Shoulder pain at night? Here’s what is causing it and how to treat it.

Are you trying to understand what could be causing your shoulder pain? Shoulder pain worsening at night is often a sign of inflammation in the shoulder joint. Unfortunately, laying in bed can cause further compression on an area that is impinged or torn leading to more pain every time you try to rest. If you experience a worsening of pain, stiffness, muscle spasms, numbness or tingling down the side that is impacted, it is possible that your pain is being caused by bursitis, tendonitis or a rotator cuff injury.

If you seem to only experience pain at night in your shoulder, it is likely that your pain has something to do with your mattress, pillow, sleeping position or sleep quality. Try to take a mental inventory of all of the activities that you notice the pain in your every day to understand what may be causing it, or what may be making it worse.

What your pain could mean based on your symptoms: 

Rotator Cuff Injuries: The rotator cuff consists of delicate SITS muscles and tendons that are very commonly injured through overuse injuries. The rotator cuff’s role in the body is stabilization of the shoulder and fluid movement of the joint. Most injuries occur from lifting objects improperly, repetitive strain on a job site, a fall, a car accident or other acute trauma to the area. Rotator cuff injuries are likely to flare up at night because of the position you sleep in. If you lay on your side it can lead to a “pinching” or further inflammation in the area.  If you experience pain when testing the range of motion (rotating the arm at the shoulder), you are likely to have a rotator cuff injury. These injuries are most commonly treated through exercises that strengthen the surrounding areas and restore range of motion, hot and cold compresses and modalities that decrease inflammation. 

Bursitis: Bursitis can be caused by the inflammation of the bursa which is a fluid filled sac that is meant to cushion joints in your shoulders, elbows, hips and knees. If you are involved in high impact sports or an activity that repeatedly puts strain on your shoulder, you may experience bursitis. Bursitis leads to swelling of the area and those who are impacted by it report extreme pain followed by more swelling. If you notice a high level of chronic pain in your shoulder and limited range of motion, it’s worth mentioning the possibility of bursitis to your doctor. There are many exercises and stretches that can treat bursitis but often getting the swelling down to a manageable level is the top priority. 

Arthritis: Arthritis is a condition that develops over time from repetitive or acute injuries and the condition often worsens over years or decades without prehabilitation and careful attention. There are over one hundred different types of arthritis but the most common classifications are osteoarthritis and rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease that is more likely to impact younger populations. In cases of RA, an individual often has “triggers” from things like diet, stress, alcohol or environment that contribute to a “flare up”. 

Osteoarthritis is most commonly seen in older populations from repeated injuries or strain in a specific area due to a mechanical process of cartilage breaking down in the joints over time, or the development of bone spurs that challenge the fluidity of joint movement and can make everyday activities incredibly painful. 

Many treatments for arthritis revolve around decreasing inflammation in the body, understanding triggers, and encouraging movement. 

Tendonitis: Tendonitis can also occur due to repetitive use over time. When tendonitis occurs in the shoulder, the tendons that attach muscle to bone become aggravated and inflamed which cause pain and stiffness. Tendonitis usually worsens at night because laying down can cause settling into a worse position or irritation as your body stays in a position that restricts circulation and blood flow throughout the night. 

Other causes of shoulder pain:

Poor posture: When we sit all day, we can start to develop pain from unergonomic sitting positions. This kind of injury doesn’t happen all at once; it is usually cumulative over time, so it is important to find a working position that allows you to sit up properly and doesn’t require you to contort awkwardly to accomplish basic movements. 

Poor quality sleep: This one is a vicious cycle. You need to sleep to heal, but you can’t sleep because you’re in pain. How frustrating! When you sleep poorly, your body prioritizes systems to keep you functioning but does not allot the energy required to properly repair itself. Poor sleep quality can also lower your pain threshold and tolerance for persistent pain, making it harder to deal with. There may be other factors around your sleep hygiene and bedtime that make your shoulder pain more prominent, too. These can include:

-Excessive stress, without winding down or relaxing before bed.

-The wrong pillow(s) or mattress

-Sleeping on the side that has an injury

New exercises or form when exercising: Did you recently start a new activity, increase your weight on an exercise or maybe tried to do an exercise that you’re not as familiar with that relies heavily on shoulder stability? All of this can lead to pain in the shoulder. Generally speaking this can be treated with adequate rest and recovery, but it is something to be mindful of to prevent further injury and to mitigate the possibility of the conditions listed above.

Repetitive strain injury – An RSI is an injury to the musculoskeletal or nervous system just like it’s hinted at by it’s name these injuries are obtained through repetitive use, or through a body part being in the same position for long periods of time. An RSI is common to the shoulder from work or leisure activities done often without proper stretches, recovery and balancing/strengthening of opposing muscle groups.

Now that you understand what may be causing the pain, let’s go onto the good news.

_{HERE’S OUR TOP 10 TECHNIQUES FOR COMBATTING SHOULDER PAIN:}

Incorporate light stretching for your shoulders, neck and back into your bedtime routine.

Doing yoga or light stretches, particularly for your head, neck, shoulders, and back before you go to sleep can help to alleviate muscle tension in your body. This is particularly important if you lead a sedentary lifestyle, as long periods of time where you are still can cause more stiffness and pain. Stretching can loosen though tight areas and restore circulation and blood flow. Even if it seems counter intuitive to move before bed it can feel great and make it easier to fall asleep. If your mobility is too heavy impacted by your pain, we highly recommend our scraping or vibration tools to stimulate blood flow and bring circulation to the area. Ideally, you will work up to doing a combination of both stretching and using vibration tools.

