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Have you ever been trying to sleep, only to have your sleep derailed by pain in your shoulder? What could possibly be causing it? And is there anything you can do about it?

There are several possible causes of shoulder pain that could happen while you’re sleeping. In this article, we’ll explore each of them in more detail as well as the steps you can take to help get a restful night’s sleep.

Certain positions, such as sleeping on your side, can put additional stress on your shoulder. This is because when you sleep on your side, your shoulder ends up bearing a lot of the weight of your torso.

One small study in people seeking care for shoulder pain evaluated the link between sleeping position and shoulder pain. It found that 67 percent of the study participants slept on the same side that they were experiencing shoulder pain.

While your sleeping position can contribute to shoulder pain, it’s not the only culprit. Several other conditions, like those below, can also cause pain when you’re trying to sleep. With each of these conditions, sleeping on the affected shoulder can exacerbate the pain.

Your rotator cuff is a collection of tendons surrounding your shoulder joint. It attaches the end of your upper arm bone to your shoulder blade, helping to secure it in the socket.

Rotator cuff injuries happen when the tendons of the rotator cuff become inflamed and irritated (known as tendinitis) or even partially or completely torn. This can occur due to:

  • an injury, like falling with an outstretched arm or abruptly lifting something too heavy
  • participating in sports that frequently use the shoulder joint, such as baseball, tennis, or rowing
  • regularly performing activities that require lifting or overhead use of your arms, such as construction or painting

Symptoms can include:

  • a dull ache or pain deep in your shoulder
  • pain that gets worse when you perform movements that involve lifting, throwing, or reaching behind your back
  • stiffness or loss of range of motion
  • disrupted sleep if you roll onto the affected shoulder

Initial treatment may be conservative. This will likely include resting and icing the affected shoulder. You can also relieve the pain with over-the-counter (OTC) anti-inflammatories, such as ibuprofen or aspirin.

Your doctor may also recommend that you work with a physical therapist. A physical therapist will help you do exercises to improve the strength and range of motion in your shoulder.

You’ll also likely have to do regular exercises at home to help ease the pain in your shoulder and to improve your range of motion.

In some cases, your doctor may give you a corticosteroid injection to help with pain and inflammation. Injuries that are severe or that don’t respond to conservative treatment may require surgery.

Bursae are small, fluid-filled sacs that help cushion the tissues around your joints. They’re found all over your body. Bursitis happens when a bursa becomes inflamed. The shoulder is one of the most common locations for bursitis.

A frequent cause of shoulder bursitis is an injury that affects the shoulder, or from repetitive actions that can overwork the shoulder joint. In some cases, however, the cause may be unknown.

The symptoms of shoulder bursitis can include:

  • localized aching or tenderness in the affected shoulder
  • pain that gets worse with movement of the affected shoulder
  • pain when pressure is applied to the area, such as when you’re lying down
  • stiffness in the affected shoulder
  • swelling and redness

At first, treatment is usually conservative. This will likely include:

  • resting the shoulder
  • taking OTC anti-inflammatories for pain and inflammation
  • doing physical therapy exercises

Corticosteroid injections administered judiciously can also afford relief.

If conservative measures are ineffective, you may need surgery to drain or remove the affected bursa.

Shoulder impingement syndrome happens when the soft tissues around your rotator cuff catch or rub on nearby tissue or bone as you move your arm.

The rubbing or catching of the soft tissue can result from:

  • swelling of the surrounding tendons (tendinitis)
  • inflammation of the surrounding bursa (bursitis)
  • the presence of bone spurs, which can develop as you age
  • a bone in the shoulder joint, called the acromion, that’s curved or hooked instead of being flat

The symptoms of shoulder impingement syndrome can include:

  • pain that’s located on the top or outer part of your shoulder
  • pain that becomes worse when lifting your arm, particularly if you’re lifting it above your head
  • pain that may become worse at night and affect sleep, particularly if you roll onto the affected shoulder
  • a feeling of weakness in the affected shoulder or arm

Initial treatment will likely involve rest, pain relief with OTC anti-inflammatories, and gentle shoulder exercises.

Corticosteroid injections may also be used for pain and swelling. Surgery to widen the area around the rotator cuff may be necessary in some cases.

