Waking up with shoulder pain? Don’t always blame your sleeping position, according to an orthopaedic specialist

Is your shoulder pain returning regularly? Know what the reasons could be, aside from poor sleeping position.

With the pressure of everyday work, you may randomly experience back or shoulder pain. Such aches are often normalised, treated with basic home remedies, and not given much thought. If you wake up in the morning with shoulder pain, you are also likely to blame it on an awkward sleeping position.ALSO READ: Is your 9-to-5 weakening your bones? Orthopaedic surgeon shares 5 warning signs

But if the ache keeps returning, persists for a long time, or disrupts your sleep, it may require serious attention. What could night-time shoulder pain indicate?

Dr Brajesh Koushle, director and unit head, department of orthopaedics, joint replacement and sports injuries, Yashoda Medicity, Ghaziabad, described why shoulder pain may keep returning. He cautioned that pain that recurs frequently, affects sleep, or is accompanied by stiffness or weakness may indicate an underlying shoulder problem.

Why is it a shoulder problem in particular? He said, “The shoulder is a highly mobile joint supported by muscles, tendons, and other soft tissues. When these structures become irritated or damaged, lying down can make symptoms more noticeable. Pressure on the affected shoulder, particularly when sleeping on the painful side, can aggravate inflamed tissues.”

Night-time shoulder pain can occur due to several conditions affecting the muscles, tendons, joints or surrounding soft tissues. The possible cause may depend on when the pain appears and whether it is accompanied by stiffness, weakness or restricted movement.

Dr Koushle said, “Several shoulder conditions can contribute to night-time discomfort. Rotator cuff problems, including tendinitis or tears, can cause a deep, persistent ache that becomes worse when lying on the affected side. Bursitis can similarly become more painful when the area is compressed during sleep.”

He added that the pain could also be caused by shoulder impingement, frozen shoulder or arthritis. “Shoulder impingement is where tendons become irritated as the arm moves. People with frozen shoulder may experience significant night-time pain along with progressive stiffness and difficulty moving the arm. Arthritis affecting the shoulder joint or acromioclavicular (AC) joint can also cause pain and reduced range of motion,” Dr Koushle said.

This shows that shoulder pain can have several causes beyond an awkward sleeping position. Therefore, it is important not to attribute every instance of shoulder pain to the same cause.

When should you pay attention?

Pain that occurs mainly when lying on one side may be related to compression, while persistent pain regardless of sleeping position may indicate an underlying condition. Weakness while lifting the arm, increasing stiffness or difficulty reaching overhead or behind the back should not be ignored.

If night-time pain continues for several weeks, repeatedly disrupts sleep, follows an injury or is accompanied by noticeable weakness or loss of movement, it is advisable to consult an orthopaedic specialist. A clinical examination and, when necessary, imaging such as an X-ray or MRI can help determine the cause.

Don't try to self-treat with massage if the pain persists.

Avoid putting direct pressure on the painful shoulder and consider sleeping on your back with a pillow supporting the affected arm. Reducing repetitive or overhead shoulder movements may also help prevent further irritation.

Ultimately, recurring night-time shoulder pain should not simply be accepted as part of getting older or sleeping awkwardly. Recognising persistent symptoms and seeking timely medical advice can help identify and treat the underlying problem before it affects everyday movement, sleep and quality of life.

When should you pay attention?

An occasional ache because of pressure on the shoulder while sleeping may ease later in the morning or if you change your sleeping position. However, pain that persists irrespective of how you sleep or begins to affect arm movement should not be ignored. Dr Koushle highlighted the following warning signs and potential causes which may mean you need to get it checked by a medical expert:

• The pain persists regardless of your sleeping position
• Continues for several weeks
• Repeatedly disrupts your sleep
• Develops after an injury
• Weakness while lifting the arm
• Shoulder becomes very stiff
• Difficult to reach overhead or behind back
• Considerable loss of movement

If you are experiencing these symptoms, try to consult an orthopaedic specialist. A clinical examination and, when required, imaging tests such as an X-ray or MRI can help detect the cause.

In the meantime, the doctor advised avoiding direct pressure on the painful shoulder and sleeping on your back with a pillow supporting the affected arm. If you continue to experience shoulder pain at night, do not normalise or ignore it. Seek medical advice to determine the cause.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.