Understanding Frozen Shoulder
Frozen shoulder is the more common term used to describe what the medical community calls adhesive capsulitis. When the shoulder joint is immobilized for an extended time, it can lead to stiffness and pain. People recovering from a recent surgery or injury to the shoulder or arm are at greater risk of developing frozen shoulder because of the time period of immobilization for the healing process to occur. Another common cause of frozen shoulder is diabetes because chronically high blood sugar levels can negatively impact the connective tissues that make up the capsule in the shoulder. The shoulder is a ball and socket joint with a capsule of soft tissue that provides support and stability for the joint. When the soft tissues that make up the capsule become thickened and tightened, it results in frozen shoulder or adhesive capsulitis.
The signs and symptoms of frozen shoulder can develop slowly over time, and you may start to notice something isn’t quite right with your shoulder when your regular routine is disrupted.
Common Symptoms of Frozen Shoulder
The most common symptoms of frozen shoulder are pain and stiffness. As the soft tissues tighten around the shoulder joint, it restricts the mobility and range of motion in the shoulder joint. This can make regular everyday movements more painful, including simple things like brushing your teeth or putting on a shirt. Along with pain symptoms, stiffness occurs as the shoulder capsule tightens and hardens over time. A stiff shoulder can reduce your typical range of motion and keep you from doing things like raising your arms above your head, lifting objects, and rotating your shoulder.
There are three stages of frozen shoulder, and the symptoms vary depending on what stage you are in. The first stage is the freezing stage when the pain starts to set in, and you notice a decrease in your typical range of motion in the affected shoulder. The second stage is the frozen stage, which is when the pain might decrease, but the stiffness in the shoulder is at its strongest, and many shoulder movements become much more difficult. The final stage is the thawing stage, where the pain and stiffness start to go away, and you begin to regain range of motion in the affected shoulder.
Why Frozen Shoulder May Affect Your Sleep
Many people with frozen shoulder also report symptoms like pain and stiffness that get worse overnight and while trying to get a good night’s sleep. Whether you are a side sleeper or not, frozen shoulder can cause discomfort that keeps you up at night and prevents you from getting comfortable. Certain shoulder movements during the day may not cause pain right away, but the stiffness and soreness might settle in once you lie down to rest. A busy day can also keep you from recognizing the strength of your pain during the day, while at night, you are more aware of the pain and other discomforts as you try to fall asleep.
Frozen shoulder can also cause worsening symptoms at night because of how your blood flow is affected when you sleep. When you are lying down, the blood flow inside your body slows down, which means water and other nutrients are filtered slowly as well. This can increase pressure on certain parts of the body and initiate inflammation. Swelling and inflammation in and around the shoulder joint will increase pain and discomfort, which can significantly disrupt your ability to sleep.
Tips for Sleeping with a Frozen Shoulder
Thankfully, there are many tips and tricks out there to help when you are sleeping with a frozen shoulder. If your pain and discomfort are keeping you up at night, then there are things you can do during the day to help proactively address symptoms that might otherwise bother you when you try to sleep. Follow your doctor’s orders and try to rest your shoulders throughout the day as much as possible. The more you use your shoulders during the day, the greater you risk aggravating the frozen shoulder and increasing your chances for pain, swelling, and discomfort when you try to go to bed at night. You may also want to take anti-inflammatory and pain medications that are over the counter and do not require a prescription.
While these medications can’t heal frozen shoulder, they can provide you with temporary relief from some of your symptoms while you heal. Taking these types of medications before bed can help address any pain, swelling, and inflammation in your affected shoulder, so you may have a better chance of getting a good night’s sleep.
Try These Sleep Positions with Frozen Shoulder
You might be wondering, “what is the best sleeping position for frozen shoulder?” Here are five sleep positions you can try to help relieve your nocturnal shoulder pain and discomfort while healing from frozen shoulder.
Use Head and Neck Support
Sleep with a Body Pillow
A body pillow can also help provide you with support while you sleep. If you are a side sleeper, then a body pillow against your back can help keep you in place so that you stay sleeping on the shoulder that does not have adhesive capsulitis. That way, your frozen shoulder can stay elevated above your heart, and you avoid putting pressure on the joint while you sleep. If you prefer to sleep on your back, then you can use a body pillow along the side of your body with the frozen shoulder to help prevent you from rolling onto that side and help keep your shoulder and arm propped in a comfortable position.
Side Sleeping with Pillow Support
One of the best sleeping positions when dealing with frozen shoulder is sleeping on your unaffected side with pillow support. If you don’t have a body pillow handy, you can use a regular bed pillow or smaller throw pillows to help support you for a lateral sleeping position for shoulder pain. Holding a pillow between your arms as you lie on your side will help keep your chest open and your shoulders in line with one another. Placing the pillow in your armpit and extending your arms out and around the pillow will help you maintain space and avoid curving your shoulders inward. A pillow between your knees will also help maintain proper posture through the base of your spine and hips, which can help prevent you from curling inward and aggravating the shoulder.
Back Sleeping with Arms by Your Side
The other recommended sleeping position for frozen shoulder is on your back with your arms by your side. When you sleep on your back with proper head and neck support, your spine stays in healthy alignment, and pressure is more equally distributed across your whole body. Try sleeping on your back and resting your arms straight by your sides with your palms facing down. This prone position with your arms extended by your sides puts the least amount of pressure on your shoulder joints and allows your muscles and soft tissues to gently stretch and release. As your muscles release, this can help to reduce any tension and stress that has built up along your neck and shoulders throughout the day.
Use a Heating Pad
Consider using a heating pad that is safe for sleeping, such as a heating pad with a timer that shuts off after a certain period of time. There are also alternative options to heating pads like a cloth bag full of cherry pits or wheat that you can heat in the microwave and then allow the warmth to naturally release against your affected shoulder. Applying heat to a stiff, sore shoulder can help reduce your pain symptoms while also encouraging the muscles and soft tissues in the joint to relax.
Avoid These Sleep Positions with Frozen Shoulder
You will want to avoid some sleeping positions with frozen shoulder because they may worsen your symptoms.
Sleeping on Your Affected Shoulder
This might seem like a no-brainer, but avoiding sleep on your affected shoulder might be easier said than done for some people. Some may find it difficult to sleep in a different position because they are used to falling asleep on their right or left side. However, it is best to avoid sleeping on the shoulder with adhesive capsulitis because it puts too much pressure on the joint. Even accidentally rolling over onto your shoulder at night can cause pain that may wake you up. That’s why sleeping with pillows to help prop you up can help prevent you from experiencing too much shoulder pain while you sleep.
Sleeping on Your Stomach
Treatment Options for Frozen Shoulder
If you are dealing with shoulder pain and stiffness that gets worse at night, then talk to shoulder pain specialists near you to find out more about your treatment options for frozen shoulder. The most important part of treating frozen shoulder is to help preserve your range of motion and mobility in the affected shoulder. Restricting movements and making time to rest will help with the healing process.
Medications for pain and inflammation that are over the counter can help temporarily relieve some symptoms, and you can talk to your doctor about recommendations for what will work best for you. Your doctor may also talk to you about other ways to manage your frozen shoulder pain, including steroid injections or numbing injections to the affected shoulder. A shoulder pain specialist may also recommend physical therapy for frozen shoulder to help safely and effectively reintroduce stretches and exercises into your routine. In rare cases, surgery may be recommended to help remove any buildup of scar tissue in the shoulder joint.
At AICA Orthopedics, our shoulder pain specialists understand the importance of getting a good night’s sleep and work with you to reduce your pain and other symptoms while addressing your frozen shoulder’s root cause. Find an AICA Orthopedics clinic in metro Atlanta near you and get started on a treatment plan today that will provide you with the quality care you need to effectively heal and recover from frozen shoulder.
Sources
- Chan, H., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore medical journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107
- Zenian J. (2010). Sleep position and shoulder pain. Medical hypotheses, 74(4), 639–643. https://doi.org/10.1016/j.mehy.2009.11.013
- Mulligan, E. P., Brunette, M., Shirley, Z., & Khazzam, M. (2015). Sleep quality and nocturnal pain in patients with shoulder disorders. Journal of shoulder and elbow surgery, 24(9), 1452–1457. https://doi.org/10.1016/j.jse.2015.02.013