Use a Sidekick scraping tool on your shoulder.

Sidekick tools are inspired by ancient wisdom for pain relief. Gua Sha is a 2000-year-old Eastern medicine technique that is used to mobilize and stimulate soft tissues. A Sidekick muscle scraper is a flat, slightly curved hand held tool that you gently and repeatedly “scrape” over your muscles. When you apply the tool to the skin over and around your shoulder, it releases adhesions underneath that cause pain and stiffness. Clinical studies have found that scraping tools successfully decreases pain, reduces inflammation, and increases blood flow to affected areas.

ICE BEFORE BED

Sometimes the best way to decrease inflammation is the old fashioned way. You can try applying an ice pack to the affected area rotating 10-15 minutes on and 10 minutes off for a half an hour or so leading up to bedtime.

SWITCH SLEEPING POSITIONS

If sleeping on your side is aggravating your shoulder pain, try sleeping on your back. It may be easier said than done, but find a way to get comfortable and see if taking the pressure off of your shoulder helps with your pain. If you’re able to get used to sleeping on your back, you may also notice an overall boost to your back health and skeletal structure.

SET A SLEEP SCHEDULE

While it can be hard to sleep when you have shoulder pain, sleeplessness can make pain symptoms worse. Creating a bedtime routine by going to sleep at the same time every night (even on weekends!) is good for regulating your circadian rhythm and will also help with restlessness at night.

Other actions you can take to prepare your body for sleep are:

• Avoiding caffeinated beverages after 10 a.m.
• Dimming your lights 1-2 hours before bedtime, which simulates natural light works and lessens brain stimulation.
• Staying off your phone screen and turning off the TV at least one hour before you try to go to sleep, for the same reasons as above – to calm your eyes and mind and lessen stimulation.
• Using black out curtains to allow for maximum melatonin production and so your know is not kept awake by artificial light
• Breathing exercises or meditation
• Journaling to put all of your thoughts on hold and to prevent anxiety or rumination that may disturb sleep

INVEST IN A NEW MATTRESS OR PILLOWS

You should replace a spring mattress approximately every 10 years but these days many of us have memory foam or mattresses in a box. These mattresses can have start to deteriorate after a few years and may need to be replaced closer to every 5 years. If your bed is still fairly new but you are experiencing pain, it could be that the mattress is not a fit for your needs. If you’re waking up with pain and stiffness, it could be that your mattress is either too soft or too stiff. A much less expensive alternative is to find the right pillows that better support your head and neck. You might also consider getting a full body pillow or mattress topper that can provide more support and take pressure off of your shoulder when you sleep.

IDENTIFY WHAT HABITS MAY BE CAUSING YOUR PAIN

A medical professional can help you diagnose the origins of your shoulder pain. Sometimes making simple ergonomic adjustments to your desk setup or repeated motions you’re engaged in, whether for work or play, can eliminate shoulder pain. To make things easier on your doctor or allied health professional use a notepad or an app to track the movements, activities or ‘triggers’ that may be causing your pain to help them have more information and narrow down what the primary cause may be.

AUDIT YOUR POSTURE THROUGHOUT THE DAY

Work on your posture. Try the “on the hour trick.” Every hour, whether you’re walking or sitting, give yourself a posture check. Are you slouching? Is your neck leaning too far forward? Whether you have good posture or bad, it’s a habit. And habits can be improved by consistently and repeatedly working on them.

FOCUS ON ANTI-INFLAMMATORY TREATMENTS

Over the counter anti-inflammatories are generally safe for most people, and in some cases,  they can help your body to heal faster simply by reducing inflammation. But if you experience anything more than mild shoulder pain or pain that lasts for more than two nights, or if you are unsure of the cause of your shoulder pain, it’s always best to consult with a medical professional.

An anti-inflammatory diet will also help and can be done without consulting a medical professional. Try adding more rich leafy greens, fatty fish, turmeric and reducing refined sugar, alcohol, gluten and dairy.

TALK TO A MEDICAL PROFESSIONAL TO GET EXTRA HELP OR A DIAGNOSIS

As mentioned earlier, there are a variety of causes of shoulder pain at night. The safest bet is to consult with a medical professional who is trained and licensed to properly diagnose your shoulder condition. And if you don’t get a satisfactory answer from one professional, always seek out other opinions.

Some of the treatments a medical professional might apply to reduce your nighttime shoulder pain include:

• Physical therapy to help with flexibility and strength imbalances
• Chiropractic adjustments to lessen pressure and improve mobility
• Muscle scraping treatments
• Massage therapy
• Anti-inflammatory medications
• Steroids and/or joint lubricant injections
• Acupuncture and/or acupressure
• Surgery, such as arthroscopic shoulder surgery

What’s most important if you’re experiencing shoulder pain at night is to be proactive about addressing it. Research shows that people who are proactive about taking care of health concerns tend to do better than those who procrastinate or avoid dealing with the issue. You should never be “too busy” to take care of your health because without it, you won’t get much done anyway! If you’re dedicated to addressing the cause of your shoulder pain and proactive about applying solutions to remedy it, you’ll start sleeping better and enjoying your waking hours even more.

If you’re ready to look at our scraping tools as a way to proactively treat your shoulder pain check out our best selling scrapers below: