How To Sleep With A Frozen Shoulder? | 8 Science-Backed Tips

Is your frozen shoulder pain starting to affect your sleep? Well, here’s all you need to know on how to sleep with a frozen shoulder.

Research shows that people with this condition are particularly vulnerable to shoulder pain, which leads to poor sleep quality. (1) Fortunately, there are 8 easy ways to get the better of your frozen shoulder.

You’ll learn how to apply each tip in your daily life, plus other recommendations to help you recover. Here are the topics I’ll cover, tap on them to go straight there:

• Sleep on your back
• Sleep on your side
• What to do if you’re a belly sleeper
• Use heating pads (DIY hot pack included)
• Pain medications
• 3 stretching exercises
• Mindfulness meditation
• Adjusting your diet
• Why does frozen shoulder hurt more at night?
• FAQs

Or read right through to learn more on how to best sleep with a frozen shoulder.

8 Tips for sleeping comfortably with a frozen shoulder 

1. Sleep on your back

You may not notice it, but you spend a third of your time sleeping on your back. (2) This sleeping position also helps you breathe better, plus relieves heartburn and back pain. 

But when it comes to shoulder pain, poor spinal alignment and support are two common culprits. They usually come from using old, worn-out pillows and/or mattress.

They won’t support your head, neck, and shoulders properly, as a fresh pillow or mattress would. This means your muscles will have to work holding the weight of your head for the duration of your sleep.

And of course, after working all night, your muscles will be tense and tired by the morning. Which increases your likelihood to experience shoulder pain during the day.

Here’s what you can do to solve this issue:

Sleep better by using extra pillows

Who doesn’t want fluffy pillows, right? Well, evidence now shows that using more and different varieties of pillows makes for a better sleeping position. (3) Here’s how to take advantage of this:

• Place one pillow under your neck and another below your upper back to support your shoulder.
• Use a body pillow underneath the elbow of your affected shoulder for support.
• Add another pillow below your lower back for better spinal alignment.

2. Sleep on your unaffected arm

This is one of the best sleep positions for a frozen shoulder. Simply because you’re not compressing your affected shoulder with your body weight.

Also, this position gives you space to move your arm to where you’re most comfortable. Still, if you’re a side sleeper, there are a few things you can add to improve your sleep quality:

Keys to sleeping better on your side

• Opt for a medium-firm mattress for better support. (4)
• Add pillows under your head for a better neck and shoulder alignment.
• Place the elbow of your sore shoulder on top of a body pillow to keep your shoulder capsule relaxed.

3. Better position for belly sleepers

Generally, it isn’t recommended to sleep on your stomach for too long. This is because you may raise your arms overhead, which can worsen shoulder pain.

Also, it can limit the movement of your diaphragm, making it harder to breathe. However, if this position helps you get quality sleep, here are some tips to avoid these complications:

A better way to sleep on your stomach

• Use a thin pillow for your head to keep your airway open.
• Place a pillow between your sore shoulder and trunk to reduce pressure on your affected arm.
• Bend your knee. This allows you to turn a bit, relieving pressure on your diaphragm.

4. Apply a hot pack before you sleep

Aside from rotator cuff injury, evidence shows that heat therapy also works well with frozen shoulder. (5) Heat provides comfort and improves blood flow to your capsule and rotator cuff.

Now, if you don’t have heating pads, don’t worry. I got you covered! With just a few items, you can reduce your shoulder pain in the comfort of your own home.

Related: Is heat good for rotator cuff pain?

Do-it-yourself heating pad

• Place a small face towel inside a resealable plastic bag.
• Pour warm water inside until the towel is damp and seal the plastic bag.
• Place another towel on your shoulder joint, to prevent skins burns.
• Put your DIY heating pad on top of the other towel.
• Do this for 20 minutes at a time.

5. Use pain medication before you sleep

Over-the-counter medications offer quick and easy pain relief for frozen shoulder. Topical and oral variants are the two most common forms.

