A Brief Anatomy Lesson
To understand what’s causing your pain, you should have a basic knowledge of the anatomy of the shoulder.
The shoulder is a major ball and socket joint; one of the most mobile joints in the body. As such, joint stability is sometimes affected if there is not enough strength to support all the moving pieces. The cherry on top is that the head of the humerus is actually larger than its accompanying socket, setting the whole shoulder area up for potential difficulties. The surrounding tendons, ligaments, and muscles help anchor the bones of the joint, but again, this support system can be compromised. Typically, injuries occur from overuse, degenerative causes, or falls, but it’s possible that your shoulder can be disturbed by other means.
The shoulder is made up of 3 bony components:
- Clavicle or collarbone
- Scapula or shoulder blade
- Humerus or upper arm bone
The ligaments, muscles, and tendons that stabilize our shoulder are known collectively as the ‘Rotator Cuff,’ as they form a ‘cuff’ around the humerus. Specifically, the Rotator Cuff includes the teres minor, subscapularis, supraspinatus, and infraspinatus muscles.
So, Why Do My Shoulders Hurt when I Sleep?
Most of us go to bed in the hopes of having a good night’s sleep, right? When we wake up with shoulder stiffness or pain in the middle of the night or morning, it’s only natural to wonder whether our sleeping posture caused the problem.
If your shoulder feels out of whack after sleeping, it is very likely that the pain is being caused by poor sleep hygiene and improper sleeping positions. If you don’t sleep in a neutral position, you are putting excess pressure on your cervical spine as well as on your neck and shoulder muscles, which is why you wake up in pain.
Here’s what to remember when choosing a sleeping posture for you:
Stomach Sleeping is Bad for Alignment
Stomach sleeping may be comfortable and a preferred position for some, but it can cause shoulder pain in the long run. Sleeping on your stomach can actually make your shoulders move forward and become misaligned causing more shoulder pain at night. Sleeping on your stomach may also cause neck pain that radiates to the shoulder. It is much better to sleep on your back as this position keeps your shoulders properly aligned. This position can also help if you have sleep apnea.
Shoulder and Collarbone Pain from Sleeping on your Side
With your entire torso leaning heavily on one shoulder for hours every night, it will come as no surprise that side sleeping is not ideal. Side sleepers are prone to having pain in their shoulders and collarbones because of the excess pressure put on the joints every time they sleep. According to a recent study, 67% of participating patients with shoulder pain were sleeping on the same side as the pain. We can infer from this that sleeping on the same side was not only making the pain worse but probably why the pain occurred in the first place.
In addition to shoulder pain from sleeping on your side, numbness and tingling from a pinched nerve can occur. Many side sleepers also wake up with stiffness in their arm or shoulder. The concentration of your weight should not be limited to one side when you sleep. Putting uneven pressure on the joints can trigger inflammation, as well as pain in your muscles and tendons, leaving you with a limited range of motion. Reducing the stress you put on your shoulders is essential to minimize and prevent discomfort. 
A Bad Mattress Can Cause Shoulder Pain
If it’s not your body position causing the pain, it could be the mattress you’re sleeping on. A poor mattress can contribute to shoulder pain by making it impossible for your body to reach a neutral spinal position or by being too hard or soft for your anatomy. For example, a too-firm mattress will not contour to the body and a sagging mattress may not provide enough support for the back and shoulders. Many people who suffer from joint pain find the Yaasa ONE mattress to be very beneficial as it provides superb body contouring around the bones and joints and is firm enough to provide proper support, yet soft enough to be comfortable.
There are also specific mattress options available if you know you are a side sleeper, stomach sleeper, or back sleeper. The right mattress can alleviate the pressure felt on the body in each position, so you can carry on sleeping how you want without causing injury to yourself. The Yaasa mattress is made of 2″ high-density support memory foam that will contour to and cushion your body in different positions.
What about Pillows? A Pillow for Shoulder Pain
Soft, reliable, and frequently underrated, pillows can also have a big impact on body alignment. Too many or overstuffed pillows can cause back and shoulder pain. Not enough pillows can mean your body isn’t in a neutral alignment while you sleep, which can lead to spine, neck, and shoulder pain.
While you are sleeping, you want the right kind of pillows in the right place beneath your head and neck to ensure a neutral spine. A shoulder pain pillow or rotator cuff pillow may be exactly what you need to alleviate your problems. These pillows come in a wide variety of materials such as foam, memory foam, feathers, and fiberfill. They also come in many shapes and sizes depending on whether you want them for your under your head, under your knees, or as back support.
The best kind of shoulder pain pillow is made of memory foam because it conforms to whatever position you are in to give the best support. Place one, like The Memory Foam Pillow under your head to get enough support for your neck so that it reaches a neutral alignment. You can also place another small pillow under the strained shoulder, making sure your spine maintains neutral alignment. If you have any back pain, a pillow beneath your knees is a good idea to alleviate tension. 
