91% of those with rotator cuff injuries experience shoulder pain at night. So, no – you’re not alone in this! It’s surprisingly common. It’s also fairly easy to manage if you follow these 5 easy tips on how to relieve rotator cuff pain at night (1)
Here’s a summary of the pointers you’ll find here, including details you’ll need if you want to put them to good use. Tap on any of them to go straight to that section:
- How to sleep with a rotator cuff tear
- 3 easy shoulder exercises
- Wear a bandage on your shoulder to sleep
- Apply ice or heat before sleeping
- Taking pain medication
- When it’s time to see your doctor?
How do you relieve rotator cuff pain at night?
1. How to sleep with a rotator cuff injury
There are some modifications you can do to alleviate rotator cuff pain while sleeping. These will differ according to your preferred sleeping position:
The first thing you should do is to avoid sleeping on your painful shoulder.
Not only does it directly compress your injured shoulder, but it also increases subacromial pressure. (2) This adds more irritation and pain to your rotator cuff tendons.
The next thing you can do is sleep on your good arm and use your pillows as support.
Here’s where you need to place them:
- Under your head to maintain good alignment between your neck and shoulders
- Between your affected arm and trunk for support
- Between your knees to help align your lower back to your hips
Aside from using more, utilizing different shapes of pillows helps reduce shoulder pain. (3) Here’s how:
- Add a cervical and shoulder blade pillow for your neck and upper back
- Place a pillow underneath your affected arm’s elbow. This helps it stay in a neutral position which lessens the strain on your rotator cuff injury.
- Another pillow under your knees for support.
Most people with rotator cuff injuries find it hard to sleep in this position. With that said, if this is your preferred position, do this:
- Avoid placing your injured shoulder overhead.
- Use a thin pillow for your head. It will help improve your posture and open up your breathing.
Further reading: Best sleeping positions for shoulder pain
2. Easy and quick shoulder stretches
Tight posterior shoulder muscles limit your shoulder motion and worsen shoulder pain at night. (4)
These three shoulder stretches can help you relax your tissues and improve your rotator cuff pain:
- Sit on the edge of your bed
- Let your arms hang at your side
- Inhale and lift your shoulders towards your ear
- Roll your shoulders back and squeeze your shoulder blades together
- Slowly exhale as you drop your shoulders down
- Do this 10 times
Modified cross-body stretch
- Lay down on your affected side, putting the weight on your ribs
- Using your healthy arm, pull your affected arm across your body
- You should be feeling the stretch at the back of your shoulder
- Hold this for 30 secs and go back to starting position
- Repeat for 3 times
- Roll on your side at a 45-degree angle, putting weight on your ribs
- Place your affected arm in front of you and bend your elbows at a 90-degree angle
- Using your good arm, press down on your forearm until you feel a mild stretch at the back of your shoulder joint
- Hold this for 30 seconds and repeat for 3 times.
Further reading: 8 safe exercises you can do with a rotator cuff injury
3. Wrap your shoulder with a bandage
The elastic bandage will act as an external cuff to keep your shoulder stable, even while you toss and turn in your bed.
Here’s how to wrap your shoulder before sleeping:
- Using a 6-inch bandage, wrap it around your upper arm bone, the roll is going in towards the chest. This will serve as your anchor
- Pull the bandage across your chest, under your armpit, and then over your affected shoulder
- Repeat the previous step, make sure to overlap half the previous layer
- Secure the end of the wrap by using a fastener or tape
This can help: Reasons why shoulder pain worsens at night
4. Apply ice/hot pack
Ice for rotator cuff tears
Icing your shoulder works as well as an injectable pain killer early on your injury. (5) Consider using one 20 minutes before you sleep and only if your shoulder pain has only been a week. To do this:
- Wrap your ice pack/cold compress with a thin sheet of clothing. This will prevent skin complications due to the cold
- Place it over your shoulder for 20 mins
- You can use an elastic bandage to keep it in place
Learn more: How to apply ice to a rotator cuff properly
Heat for rotator cuff tears
You should use a heating pad if you have had shoulder pain for more than a week. It increases blood flow to your tendons, which reduces pain and muscle spasms.
Wrap your heat pad with a towel to prevent heat from dissipating. Apply the same procedures when using ice.
Further reading: How and when to use heat for rotator cuff injuries
5. Take pain medications
NSAIDs are a type of medication that decreases the level of pain hormones, such as prostaglandins. In turn, it reduces inflammation of your rotator cuff, which also inhibits pain.
Remember that these medications can have side effects and are not intended for long-term use. It’s always better to consult your doctor before taking any form of medication.
When should I see my doctor?
Make an appointment with your doctor if you are experiencing (6):
- Arm numbness
- Intolerable pain especially at night
- Progressive limitation in your arm motion
- Severe arm weakness
- Unexplained weight loss
What is the best pain reliever for rotator cuff pain?
Ibuprofen and acetaminophen work well as a form of pain relief. (7) Use sparingly to prevent complications
Is it OK to massage a torn rotator cuff?
Yes. Massage is a great way to decrease muscle tension and spasm on your rotator cuff. Apply pressure as necessary.
What happens if a torn rotator cuff goes untreated?
You can develop chronic shoulder pain, have difficulty in raising your arms to parallel and progressive weakness.
How long does physical therapy take for a rotator cuff tear?
Depending on your rotator cuff issues, it can take anywhere between 2 weeks to 4 months of physical therapy.
Put off the hassle and stress of trying to sleep with pain. With these 5 quick and easy tips, you now have more control over relieving your nighttime pain.
- Khazzam, Michael S et al. “Sleep Quality in Patients With Rotator Cuff Disease.” The Journal of the American Academy of Orthopaedic Surgeons vol. 26,6 (2018): 215-222. DOI: 10.5435/JAAOS-D-16-00547
- Werner, Clément M L et al. “Subacromial pressures vary with simulated sleep positions.” Journal of shoulder and elbow surgery vol. 19,7 (2010): 989-93. DOI: 10.1016/j.jse.2010.04.039
- 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
- Tahran, Özge, and Sevgi Sevi Yeşilyaprak. “Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome.” Sports health vol. 12,2 (2020): 139-148. doi: 10.1177/1941738119900532
- Kara, Yavuz Selim et al. “A comparison of ice wrap and subacromial injection for postoperative pain and edema control following arthroscopic rotator cuff repair.” Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology vol. 21,1 17. 2 Sep. 2020, DOI: 10.1186/s10195-020-00556-6
- 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
- AlRuthia, Yazed et al. “Efficacy of acetaminophen versus ibuprofen for the management of rotator cuff-related shoulder pain: Randomized open-label study.” Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society vol. 27,6 (2019): 882-888. doi: 10.1016/j.jsps.2019.06.001