Topical medications directly target your shoulder joint but are less effective in reducing pain. Oral medications give a stronger effect but are prone to complications, such as stomach upsets.

Both work the same way, though – by reducing your shoulder pain and inflammation. Yet, consult with your doctor on which type works best for you. More so if you have a previous health condition.

Related: The 3 frozen shoulder stages + symptoms

6. Do these 3 stretching exercises

As your frozen shoulder progresses, so too are the changes with your symptoms. Aside from shoulder pain, you’ll start to notice muscle tightness and tension around your affected arm.

This comes from adhesions and scar tissue build-up within your shoulder capsule. But, the good thing is that the frozen shoulder will resolve over time.

Until then, relieve pain and stiffness before sleep with these home stretching exercises:

Pendulum stretch

• Stand with your good arm holding onto a sturdy table/chair.
• Bend at your hips and relax your affected arm.
• Gradually shift your weight forward and back.
• Use your body’s momentum to move your affected arm.
• Do this for 10 repetitions.

Cross arm stretch

• Bring your affected arm across your opposite shoulder in a horizontal position.
• Stretch it by pulling it across, using your other arm to apply gentle pressure.
• You should be feeling the stretch around your shoulder blade.
• Hold for 30 seconds and repeat twice.

Shoulder shrugs

• While sitting or standing, start with your chest out and chin tucked in.
• Slowly inhale as you lift both of your shoulders close to your ears.
• Hold for 5 seconds once you reach the top.
• Gradually exhale as you lower your shoulders back and down to starting position.
• Repeat 5 times.

Learn more: 14 Frozen shoulder exercises at home to boost recovery.

7. Mindfulness meditation

The practice of mindfulness meditation has been around for centuries. But new research shows it is extremely beneficial in relieving pain. (6)

You see, experiencing shoulder pain not only affects your daily activities. It can also stoke the feeling of depression and anxiety. (7) Brooding over your frozen shoulder at night will only magnify your symptoms.

Now, mindfulness meditation helps you remove the focus from your frozen shoulder symptoms and replace it with relaxation and wellbeing.

You’ll release endorphin hormones in turn. They’re natural painkillers, meaning you’ll feel pain relief, relaxed muscles, and will fall asleep faster.

And the best of all? It’s free!

How to relieve your shoulder pain with mindfulness meditation?

• Start by sitting, laying down, or being in a comfortable sleep position.
• Set your timer for 5 minutes.
• Close your eyes and focus on your breath.
• Feel your belly expanding and receding with each breath.
• Then focus on your shoulder. Try lowering your pain level with each exhale.
• It’s perfectly normal if your mind wanders around. Aim to refocus with each breath.

Pro tip: There are tonnes of videos for guided mindfulness meditation on the web. A quick search will yield thousands of results – choose one and begin your mindfulness practice easily.

8. Changing your diet

Hippocrates might be onto something when he said: “Let food by thy medicine, let thy medicine be thy food.”

And, recent evidence supports him – your diet certainly affects your body’s inflammation levels. (8)

A diet rich in white bread, soda, sugar, and red meat can raise your inflammatory markers. It could also make it easier for you to increase your weight to unhealthy levels. (8)

The problem with this is that increased inflammatory markers and obesity make it harder to recover from a frozen shoulder. So, you can promote healing by choosing a diet rich in anti-inflammatory foods.

Eat these anti-inflammatory foods to reduce pain

• Dark green veggies such as spinach, kale, and broccoli.
• Fruits like berries and avocados.
• Fatty fish like salmon and mackerel.
• Olive oil.
• Green tea and coffee.

Learn more: 4 diets for frozen shoulder.

Why does frozen shoulder hurt more at night?

There are a lot of factors to consider:

Less distraction

Throughout the day, you receive a lot of stimulation from different sources. A few examples are the constant notifications on your phone and noises on the street.