My Problem Isn’t Related to Sleeping: Other Causes of Shoulder Pain
Besides sleeping in the wrong position, there are other factors that can result in shoulder pain, including injury or trauma, repeated motion, medical conditions, and stress. Many of these are the result of an injury to the shoulder either acutely or as a build-up over time. However, there are also medical reasons why the shoulder may experience pain as a result of a problem elsewhere in the body:
Poor Posture: If your thoracic spine is constantly bent or hunched over, you can experience spinal stiffness that will affect your shoulder. This type of stiffness is commonly caused by poor posture during the day. Constant leaning over our smartphones and computers leaves our thoracic spine bent for hours. Poor posture inhibits spine and rib cage mobility, putting us at risk of more shoulder injuries. If your computer is not already at eye level, try a computer stand or a stack of books that will lift the monitor up. This way, you won’t need to lean over to work. 
Repetitive Movements: If your job requires you to do heavy lifting or repetitive movements day in and day out, you are at a greater risk of experiencing shoulder pain. For example, shelf-stockers are likely to experience shoulder pain due to the constant wear-and-tear on the same joints and muscles day after day.
Medical Reasons Why You Might be Experiencing Shoulder Pain
Rotator cuff tendinitis (tendonitis): Rotator cuff tendinitis is a common shoulder problem that can cause severe shoulder pain. This acute condition is caused when the rotator cuff tendons are inflamed or irritated.
Rotator cuff tendinosis: Rotator cuff tendinosis is a chronic or recurring condition caused by repetitive wear and tear (degeneration) of the rotator cuff tendons.
Torn rotator cuff: A rotator cuff tear occurs when one or more of the rotator cuff tendons are torn away from the bone. The tears can be partial or complete and can occur as a result of injury or repeated daily use. Rotator cuff tears affect nearly two million people per year, so if you suffer from this injury, you are not alone.
Shoulder impingement syndrome: Shoulder impingement occurs when the rotator cuff rubs against the part of the shoulder blade called the acromion. The acromion is a bony projection on the scapula. When you lift your arm, the space between the rotator cuff and acromion narrows, squeezing the bursa, a small, fluid-filled sac that cushions tendons, muscles, and bones near your joints throughout your body. This can lead to impingement as blood flow is reduced and the tendons start to fray. Sometimes impingement syndrome requires surgery to ease the pain and improve mobility. Surgery can also reduce damage to the tendons.
Frozen shoulder (Adhesive capsulitis): Adhesive capsulitis is very painful and disabling and the cause for it is not known. It occurs when the connective tissue around the glenohumeral joint becomes inflamed and stiff. This greatly restricts movement and even gentle bumping can result in extreme pain and cramping. If medical management and physical therapy are not sufficient, surgery is required.
Shoulder bursitis: This is an inflammation of the bursa. Bursitis can cause pain and weaken the entire shoulder area. Besides the shoulders, bursitis most often occurs in the hips and elbows.
Subacromial bursitis: This type of shoulder bursitis is typically related to shoulder impingement syndrome. Subacromial bursitis occurs when the rotator tendons and muscles become irritated and inflamed as they pass under the subacromial space.
Shoulder arthritis or osteoarthritis: Arthritis is an inflammation of the joints. It can occur throughout the body, affecting one or more joints; in this case, those in the shoulder. There are over 100 different types of arthritis requiring different treatment modalities. Osteoarthritis involves the “wear and tear” of the entire joint including the bone, ligaments, cartilage, and joint lining.
Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disorder that causes pain and inflammation.
Bone spurs: A bone spur, also known as an osteophyte is a bony growth that forms on a normal bone. They are often caused by arthritis in an aging shoulder and can be very painful. There are several forms of treatment for this condition, including movement therapy, non-surgical treatments, and arthroscopic surgery. During the surgery, the doctor will make a series of small incisions to remove bits of extra bone. Fortunately, the recovery time after this surgery is typically minimal at a few weeks. 
Shoulder separation: This injury involves the separation of the shoulder blade from the clavicle at the AC joint (acromion-clavicle joint). It typically occurs as a result of a direct fall onto the shoulder, in which the force is strong enough to injure the ligaments in the area. Without the stabilizing ligaments, a painful separation can occur. 
Gallbladder issues: Sometimes, rotator cuff issues might come from medical conditions not related to the shoulder at all. Believe it or not, the gallbladder, a small sac-shaped organ located beneath the liver, can cause shoulder pain. After the liver secretes bile, it is stored in the gallbladder. However, there are times that the gallbladder becomes inflamed. The resulting pain can be felt between the shoulder blades.
