Shoulder Pain at Night? It’s Not Just How You Sleep

Tossing, Turning, and Still Aching?

You finally get into bed, ready to rest — but as soon as you lie down, your shoulder starts to throb. You change sides, stack pillows, maybe even sit up for a while… yet the ache keeps coming back.

If this sounds familiar, you’re not alone. Many people blame their pillow or mattress, but persistent shoulder pain at night often points to something deeper than your sleeping position.

At 360 Orthopedics, our team of orthopedic surgeons, sports medicine specialists, and physical therapists see this every day. Nighttime pain is often a key sign that your shoulder needs more than just new bedding — it needs expert care.

Why Shoulder Pain Often Worsens at Night

While some discomfort may come from how you sleep, the most common reason for nighttime pain is inflammation inside the shoulder joint or surrounding tissues. Lying down can increase pressure on the shoulder, and with fewer distractions at night, that ache becomes hard to ignore.

Here are a few of the most frequent culprits:

Rotator Cuff Injuries

• Tiny tears or irritation in the tendons that stabilize your shoulder.
• Pain often feels like a dull ache that worsens when you lie on that side or lift your arm overhead.
• Can develop gradually from repetitive motions — think pickleball, swimming, kayaking, or overhead lifting at the gym.

Shoulder Bursitis

• Inflammation of the fluid-filled bursa sacs that cushion your joint.
• Pain can feel sharp and tender, especially when you put weight on the joint at night.

Frozen Shoulder (Adhesive Capsulitis)

• Stiffness and restricted range of motion, often paired with a deep ache at night.
• Common in adults 40–60 and in those recovering from an arm injury or surgery.

Arthritis of the Shoulder

• Gradual breakdown of cartilage can cause aching that’s worse after activity and at night.
• Often felt as a grinding or deep ache.

Shoulder Impingement Syndrome

• Occurs when the tendons or bursa get “pinched” under the shoulder blade.
• Pain may be sharp with reaching or lifting, then throbs later in the evening.

When the Pain Isn’t Just the Shoulder

Sometimes neck or upper spine issues — such as a pinched nerve or cervical arthritis — can radiate pain into the shoulder, especially at night. That’s why a precise diagnosis from a specialist is key.