You find a comfortable position, drift off, then wake at 2am with your shoulder throbbing and your arm tucked under the pillow. Many people find shoulder pain is at its loudest at night. There are some good reasons for this, and a few changes can help you sleep more comfortably.

Why shoulders often ache more at night

Night pain is one of the most common complaints in people with shoulder pain. One study found most people with shoulder pain reported poor sleep. Several things are thought to play a part:

• Pressure. Lying on your shoulder presses your body weight through it.
• No distractions. At night there’s nothing to take your attention away from the ache.
• Less protection. In deeper sleep your muscles relax, so your arm can drift into positions you’d avoid while awake.

Where your arm ends up

Many people sleep with an arm stretched above their head or tucked under the pillow. This holds the shoulder in a raised, squeezed position for long periods, and it’s a common reason people wake with an aching shoulder.

Hugging a pillow in front of you can give your arm somewhere comfortable to rest, so it’s less likely to drift overhead.

Lying on your sore side

Lying on a sore shoulder is one of the most common triggers for night pain. If you can, starting the night on your other side may help, with a pillow in front of you to support the sore arm. Your body will still move during the night, and that’s okay. Most people change position many times while asleep, and those shifts help stop stiffness building.

If you sleep on your back

On your back, a sore arm can drop backwards, stretching the front of your shoulder. A small pillow or folded towel under your elbow and upper arm can keep it supported and level with your body.

Moving in the day helps the night

A shoulder that hasn’t moved much during the day can feel stiffer and achier at night. Gentle movement through the day, within a comfortable range, may help it feel easier by bedtime. Exercise is a key part of managing shoulder pain for many people.

Sleep and pain affect each other

A broken night can make you more sensitive to discomfort the next day, which can make the following night harder too. Getting comfortable in bed can help break that cycle.

Something to try this week

Start each night on your other side, hugging a pillow in front of you so your sore arm rests on it. Notice whether you wake less.

What to take away

• Start the night on your other side if you can.
• Hug a pillow to stop your arm drifting overhead.
• Support your arm with a pillow if you sleep on your back.
• Move your shoulder gently during the day.

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