Osteoarthritis happens when cartilage, which provides cushioning between your bones, begins to break down. It can affect various joints throughout the body, including your shoulder.

Shoulder osteoarthritis can naturally occur as you age. It can also happen due to previous injuries that affected the shoulder joint, such as a rotator cuff tear or a dislocated shoulder.

Symptoms of shoulder osteoarthritis can include:

  • pain, which is initially worse when you move your shoulder but can eventually occur while at rest or while sleeping
  • stiffness or loss of range of motion
  • grinding or clicking sounds that happen when you move your shoulder

Treatment can include using oral or topical pain relievers as well as specific physical therapy exercises for arthritis in the shoulder.

Corticosteroid injections can also help with inflammation. Surgery may be recommended if nonsurgical treatments don’t help relieve your shoulder pain.

Frozen shoulder happens when the connective tissue in your shoulder joint thickens, which can impair movement.

What exactly leads to frozen shoulder is unknown. What is known is that the risk increases when your shoulder has been immobilized for a long time due to things like recovery from injury or surgery. Underlying conditions like diabetes may also increase the risk of this condition.

The symptoms of frozen shoulder occur in three stages:

  1. Freezing. This is characterized by pain with movement and less range of motion.
  2. Frozen. Pain lessens, but your shoulder becomes stiff and movement is difficult.
  3. Thawing. Your range of motion begins to gradually improve.

When you experience pain from frozen shoulder, it may be worse in the evenings. This can disrupt your sleep.

Treatment for frozen shoulder is focused on relieving pain and promoting range of motion. This can be accomplished with OTC pain relievers and physical therapy.

More persistent cases may require corticosteroid injections, shoulder manipulation, or surgery.

If you’re experiencing pain when you sleep on your shoulder, some of these tips may help make sleeping more comfortable:

  • Avoid sleeping on the affected shoulder. Adjusting your sleeping position to the opposite side or to your back or stomach may help take pressure off an aching shoulder.
  • Utilize a pillow. Most of us change positions in our sleep. If you’re concerned about rolling onto your sore shoulder, try placing a pillow in a way that will prevent you from doing so.
  • Stay active. Regular exercise can boost your blood flow and circulation. This, in turn, may help the muscles and tendons in your shoulder to heal faster if you have an injury. Additionally, performing gentle shoulder stretches or exercises may help reduce shoulder pain.
  • Know your limits. Avoid activities during the day that could lead to further irritation of your shoulder.
  • Use OTC pain relievers. Try taking an OTC pain reliever, such as ibuprofen or acetaminophen, shortly before bed.
  • Practice good sleep habits. Keep a regular sleep schedule. Turn off any TVs, computers, phones, or other screens shortly before bed. Avoid caffeine, nicotine, and alcohol in the evening.

There are some steps you can take to keep your shoulders strong, healthy, and injury-free. Here are some suggestions:

  • Avoid repetitive motions, if possible. Repetitive movements such as lifting and throwing can place strain on your shoulder joint.
  • Take breaks. If you’re going to be performing repetitive motions as part of your job or a sport, be sure to take regular breaks.
  • Exercise. Keeping the muscles around a joint strong can help protect the joint and prevent injury. Be sure to properly warm up and stretch first.
  • Use a dolly or wheelbarrow for heavy loads. This can reduce the strain on your shoulders from lifting or carrying a heavy object.

Make an appointment with your doctor if you experience shoulder pain while sleeping, or while you’re awake, that’s:

  • sudden or severe
  • persistent, lasting more than a few weeks
  • disruptive to your day-to-day life, including your sleep
  • accompanied by weakness or a loss of motion
  • associated with an injury

Pain while sleeping on your shoulder can have many causes. Some of the most common causes include rotator cuff injuries, bursitis, and osteoarthritis.

Sleeping on your side can place additional pressure on your shoulder, causing irritation or pain. Sleeping on a shoulder that’s already sore or injured can make the pain worse.

If you experience shoulder pain at night, try to adjust your sleeping position so you’re not resting directly on your shoulder. Use pillows to prevent yourself from rolling onto your shoulder. OTC pain relievers and practicing good sleep habits may also help.

If you experience shoulder pain that’s disruptive, severe, or persistent, be sure to see your doctor. They can help diagnose your condition and recommend a treatment plan that’s right for you.