Sleep is meant to be restorative. It increases blood flow to the muscles, boosts the immune system, and triggers the release of hormones that restore sore, damaged muscles and help heal wounds. Unfortunately, the simple act of sleeping can sometimes lead to pain rather than healing it. People are more likely to encounter pain upon waking in their lower back, neck, and shoulders.
Shoulder pain can heavily impact our day, making it difficult to perform everyday tasks, especially those that involve lifting or pulling. Pain affects our ability to focus on the task at hand. It’s exasperating, waking up to a sore shoulder, particularly if the cause of the pain is a mystery. There are several conditions and situations that might cause an individual to develop shoulder pain during their sleep. From rotator cuff injuries to awkward sleeping positions, here are some of the most common.
Frozen Shoulder
Frozen shoulder is a painful condition that restricts arm movement and range of motion due to a reduction in lubricating fluid in the joint capsule. This condition is usually temporary, lasting a year or two without treatment, and is most likely to strike women experiencing hormonal fluctuations. Although frozen shoulder typically self-corrects in time, treatment can reduce the severity and speed of healing. During the early stages of frozen shoulder, increased pain is often experienced in the morning hours.
Rotator Cuff Complications
The structure of muscles and tendons that cover the head of the upper arm bone and keep it attached to the shoulder blade is called a rotator cuff. The rotator cuff is a common source of shoulder pain and can be affected in a few different ways. Rotator cuff complications often cause ongoing pain rather than specifically morning pain, but it is frequently worse in the mornings.
Tendinitis
This is caused by irritation and inflammation of the tendons that hold the rotator cuff together.
Bursitis
Bursae are cushions of fluid that protect the bones in the joint from rubbing together when they move. Bursitis is when the bursae become painful and inflamed.
Impingement
Inflammation that’s caused by the top edge of your shoulder bone impinging into the joint.
Sleeping Position
The position you sleep in may exacerbate shoulder pain as well. A small study in 2017 claimed that sleeping on your back with your dominant hand on your forehead is the most likely position to lead to pain. While the study was very small and has not yet been repeated, the results make some sense. The position described puts more stress on the spine, neck, and shoulder muscles than other positions studied, which would trigger both pain in the shoulder and more frequent headaches.
Sleeping directly on the upper arm can also cause pain. This position wedges the upper head of the arm bone into its shallow socket while you sleep. Turning your body when you sleep so that your weight isn’t directly on the upper arm should relieve this pressure. Sleeping with your elbow elevated over your head is another position likely to cause pain as the rotator cuff and shoulder bursae can become pinched between the bone and the socket when the muscles fully relax. Side sleepers should be careful not to sleep on the affected shoulder to avoid experiencing further shoulder problems.
Getting the Right Sleeping Environment
Choosing the right pillow or sleeping in a reclined position can also help you get more hours of sleep and help provide nighttime shoulder pain. You might even consider purchasing an adjustable bed so you can improve your sleeping posture and avoid severe shoulder pain when you wake up. Though you might not be able to use your favorite sleep position, it’s a simple solution to help you attain restorative sleep and get a good night’s rest. Find you can’t get into a comfortable position or are still waking with a painful shoulder. You might see if there’s not an underlying condition, like structural damage or rotator cuff problems, that could be the cause of pain.
Management and Treatment Options
Physical therapy is often utilized to maintain flexibility in the injured shoulder. Specialized shoulder stretches and exercises can help improve mobility and provide pain relief. Once the pain is reduced, your physical therapist will likely focus more on improved shoulder strength. The improved strength will reduce the chance of the issue reoccurring.
Over-the-counter anti-inflammatory pain medications such as aspirin, ibuprofen, and acetaminophen are often recommended to fight the inflammation that causes shoulder pain in the morning. Anti-inflammatory foods such as peppers, leafy greens, and olive oil may also help to manage the symptoms.
More severe cases can sometimes be helped by injecting corticosteroids directly into the joint. This typically helps quickly, but its effects eventually fade and subsequent injections are not always as successful as the first.
In some cases, even injections and painkillers aren’t enough to restore motion and eliminate pain. Your doctor may recommend surgery for some types of pain that are unresponsive to other methods of relief. Surgery can treat or mitigate issues with arthritis, rotator cuffs, and torn or tight tendons in the shoulder.
When to Visit Your Doctor
While occasional shoulder pain that develops when we sleep is fairly easy to control by shifting our bodies, employing exercise techniques, or using over-the-counter medications, some types of shoulder pain require medical intervention. Make an appointment to talk to your doctor if your pain is sudden or severe, persistent, or is accompanied by:
- Arm weakness
- Injury
- Loss of motion
- Sleep disruptions
*Although shoulder pain is not usually life threatening, if you wake up to unexplained severe or crushing pain in your shoulder, especially your left shoulder, don’t dismiss it. Pain from a heart attack can be referred to the shoulder rather than the chest. Other symptoms that you may be having a cardiac event include dizziness, feeling faint, cold sweats, pain that radiates to the jaw and neck, shortness of breath, or a feeling of impending doom.
Shoulder pain that develops while we sleep is a fairly common occurrence. It can be caused by anything from a medical condition to just sleeping in the wrong position for your body. Many instances of shoulder pain can be easily managed at home with exercise, awareness, and over-the-counter medication. However, if you experience shoulder pain that prevents sleep or otherwise impacts your daily life, contact your doctor.
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