Shoulder Pain? Avoid These 3 Sleeping Positions

shoulder pain sleeping positions to avoid

When you have shoulder pain, sleeping comfortably can be challenging. Your go-to sleeping position, no matter how comfortable it seems, might actually worsen your shoulder pain! 

You don’t want to wake up with more shoulder pain simply because you slept wrong. So keep reading to learn three sleeping positions to avoid at all costs. I’ll show you what not to do and also share some ideas on how to sleep with less shoulder pain. 

Avoiding Shoulder Pain at Night

I’m a physical therapist, and part of my job is helping people find relief from shoulder pain—not only at the clinic through exercises and stretches, but also at home. Everyday habits, including nighttime sleep positions, can either help or hurt existing pain.

As a ball-and-socket joint, your shoulder is capable of moving in several directions. But there are a couple positions in particular that can worsen a painful shoulder:

  • Abduction: the vertical movement your shoulder makes to raise your arms away from your body, such as when you make a snow angel. 
  • External rotation: a lateral, outward opening of the shoulder joint, which you might do to reach behind the chair next to you while driving, for example. 

A healthy shoulder joint can perform these movements without an issue, but sleeping in abduction or external rotation may stress an already weakened or inflamed shoulder. 

3 Easy Fixes for Shoulder Pain at Night

Unfortunately, there isn’t one simple sleep position that will keep your shoulders out of abduction or external rotation. But I’ve discovered three easy fixes you can use to ensure your shoulder is in an optimal position, no matter your posture. 

For Back Sleepers

Let’s start with back sleepers. Although sleeping on your back can help keep your spine in a nice, neutral position, the benefits to your shoulder all depend on what you do with your arms. 

First, you absolutely must avoid sleeping with your arms propped up, and with your hands near or behind your head (the classic, “relaxed” pose). That’s because this pose puts your shoulder in an abducted and externally rotated position (what we call a 90/90 position). If you have a history of shoulder dislocation, then this position makes your shoulder particularly vulnerable to irritation and pain.

shoulder positions for sleeping

The best way to protect and support your shoulder is to keep your arms in front of you, close to your body. I recommend holding a pillow to your side and resting your arm on top of it. This will place your arm in a stable position and help prevent any further irritation that could arise from rapid movements or “catches” you may cause when positioning your arms overhead.

For many back sleepers, myself included, nighttime habits are difficult to break. But a prop pillow can help you minimize pain and get a more comfortable night’s sleep. 

For Side Sleepers

The next position to avoid is most commonly seen with side sleepers. If you sleep with your hands under your head or with one arm extended overhead, you could be irritating your shoulder pain at night. In both of these positions, your arm usually ends up abducted beyond 90° and rotated externally. 

Besides the abduction and external rotation, the real problem with this position is that resting your head on your hands or arms places considerable compressive force on your shoulder. 

shoulder pain sleeping positions

A better way to side-sleep is to make a gutter for your arm. Take an extra pillow and place it on your bed below your shoulder, to prop up your torso. That way, when you lie on your side, you can extend your arm in the “gutter” or gap created by the two adjacent pillows. This adjustment helps take some of the pressure off your shoulder and keeps it from excessive abduction and external rotation.

Now we’ll take a look at the third position to avoid, especially if you are a stomach sleeper.

For Stomach Sleepers

In my time as a PT, I’ve found that most stomach sleepers like to rest with their head turned to one side and both arms overhead under a pillow. But just as we saw with back sleeping, keeping arms raised overhead puts the shoulder into a vulnerable and sometimes painful position of extreme abduction and external rotation.

shoulder pain sleep positions

So if you prefer to sleep on your stomach, try to position your painful shoulder along your side, using only one arm to prop your pillow and head for support. I recommend placing an additional pillow to the side, under your chest and head, so that your shoulder rests in a more neutral position. 

When you have neck or shoulder pain, sleeping on your stomach poses a particular challenge for finding a comfortable position. But with an extra pillow or two, you can take steps to adjust your sleeping posture and find relief. 

Final Thoughts

Whether you are a back, side, or stomach sleeper, shoulder pain can make it really uncomfortable to sleep at night. But these small changes can help you find a better sleeping position so you wake up as pain-free as possible. 

Besides adding a pillow or two to your sleeping position, there are other things you can do to alleviate shoulder pain. Check out these 10 exercises to relieve shoulder pain at home. 

Tim Fraticelli DPT, MBA, CFP®

Tim Fraticelli is a Physical Therapist, Certified Financial Planner™ and founder of PTProgress.com. He loves to teach PTs and OTs ways to save time and money in and out of the clinic, especially when it comes to documentation or continuing education. Follow him on YouTube for weekly videos on ways to improve your financial health.