Night-Time Shoulder Pain: Why It Happens and How to Find Relief

If shoulder pain wakes you up at night, keeps you from sleeping on your side, or makes simple movements uncomfortable, you’re not alone. Night-time shoulder pain is one of the most common symptoms patients bring to Plano Orthopedic & Sports Medicine Center (POSMC). In fact, shoulder problems often feel worse at night—even when they seem manageable during the day.

In this guide, we break down why nighttime shoulder pain happens, which conditions commonly cause it, and when it’s time to see an orthopedic specialist.

Why Does Shoulder Pain Get Worse at Night?

Many people assume shoulder pain is caused by the way they sleep. While sleeping positions can contribute, night-time pain is usually a sign of an underlying shoulder problem that becomes more noticeable when the body is at rest.

Here are the most common reasons shoulder pain intensifies at night:

1. Reduced Blood Flow While Lying Down

When you lie flat, the natural circulation to the shoulder can slow slightly. If you already have inflammation, this reduced flow can make the shoulder feel stiff, sore, or “throbbing.”

2. Compression from Sleeping on Your Side

Side sleepers often experience worsening pain because the shoulder is compressed for hours at a time. This can irritate the rotator cuff, AC joint, and surrounding soft tissues.

3. Muscle Fatigue from Daytime Activity

Inflamed or injured shoulder tissues may tolerate daytime activities but become irritated from accumulated use once the body enters rest mode.

4. Inflammation Peaks at Night

The body’s natural inflammatory response cycles can intensify discomfort during the night.

Most Common Causes of Night-Time Shoulder Pain

Night-time shoulder pain is rarely “just sleeping wrong.” It usually points to one of several orthopedic issues.

1. Rotator Cuff Tendinitis or Tear

The rotator cuff helps stabilize and move the shoulder. If these tendons become inflamed or torn, patients frequently report:

Pain when lying on the affected side
Difficulty lifting the arm
Sharp pain with reaching
Persistent aching at night

Rotator cuff irritation is one of the top causes of night-time shoulder discomfort.

2. Shoulder Impingement

This occurs when the rotator cuff gets pinched under the acromion (the top part of the shoulder).
Symptoms include:

Pain when reaching overhead
Pain when lying on the shoulder
A deep ache that worsens at night

Sleeping with the arm above the head can make impingement worse.

3. Bursitis

The shoulder has fluid-filled sacs called bursae that help reduce friction. When inflamed, they can cause:

Swelling
Pain with movement
Significant night-time pain

4. Frozen Shoulder (Adhesive Capsulitis)

This condition causes severe stiffness in the shoulder joint. Early on, night pain is often the first and most severe symptom. Many patients report difficulty finding any comfortable sleeping position.

5. Arthritis of the Shoulder

Arthritis causes joint inflammation and stiffness. Pain often increases at night or first thing in the morning.

6. SLAP Tears or Labral Injuries

Damage to the labrum can create instability and aching that intensifies when lying down.

7. Poor Sleeping Posture

While not the root cause of most cases, sleeping positions can worsen symptoms if the shoulder is already injured.

How to Sleep Better with Shoulder Pain

Here are proven strategies to reduce shoulder pain at night:

Avoid Sleeping on the Painful Side

This reduces compression on irritated tissues.

Use a Pillow Under the Arm

Supporting the arm helps relieve pressure from the shoulder joint.

Try Sleeping on Your Back

This is often the most neutral, least irritating position.

Use Anti-Inflammatories (If Approved by Your Doctor)

Medications like ibuprofen can reduce night-time inflammation.

Ice Before Bed

Applying ice for 15–20 minutes before lying down helps calm swelling and pain.

Stretch and Strengthen

Gentle shoulder exercises can improve blood flow and mobility.

When Should You See a Shoulder Specialist?

You should schedule a visit with an orthopedic shoulder expert if:

Your night-time shoulder pain has lasted more than 1–2 weeks
You cannot sleep on one side
The pain is sharp or worsening
You have weakness in the arm
You experience clicking, popping, or catching
You have stiffness that limits daily movement

Many causes of shoulder pain worsen without treatment. Early evaluation is the best way to prevent long-term damage.

How POSMC Can Help

Plano Orthopedic & Sports Medicine Center offers complete shoulder care, including:

Accurate diagnosis with on-site imaging
Treatment options ranging from physical therapy to injections
Advanced shoulder arthroscopy
Specialized care for rotator cuff tears, impingement, bursitis, and frozen shoulder
Board-certified orthopedic surgeons specializing in shoulder injuries

Our team treats patients from Plano, Frisco, Allen, McKinney, and surrounding North Texas communities—and we are ranked #1 across dozens of shoulder-related search terms in these markets.

Schedule an Appointment Today

If shoulder pain is keeping you up at night, you don’t have to struggle through it.
POSMC’s shoulder specialists can identify the cause and create a personalized treatment plan to help you sleep comfortably again.

Call us today or request an appointment online.