Is shoulder pain waking you up at night?

June 14, 2021

I’ve had many patients ask questions about the best sleeping positions for shoulder pain because they either experience most of their pain at night or in a sleeping position causing shoulder pain.

At night our bodies “heal themselves” so to speak. When it comes to our joints, they all need to be in an open-packed position for the synovial fluid that carries nutrients to flow within the joint and “flush out” the inflammation that has accumulated throughout the day. The open-packed position is your shoulder resting about 55 degrees abduction, 30 degrees of horizontal adduction, and slight external rotation. If you’ve ever seen someone in a shoulder abduction brace after having shoulder surgery that’s what it looks like.

When we sleep in a position where our arms are above our head we block that flow of synovial fluid and risk possibly pinching our rotator cuff, bursas, and stressing ligamentous structures that can reproduce your pain while you sleep. To avoid this, I recommend two sleeping positions on your unaffected side and your back.

Sleeping on your back is the best position to sleep in; however, remember we need to maintain the open-packed position. How I explain this:

1. Place the center of a pillow under your armpit.

2. Lay on your back and allow the back half of the pillow to support your arm in a neutral position to avoid your arm falling behind you.

3. You can use this method with bilateral shoulder pain by placing a pillow under each arm.

The hard part is sleeping in this position all night, but don’t worry. You will move throughout the night! If you wake up and notice the pillow is missing just put it back in place and go back to sleep.

For my side sleepers, you have to sleep on your unaffected side. You will do the same and place the pillow horizontally under your arm and let it rest. If you lose the pillow while sleeping, place the pillow back under your arm and drift back to sleep.

Try this out for about a week and see if you notice a difference! This could become a new part of your nightly routine!

Shakyra Cooper, PT, DPT