Shoulder pain at night is one of the most frustrating symptoms people experience. It can make it difficult to find a comfortable sleeping position, disrupt your sleep, and leave you feeling tired and sore the next day.
While many people assume they have simply “slept on it wrong”, persistent shoulder pain at night is often a sign that something else is happening.
The good news is that most causes of shoulder pain at night respond well to the right physiotherapy treatment.
Why Is Shoulder Pain Worse at Night?
There are several reasons why shoulder pain often feels worse after you go to bed.
These include:
- Less distraction from daily activities, making pain more noticeable
- Increased pressure on the shoulder when lying on your side
- Inflammation building throughout the day
- Stiffness from remaining in one position for long periods
Melatonin:
- At night, melatonin – the sleepy hormone, is released
- Research has indicated that in patients with rotator cuff tears & frozen shoulder, melatonin can stimulate nerves & chemicals which increases sensitivity to touch & pain
- This can give reason as to why your shoulder pain is worse at night
Night pain doesn’t always mean the injury is severe, but it shouldn’t be ignored if it continues.
Common Causes of Shoulder Pain at Night
Some of the most common conditions include:
- Rotator cuff tendinopathy
- Rotator cuff tears
- Shoulder bursitis
- Frozen shoulder (adhesive capsulitis)
- Shoulder impingement
- Osteoarthritis
A physiotherapist can determine which structure is responsible through a thorough assessment.
Signs You Should See a Physiotherapist
Consider booking an assessment if your shoulder pain:
- Wakes you during the night
- Persists for more than two weeks
- Limits overhead movement
- Makes dressing difficult
- Causes weakness when lifting
- Is affecting work, sport or daily activities
Early assessment often leads to a quicker recovery.
7 Ways to Reduce Shoulder Pain at Night
1. Avoid Sleeping Directly on the Painful Shoulder
2. Support Your Shoulder With Pillows
3. Keep Your Shoulder Moving
4. Manage Inflammation
5. Improve Shoulder Strength
6. Improve Posture Throughout the Day
7. Don’t Wait Too Long
When Should You Seek Urgent Medical Attention?
While most shoulder pain is musculoskeletal, seek urgent medical attention if you experience:
- Sudden inability to move the arm after trauma
- Severe night pain that wakes you up
- Fever, redness or warmth around the shoulder
- Unexplained weight loss
- Chest pain or pain spreading into the jaw or left arm
These symptoms require immediate medical assessment.
How Physiotherapy Can Help Shoulder Pain at Night
Your physiotherapist will identify the cause of your shoulder pain and develop an individualised treatment plan.
Treatment may include:
- A comprehensive shoulder assessment
- Hands-on therapy
- Individualised exercise prescription
- Load management advice
- Sleep position education
- Progressive strengthening to prevent recurrence
The goal isn’t just to reduce pain, it’s to help you return to sleeping comfortably and getting back to the activities you enjoy.
Sleep Better With Expert Shoulder Care
If shoulder pain at night is affecting your sleep, don’t put up with it. The sooner the cause is identified, the sooner you can begin the right treatment.
At Essential Health Physiotherapy, we assess and treat all types of shoulder pain using evidence-based physiotherapy tailored to your individual needs.
Book an appointment today and let our experienced physiotherapists help you sleep better, move better, and get back to doing what you love.
If you want to sleep without shoulder pain, call us at 07 3132 0898
References
Ha, E., Lho, Y.-M., Seo, H.-J., & Cho, C.-H. (2014). Melatonin plays a role as a mediator of nocturnal pain in patients with shoulder disorders. The Journal of Bone and Joint Surgery, 96(13), e108. https://doi.org/10.2106/JBJS.M.01011
Littlewood, C., Bateman, M., Clark, D., Selfe, J., Stephens, V., & May, S. (2019). Rehabilitation following rotator cuff repair: A systematic review. Shoulder & Elbow, 11(2), 81–92. https://doi.org/10.1177/1758573218782153
Lewis, J. S. (2015). Rotator cuff related shoulder pain: Assessment, management and uncertainties. Manual Therapy, 20(1), 2–11. https://doi.org/10.1016/j.math.2014.09.009
Kuhn, J. E. (2009). Exercise in the treatment of rotator cuff impingement: A systematic review and synthesised evidence-based rehabilitation protocol. Journal of Shoulder and Elbow Surgery, 18(1), 138–160. https://doi.org/10.1016/j.jse.2008.06.004
Check our Previous Blogs
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