is why an individual assessment may be helpful if your pain persists or is affecting your everyday life.
3. Certain movements or positions may be uncomfortable
When your shoulder is painful, you may notice that particular movements or positions make your symptoms worse.
This does not automatically mean that the movement is causing further damage.
You may find it helpful to temporarily modify activities that clearly aggravate your symptoms, while continuing comfortable movement where possible.
The NHS advises people with shoulder pain not to completely stop using the shoulder and recommends staying active and gently moving it.
4. You may have become less active because of the pain
When something hurts, it is natural to reduce how much you use it.However, completely avoiding movement for a prolonged period can contribute to stiffness and make it harder to return to your usual activities.For many shoulder problems, appropriate movement and exercise can form part of recovery. The amount and type of exercise that is appropriate will depend on your symptoms and the underlying problem.
If you are unsure what exercises are appropriate, an assessment can help identify suitable options.
5. Sleep and pain can influence each other
Shoulder pain can make it harder to sleep, and poor sleep or tiredness may make pain feel more difficult to manage.This does not mean that your pain is "just because of poor sleep".
Pain is real, but factors such as sleep, stress and tiredness can influence how strongly symptoms are experienced.
NHS musculoskeletal information also highlights the potential influence of sleep and stress on pain.
If your shoulder pain is repeatedly disturbing your sleep, it may be helpful to consider both your shoulder symptoms and your sleep routine
Should I sleep on my painful shoulder?
There is no need to force yourself to sleep in one particular position.However, if lying on the painful shoulder clearly increases your symptoms, changing position may make you more comfortable.You could try sleeping on your opposite side with a pillow supporting the affected arm, or on your back with your arm comfortably supported.
The aim is not necessarily to find a perfect sleeping position.
It is to find a position that allows you to sleep comfortably while your symptoms settle.
Should I keep moving my shoulder if it hurts?
For many shoulder problems, completely stopping movement is not recommended.The NHS advises staying active and gently moving the shoulder, while avoiding activities that clearly make symptoms worse.You may find that your shoulder tolerates some movements better than others. Shoulder pain exercise can often be adjusted according to your current symptoms and gradually progressed as your movement and tolerance improve.
If an exercise consistently causes a significant increase in your symptoms, it may be appropriate to modify the movement or seek individual advice.
When should I have my shoulder assessed?
Consider seeking professional advice if:
your shoulder pain is getting worse
your symptoms are not improving
your pain is regularly disturbing your sleep
you are finding it difficult to move your arm or shoulder
your shoulder pain is affecting work, exercise or everyday activities
you are experiencing repeated episodes of shoulder pain.
The NHS advises seeking medical advice if shoulder pain is getting worse, does not improve, or it is very difficult to move the arm or shoulder.
A physiotherapy assessment can help explore your symptoms, movement, strength and functional difficulties and consider whether physiotherapy is appropriate or whether further medical assessment may be needed.
What if my shoulder pain is mainly at night?
If your shoulder pain is repeatedly waking you, it is worth paying attention to how long this has been happening and whether you have any other symptoms.Night-time pain can occur with different shoulder conditions, so it does not necessarily mean that there is a serious problem. However, persistent or worsening symptoms should not simply be ignored.
In particular, seek professional advice if your pain is getting worse, is affecting your daily activities, or is accompanied by significant stiffness or difficulty moving your arm.
What can you do tonight?
If your shoulder is painful when you sleep, you could try:
Avoiding direct pressure on the painful shoulder if this makes your symptoms worse.
Supporting your arm with a pillow to find a more comfortable position.
Changing position if you have been lying in one position for a long time.
Keeping your shoulder gently moving during the day, within what feels manageable.
Temporarily modifying activities that clearly aggravate your symptoms.
Considering advice from a pharmacist or healthcare professional if you need help with pain relief.
These measures may make symptoms more manageable, but they do not replace an assessment if your symptoms persist or worsen.
When should shoulder pain be assessed urgently?
Seek urgent medical advice if you have:
sudden or very severe shoulder pain
an inability to move your arm
a significant change in the shape of your shoulder or arm
significant swelling
persistent pins and needles or loss of sensation
an arm or shoulder that feels unusually hot or cold
shoulder pain that started after an injury or accident
severe pain affecting both shoulders
shoulder pain accompanied by feeling feverish or generally unwell.
If you are unsure how urgently you need help, contact NHS 111 or seek appropriate medical advice.
Could physiotherapy help?
The appropriate treatment for shoulder pain depends on the cause and your individual symptoms.
Physiotherapy may be appropriate for some shoulder problems and can include advice about activity, movement and exercise.
The CSP emphasises the importance of appropriate assessment and evidence-informed self-management for shoulder problems.
An assessment can help you understand what may be contributing to your symptoms and whether physiotherapy is appropriate for you.
Could I help with your shoulder pain?
If shoulder pain is regularly affecting your sleep or daily activities, shoulder pain physiotherapy can help assess what may be causing your symptoms and guide you through appropriate treatment and rehabilitation.
Medical information
This article is for general information only and is not intended to replace individual medical or physiotherapy assessment, diagnosis or treatment. Everyone's symptoms and circumstances are different, so information that may be appropriate for one person may not be appropriate for another.If you are concerned about your symptoms, or they are persistent, worsening or affecting your daily activities, please seek appropriate professional advice.
Sources and evidence
This article has been informed by current healthcare evidence and publicly available clinical guidance, including information from the NHS, NICE and the Chartered Society of Physiotherapy (CSP), where relevant.