This distracts your brain, making it easier for you to zone out of your symptoms.

But at night, everything is quieter and there’s less distraction. This allows more introspection, which can magnify your perception of shoulder pain.

Hormones 

Constant shoulder pain leads to sleepless nights and may mess up your hormones. Two of which are melatonin and cortisol.

Research shows that aside from helping you sleep, melatonin helps regulate your pain. (9) But, even just one poor night of quality sleep lessens the level of this hormone at night, which can lead to more shoulder pain.

Meanwhile, cortisol helps you stay awake and is one of your body’s anti-inflammatory hormones. As with any hormone, cortisol levels fluctuate throughout the day.

It drops during the first few hours of your sleep and picks back up again as you wake up. (10) But, changes in these patterns can make your pain worse.

Inflammation

Inside our shoulder joint is synovial fluid. This fluid nourishes our cartilage, making for a smoother shoulder range of motion.

But as your frozen shoulder progresses, adhesions and scar tissue also builds up. This reduces your synovial fluid, from as high as 30mL, all the way down to 5mL. (11)

Less fluid means more friction and joint inflammation with each movement. So, as you rest at night, the inflammation accumulated inside your shoulder joint can start causing you pain.

Compression

People don’t usually stay in one position when they sleep at night. You constantly toss and turn to find the most comfortable spot.

But there are times when you unconsciously put your upper arm bone in an unusual position. Like when you sleep on your affected arm or raise it overhead.

Both of which compress your joint capsule, impeding blood flow. If kept for too long, they can lead to excruciating shoulder pain.

FAQs

Conclusion

Frozen shoulder is more than just a “sore shoulder” issue. The nature of this painful condition makes it particularly tough to deal with, as it affects not only daily life but sleep as well.

Fortunately, with a few changes, you don’t need to spend a ton of money to sleep better with a frozen shoulder.

We hope you can put each tip to good use. And if it helps, consult with your physical therapist to get ahead of your condition.

Resources

1. Mulligan, Edward P et al. “Sleep quality and nocturnal pain in patients with shoulder disorders.” Journal of shoulder and elbow surgery vol. 24,9 (2015): 1452-7. DOI: 10.1016/j.jse.2015.02.013
2. 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
3. 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
4. Jacobson, Bert H et al. “Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain.” Applied ergonomics vol. 42,1 (2010): 91-7. DOI: 10.1016/j.apergo.2010.05.004
5. Leung, May S F, and Gladys L Y Cheing. “Effects of deep and superficial heating in the management of frozen shoulder.” Journal of rehabilitation medicine vol. 40,2 (2008): 145-50. DOI: 10.2340/16501977-0146
6. Zeidan, Fadel, and David R Vago. “Mindfulness meditation-based pain relief: a mechanistic account.” Annals of the New York Academy of Sciences vol. 1373,1 (2016): 114-27. doi: 10.1111/nyas.13153
7. Ding, Huairong et al. “A report on the prevalence of depression and anxiety in patients with frozen shoulder and their relations to disease status.” Psychology, health & medicine vol. 19,6 (2014): 730-7. DOI: 10.1080/13548506.2013.873814
8. “Foods that fight inflammation”. Harvard Health Publishing, November 16, 2021. https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
9. Ha, Eunyoung et al. “Melatonin Plays a Role as a Mediator of Nocturnal Pain in Patients with Shoulder Disorders.” The Journal of bone and joint surgery. American volume vol. 96,13 (2014): e108. DOI: 10.2106/JBJS.M.01011
10. Hannibal, Kara E, and Mark D Bishop. “Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation.” Physical therapy vol. 94,12 (2014): 1816-25. doi: 10.2522/ptj.20130597
11. Dias R, Cutts S, Massoud S. Frozen shoulder BMJ 2005; 331 :1453 doi: https://doi.org/10.1136/bmj.331.7530.1453