How to Sleep Without Shoulder Pain: Tips from an Osteopath

Why Shoulder Pain Feels Worse at Night

If you struggle to find a comfortable sleeping position because of shoulder pain, you’re not alone. Many people with shoulder impingement, rotator cuff irritation, or frozen shoulder notice their pain increases when lying down.

At night, the muscles around your shoulder relax, and fluid pressure can build up around inflamed tissues. This can compress the rotator cuff tendons or bursa, making pain sharper or even waking you up.

An Osteopath’s Perspective

As an osteopath, I often explain that shoulder pain isn’t always just a shoulder problem. Poor posture, neck tension, and restricted movement through the upper back (thoracic spine) can all contribute to impingement or discomfort when lying down.

By addressing these underlying mechanical issues through osteopathic treatment, we can help restore balance, reduce inflammation, and make it easier for your shoulder to settle — both day and night.

Best Sleeping Positions for Shoulder Pain Relief

1. Sleep on Your Non-Painful Side

If one shoulder is sore, try lying on the opposite side.

• Place a pillow in front of your chest to rest your top arm comfortably across your body.

• Use a small rolled towel or pillow between your arms to reduce strain on the painful shoulder.

2. Back Sleeping (Supine)

This is often the best position for shoulder impingement.

• Support your arm with a thin pillow or folded towel under the elbow to take pressure off the joint.

• Keep a pillow under your knees to support the lower back and maintain spinal alignment.

3. Avoid Sleeping Directly on the Painful Shoulder

This compresses the joint and irritates inflamed tissues. If you tend to roll onto that side, try placing a firm pillow behind your back as a reminder to stay off it.

Stretch and Relax Before Bed

Gentle shoulder and upper-back mobility work can reduce stiffness before you sleep. Try:

• Shoulder rolls

• Gentle chest stretches

• Deep breathing to relax your neck and shoulder muscles

Avoid aggressive stretches late at night — focus on relaxation, not exertion.

Extra Tips for Better Sleep

• Use a supportive pillow: A medium-firm pillow that keeps your neck in line with your spine helps prevent extra strain on shoulder structures.

• Watch your mattress: Too soft, and your shoulder sinks too deeply; too firm, and pressure increases. A medium-firm mattress usually works best.

• Manage inflammation: Apply a cold pack (10–15 minutes before bed) if your shoulder feels hot or swollen.

• Don’t ignore ongoing pain: Persistent shoulder pain that interrupts sleep for more than 2 weeks should be assessed by an Osteopath or other qualified practitioner.

When to See an Osteopath

If your shoulder pain keeps you up at night or limits your daily movement, an Osteopath can help by:

• Reducing joint restriction and muscle tension

• Improving posture and biomechanics

• Supporting natural healing through gentle, hands-on techniques

A thorough assessment ensures we treat the root cause — not just the symptoms.