Why does my shoulder hurt more at night?
Shoulder pain seems worse at night for three reasons. You are lying still, so nothing distracts you. Lying on the shoulder or with the arm across the body squeezes the tendons, and inflamed tissue aches more when you lie flat.
The pain is real, even if the shoulder looks and moves well in the day. It is one of the most common reasons people come to a physiotherapist.
What are the common causes?
A few patterns come up again and again:
- Rotator cuff tendon irritation or a small tear, with pain on lifting the arm and lying on that side.
- Subacromial or shoulder impingement, with a painful arc when raising the arm.
- Frozen shoulder, with growing stiffness and night pain.
- Neck problems that refer pain to the shoulder.
- Arthritis of the shoulder joint, less common but possible.
See our pages on shoulder pain, rotator cuff shoulder pain and frozen shoulder.
When is shoulder pain a medical emergency?
Left shoulder or arm pain that comes with chest tightness, shortness of breath, sweating, nausea or feeling faint can be a heart problem. Do not wait for it to settle. Go to the emergency department, such as Hospital Raja Permaisuri Bainun, or call for an ambulance.
Also see a doctor soon if the shoulder is hot, red and swollen, if pain follows a fall, or if you have fever or unexplained weight loss. These signs need medical review first.
How should I sleep with a sore shoulder?
Try these adjustments tonight:
- Sleep on your back with a small pillow under the sore arm, so it rests slightly forward.
- Or sleep on the other side with a bantal peluk or a pillow hugged in front of your chest.
- Avoid lying on the sore shoulder, and avoid sleeping with your hand under the pillow.
- Keep the air-conditioner or fan from blowing straight onto the shoulder, which can leave it tight.
- Before bed, a warm shower or a warm towel can ease the muscles.
Position changes do not treat the cause. They help you sleep while the cause is treated. Our page on sleeping position for back pain has more on pillows.
Which everyday tasks should I change for a week?
Give the shoulder a break from the jobs that load it. In Ipoh homes, that means:
- Hanging laundry on a high line or bamboo pole.
- Reaching for the top shelf for the rice cooker or pots.
- Carrying heavy shopping bags from the wet market or car.
- Riding a motorcycle for a long time.
- Overhead strokes in badminton.
Use a lower line, a stool, a trolley or a smaller load. For sports, read badminton shoulder pain.
What does physiotherapy add?
A physiotherapist works out which structure is irritated, calms the pain with the right movement and gives exercises for the rotator cuff and shoulder blade. For frozen shoulder, evidence from a meta-analysis shows a steroid injection helped pain best in the short term, and that adding home exercises gave extra benefit later [1]. A doctor makes the injection decision, and physiotherapy fits alongside it.
Our home physiotherapy lets us look at the bed, pillows and shelves you use. Read injection or physiotherapy to weigh your options. Our Canning Garden centre is opening soon.