Woke Up With Shoulder Pain: 10 Treatments to Try
Shoulder pain treatments depend upon the origin of the pain. For simple strains or sprains, rest and intermittent icing may be in order. On the other hand, for an acute fracture or severe degenerative arthritis, shoulder replacement surgery may be required. Chiropractic care and physical therapy are often effective for both acute and chronic pain. Sometimes, injections that include pain relievers and steroids are also of value for stiffness and joint pain.
- Sleep in a reclining positioning
For those who are dealing with a shoulder impingement, arthritis, or bursitis, sleeping on a reclining chair or adjustable bed, like The Yaasa Adjustable Bed, may help alleviate the issue. If you lift your upper body to a 45 degree while sleeping, there is less stress put on your neck and shoulder blade area. An adjustable bed frame will allow you to prop up your body without dealing with falling pillows to help you get a great night’s sleep and wake up feeling refreshed.
- Stretch it out
If you don’t already, try doing some light stretches for your whole body first thing in the morning. You don’t need any special equipment to feel better right away. Night pain can mean that the blood flow in a particular area of your body is not sufficient. Stretching allows more blood to flow in your muscles and joints, reducing any inflammation while enhancing your range of motion. Make sure you not only stretch your arms and shoulders but your neck as well! If the night pain doesn’t go away during the day, the way you sit in the office could be a part of the problem, and an adjustable (standing) desk might be the solution to this and many other health issues.
Try yoga for shoulder pain
Similar to stretching, you can try taking a beginner’s yoga class or even doing a few postures at home to regain mobility and strength in your shoulder area. A daily yoga practice is a healthy way to stretch your muscles and joints, which will alleviate pain by increasing blood flow. As yoga uses the natural weight of your body, it is a gentle way to exercise without putting too much strain on your shoulders. This guide shows a few examples of poses for you to try at home. If you have any concerns with postures, consult a trained yoga professional and your doctor to create a routine that works for your body.
- Apply an ice pack
We’re getting really fancy with this tip: try using an ice pack on an injured shoulder. We know, it’s a big ask. If it’s simply too much, you can also substitute a pack of frozen peas. We don’t judge.
Place the ice pack on the painful muscles. Leave for 10-15 minutes and repeat in 20-minute intervals, rubbing the area gently in between ice sessions.
- Use a hot compress or heating pad
If you have stiff joints or aching muscles, a heating pad or hot compress may be preferable to an ice pack. Apply the hot compress for up to 20 minutes at a time. Then, do some gentle stretches to help increase blood flow to the affected areas.
- Don’t use your phone in bed
Ever heard of text neck? Experts recommend that we avoid using our phones while we are in bed as this can cause undue stress to our neck. The strained neck muscles can exacerbate any neck pain and cause it to radiate to the shoulders. When you tilt your head forward to check your smartphone, you are putting a lot of strain on your muscles, tendons, and ligaments in your neck. Staying in this position can cause pain in the long run. When you do use your smartphone, set it on speaker whenever appropriate so that you do not cause undue strain.
- Schedule a physical therapy session
Physical therapy is often one of the first steps to resolving shoulder pain. A physical therapist can teach you specific shoulder and arm exercises, from stretching and strengthening to joint mobilization and beyond. They may integrate any number of therapies like electrical stimulation, heat, and ice to help with your treatment. 
- Ask your doctor about medications
Those who are suffering from shoulder pain at night may take advantage of over-the-counter medications to help reduce the pain that they are feeling. If this is not enough to soothe your pain, consult your doctor. Sometimes, doctors may choose to administer injections at the site of pain. These include steroid injections to reduce swelling or pain medicine at specific trigger points.
- The last resort: surgery
In more serious cases, shoulder pain can only be alleviated with surgery. For example, rotator cuff surgery is a common surgery to repair the tear. It is considered arthroscopic, meaning that the surgery is done by creating small holes using a fiber-optic camera. During this surgery, the inflammation in the bursa on your rotator cuff will be removed. Adhesive capsulitis (frozen shoulder) is another condition that causes disabling pain and may require surgery.
- Talk to your physician
When your shoulder and upper arm pain at night does not resolve, it’s time to visit the doctor. Your doctor will perform a physical examination and ask detailed questions regarding any injuries, activities, and your sleep routine and sleep posture. Your doctor may order tests to determine whether the pain is actually due to a shoulder problem or the pain is radiating due to a neck or spine issue. In these cases, you can work with your health care provider to create a treatment plan that best provides the most pain relief.
We hope this guide helped you because we know the far-ranging impact of constant neck and shoulder pain. No matter the cause, neck and shoulder problems can severely limit movement and quality of life. You deserve better. Imagine waking up pain-free — it’s great motivation to make a change!