Pain in Shoulder When Lying Down

Shoulder pain that shows up when you lie down can be frustrating; especially when it disrupts your sleep. Many people notice shoulder pain at night even when daytime activities feel manageable. The good news is that this type of pain is common, and in many cases, it can be addressed with the right approach.

Understanding why your shoulder hurts when lying down can help you decide what to do next and when to seek help.

Common Causes of Shoulder Pain When Lying Down

Postural and Position-Related Issues

Sleeping position plays a big role in shoulder discomfort. Lying on one side for long periods, sleeping with your arm overhead, or using an unsupportive pillow can place extra stress on the shoulder joint and surrounding muscles.

Poor daytime posture, such as rounded shoulders or prolonged desk work, can also make nighttime pain more noticeable once the body relaxes.

Muscle or Tendon Irritation

Overuse, repetitive motions, or minor strains can irritate the muscles and tendons around the shoulder. When you lie down, changes in blood flow and joint position may make these irritated tissues more sensitive, leading to pain at night.

Rotator Cuff Conditions

The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Tendinitis, small tears, or weakness in this area commonly cause pain when lying on the affected side or when the arm is unsupported.

Arthritic Changes

Arthritis in the shoulder joint can cause aching, stiffness, and discomfort that worsens at night. Inflammatory changes may become more noticeable during rest, especially if the joint has limited mobility.

Injury or Degenerative Issues

Previous injuries—such as falls, sports injuries, or repetitive strain—can lead to lingering shoulder pain. Degenerative conditions may develop gradually and often present as night pain before daytime symptoms become obvious.

Simple Ways to Reduce Shoulder Pain While Lying Down

For mild or occasional discomfort, these strategies may help:

• Adjust your sleeping position: Avoid lying directly on the painful shoulder. Try sleeping on your back or the opposite side.

• Support the arm: Use a pillow under the arm to keep the shoulder in a neutral, relaxed position.

• Check your pillow height: A pillow that keeps your neck aligned can reduce strain on the shoulder.

• Gentle movement during the day: Light stretching and avoiding prolonged stiffness can help nighttime comfort.

• Avoid aggravating activities before bed: Heavy lifting or overhead activity late in the day may increase nighttime pain.

If pain improves with these changes, the issue is often related to posture, positioning, or minor irritation.

When Shoulder Pain at Night Should Be Checked

It’s time to have your shoulder evaluated if:

• Pain persists for more than a few weeks

• Pain consistently wakes you up at night

• You notice weakness, limited motion, or sharp pain

• Pain follows an injury or fall

• Symptoms gradually worsen instead of improving

Night pain can sometimes be an early sign of a more significant shoulder issue that responds best to early treatment.

How Physical Therapy Can Help Shoulder Pain

Physical therapy focuses on identifying the source of shoulder pain rather than just treating symptoms. A physical therapist will assess posture, shoulder movement, strength, and how surrounding areas like the neck and upper back contribute to the problem.

Treatment may include:

• Improving shoulder and upper back mobility

• Strengthening stabilizing muscles

• Correcting posture and movement patterns

• Education on sleep positioning and activity modification

  
  

At Doylestown Sports Medicine Center, physical therapists help patients address shoulder pain so they can sleep comfortably and return to daily activities with confidence.

When to See a Physical Therapist

Consider physical therapy if:

• Shoulder pain when lying down is ongoing or worsening

• Home adjustments are not helping

• Pain affects sleep, work, or daily life

• You want to prevent a minor issue from becoming chronic

Early care often leads to faster recovery and better long-term outcomes.

Pain in the shoulder when lying down is common and can come from posture, muscle irritation, arthritis, injury, or degenerative changes. While simple adjustments may help mild discomfort, persistent or worsening pain should be evaluated by a physical therapist.

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Why does my shoulder hurt more when I lie down?

Lying down changes shoulder positioning and blood flow. If muscles, tendons, or joints are irritated, pain may become more noticeable at night.

Can sleeping position cause shoulder pain?

Yes. Sleeping on one side, placing the arm overhead, or lacking proper pillow support can increase stress on the shoulder and cause discomfort.

Is shoulder pain at night a sign of rotator cuff problems?

It can be. Rotator cuff irritation or weakness often causes pain when lying on the affected shoulder or when the arm is unsupported.

Can arthritis cause shoulder pain when lying down?

Yes. Arthritic changes can cause stiffness and aching that worsen during rest, making nighttime pain more noticeable.

How long should shoulder pain last before seeing a physical therapist?

If pain lasts more than a few weeks, disrupts sleep, or is getting worse, it should be evaluated by a physical therapist.

Can physical therapy help shoulder pain at night?

Yes. Physical therapy improves mobility, strength, posture, and movement patterns to reduce pain and restore comfortable sleep.