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5 Reasons Your Shoulder Hurts at Night
April 15, 2025
If shoulder pain wakes you up or makes it hard to fall asleep, you’re not alone.
That deep ache or sharp twinge can come from a few different things – and yup – your sleep position might be one of them.
We checked in with Lee Bloom, MD, an orthopedic surgeon at the Connecticut Orthopaedic Institute, to get to the bottom of it. Here’s what could be causing your shoulder pain and how you can start feeling better at night.
1. Rotator cuff trouble.
Your rotator cuff is a group of muscles and tendons that help move and stabilize your shoulder.
If the rotator cuff is to blame for your shoulder trouble, you might notice soreness, stiffness or pain that gets worse with movement.
“If it’s injured or inflamed, sleeping – especially on that side – can become painful fast,” explains Dr. Bloom.
2. Arthritis flare-ups.
Both osteoarthritis and rheumatoid arthritis can cause shoulder pain that gets worse at night.
“The inflammation and stiffness tend to flare when you’re resting, which is frustrating when all you want is a good night’s sleep,” says Dr. Bloom.
> Related: What Different Types of Shoulder Pain Could Mean
3. Bursitis.
The bursa is a small, fluid-filled sac that cushions your shoulder joint. When it’s inflamed, you can develop bursitis.
“Nighttime pressure can make it more noticeable,” says Dr. Bloom. “You might feel a deep, achy pain – especially if it flares up when you lie on the affected side.”
4. Poor sleep support.
The wrong pillow or an unsupportive mattress can leave your shoulder misaligned.
“Extra pressure on your shoulder can add up to pain over time, even if there’s no underlying injury,” says Dr. Bloom.
> Related: How to Choose the Right Pillow for Neck Pain
5. Your sleep position.
Your go-to sleep position matters more than you think.
Dr. Bloom breaks it down:
- Side sleepers: Constantly lying on the same side? That shoulder’s bearing all your body weight. Try switching sides or using a body pillow for better support.
- Back sleepers: While this is usually shoulder-friendly, make sure your pillow keeps your spine aligned.
- Stomach sleepers: This position twists your neck and shoulders in awkward ways. Try shifting to your back or side instead.
Tips to help you sleep.
Shoulder pain can make getting the rest you need tough – but a few changes might help.
Here’s what Dr. Bloom recommends:
- Sleep on your back or the non-painful side.
- Use a small pillow under your arm for support.
- Choose a supportive mattress and pillow.
- Try a heating pad or ice pack before bed.
- Do gentle stretches in the evening to relax the shoulder.
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When to see your doctor.
If your shoulder pain isn’t letting up, don’t ignore it.
Call your doctor if:
- The pain doesn’t improve with home care.
- It’s severe or regularly wakes you up.
- You notice swelling, redness or warmth around the shoulder.
“The cause of shoulder pain can differ for everyone,” says Dr. Bloom. “Address it early so we can figure out what’s going on and create a personalized plan to help you feel better.”