With more and more reasons to keep us awake, a night of blissful sleep seems impossible these days. More so if you’re in pain. So what is the best sleeping position for shoulder pain?
There are many opinions about this but, as a general rule, sleeping either on your back or your side is the healthiest way to sleep.
But, of course, there’s always more to it than meets the eye. We will talk about this in a bit, but we will also address the following topics related to sleeping with shoulder pain:
- How to sleep with shoulder pain
- Best sleeping positions for shoulder impingement syndrome
- What to do with a unilateral shoulder pain
- And many more!
To get things started, perhaps it’s best to ask: Does it even matter?
Does it matter what position you sleep in?
Yes! Your sleeping position affects not just your shoulder joint but your neck and back as well. The quality of your sleep determines how well-rested and productive you’ll be.
We frequent a specific position to fall asleep faster. But if your shoulders are in pain as you try to sleep, this may be hard to replicate.
So let’s level up the way you sleep! Here are some of the most common sleep positions and what you should do to prevent flare-ups.
Sleep positions for shoulder pain (and how to make them better)
On average, you’ll spend a third of your time lying on your back when you sleep. (1) So, to avoid any issues, the key here is the alignment of your head and spine. You’ll want both to be well supported with pillows to avoid experiencing neck and shoulder pain.
Benefits of sleeping on your back:
- Helps reduce tension headaches
- Reduces the formation of facial wrinkles. (2)
- Relieves sinus build-up
- Promotes proper chest expansion and breathing
How to sleep even better:
Add more pillows.
Place a small pillow under your knees. This helps keep your spine neutral, putting less tension on your lower back and shoulders.
Include different shapes and sizes.
Aside from your standard pillow, include a cervical and shoulder blade pillow in your bed. Research finds that the combination of these three while sleeping on your back gives the most support and comfort. (3)
Keep your arms busy
Avoid placing your arms overhead. This increases demand on your shoulder muscles, which leads to spasms and pain. (4) So place a pillow on your side or belly to reduce tension on your shoulders
Only about 7% prefer to sleep on their belly. (1) It can help reduce instances of snoring and sleep apnea. (5) But it has potential drawbacks as well. So if you fall asleep faster in this position, the angle and placement of your head prove to be vital in limiting these symptoms.
What to look out for:
You’re putting your weight against your diaphragm. This makes it harder to breathe naturally. You might end up using more muscles from your neck and upper body to compensate, thus increasing your shoulder pain.
Most people tend to place their arms overhead and turn their heads to one side. This places tension on your shoulders, which may worsen underlying rotator cuff injuries.
What can you do to sleep better:
Use a thin pillow.
This reduces the strain and angle of your head and neck.
Place a rolled towel under your hips.
This will keep your back in a neutral position, taking the pressure off your spine.
Make a few tweaks.
Instead of directly sleeping on your stomach, try a three quarter sleeping position.
- Place your good arm underneath your pillow
- With your injured shoulder, place it on the side of your body and bend your elbows
- Slightly bend your leg that is in line with your affected shoulder.
This will help reduce shoulder pain while still sleeping on your stomach.
By far the most popular among the three. More than half the amount of time you sleep, you end up sleeping on your side. And this keeps increasing as we age. (6)
This can be a good thing if you tend to snore or have stomach issues. But side-sleeping can also cause shoulder pain, particularly if you have rotator cuff problems.
Sleeping on your side for too long can increase subacromial pressure. (7) What this means is that direct compression of your weight against your sore shoulder can flare up symptoms of pain and inflammation.
Why you should be sleeping on your side:
- Decreases the frequency and intensity of snoring by reducing airway compression
- Improves digestion and prevents gastric acid reflux
- Reduces incidence of morning back pain
How to sleep even better:
Try sleeping on your good arm.
This may come as a no-brainer but most people tend to sleep on their painful shoulders. (8) It may be due to the temporary comfort of the mattress or from habit. But, direct pressure can reduce blood flow to your shoulder, causing further damage and pain.
Keep that alignment in check
Use the right pillow height. This prevents your head from sagging down the bed. It also keeps a more relaxed and neutral position for your head, neck, and shoulders.
When to consult your physician
If you feel like it’s more than just shoulder pain, here are red flags you should be looking out for (9):
- Any palpable mass or swelling around your shoulder
- Shoulder pain accompanied by fever or malaise
- Intense pain even with pain medications
- Gradual weakness of your arm
How to sleep with shoulder impingement?
Certain sleeping positions can reaggravate your shoulder impingement. Avoid sleeping on your belly and laying on your affected shoulder. This leads to more tension and rotator cuff pain.
You can either:
- Sleep on your back: use the three-pillow combination for shoulder comfort and protection.
- Sleep on your good arm: Use the right pillow height for proper alignment of your head and spine. Also, place a pillow between both arms to prevent your affected shoulder to sag down.
How to sleep with a frozen shoulder?
First of all, avoid sleeping on your belly and your affected arm. This will lead to more pain.
I recommend sleeping on your back. Place a pillow or rolled towel between your trunk and upper arm bone and underneath your forearms. This will position your inflamed shoulder capsule in its relaxed state.
Related: All you need to know about frozen shoulder.
The “best” sleeping position for a painful shoulder can be subjective. As a general rule though, avoid sleeping on the painful shoulder and maybe give back-sleeping a try. No matter what position you feel comfortable in, though, a few tweaks and pillows can help.
- Skarpsno, Eivind Schjelderup et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and science of sleep vol. 9 267-275. 1 Nov. 2017, doi: 10.2147/NSS.S145777
- Poljsak, Borut et al. “The influence of the sleeping on the formation of facial wrinkles.” Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology vol. 14,3 (2012): 133-8. DOI: 10.3109/14764172.2012.685563
- Liu, Shuo-Fang et al. “Shape design of an optimal comfortable pillow based on the analytic hierarchy process method.” Journal of chiropractic medicine vol. 10,4 (2011): 229-39. doi:10.1016/j.jcm.2011.04.002 doi: 10.1016/j.jcm.2011.04.002
- Lee, Won-Hwee, and Min-Seok Ko. “Effect of sleep posture on neck muscle activity.” Journal of physical therapy science vol. 29,6 (2017): 1021-1024. DOI: 10.1589/jpts.29.1021
- Ravesloot, M J L et al. “The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature.” Sleep & breathing = Schlaf & Atmung vol. 17,1 (2013): 39-49. DOI: 10.1007/s11325-012-0683-5De Koninck, J et al. “Sleep positions and position shifts in five age groups: an ontogenetic picture.” Sleep vol. 15,2 (1992): 143-9. DOI: 10.1093/sleep/15.2.143
- Cabuk, H et al. “Effects of Sleeping Positions on the Rotator Cuff Pathology”. Medicine Science 2015;4(4):2825-33 DOI:10.5455/medscience.2015.04.8310
- Zenian, John. “Sleep position and shoulder pain.” Medical hypotheses vol. 74,4 (2010): 639-43. DOI: 10.1016/j.mehy.2009.11.013
- Artus, Majid et al. “The painful shoulder: an update on assessment, treatment, and referral.” The British journal of general practice : the journal of the Royal College of General Practitioners vol. 64,626 (2014): e593-5. doi: 10.3399/bjgp14X681577