Shoulder Pain in the Morning, Why do I wake up with it?

There are a number of reasons why you might be experiencing shoulder pain in the morning, including sleep position, osteoarthritis, a pinched nerve, rotator cuff tendinitis and more. The most common reason for this kind of pain in the morning is sleep position, but there are a variety of other things that might be going on. If you aren't suffering with a chronic joint pain condition, it's likely that you've slept in a way that's put your shoulder joint under strain. However, if your pain does persist, it's a good idea to get your symptoms checked out by a doctor for peace of mind.

Here's a summary of common causes of shoulder pain in the morning:

• Sleep position
• Frozen shoulder
• Osteoarthritis
• Rotator cuff tendinitis
• Pinched nerve
• Scapular dyskinesis
• Previous injury

Let's take a look at these in more detail.

Sleep Position

If you are wondering whether sleeping position affects shoulder pain, the short answer is yes, it can. Research shows that there is a direct link between sleeping position and shoulder pain, and can be worsened by only sleeping on one side.

Most of us have a preferred sleeping position that we find the most comfortable, and may also have a side of the bed that we prefer to sleep on. Both of these habits could be contributing to your morning shoulder pain if it means you mostly sleep on one side.

If you are experiencing shoulder pain in the morning, start taking note of your usual sleep position and consider whether this could be contributing to your symptoms.

Here are some of the most common sleep-related causes of morning shoulder pain to consider:

• Old or unsuitable mattress - over time, it's likely that a mattress will lose its original form. For example, parts of the mattress can become sunk and uneven. The same goes for old bed frames, where shifted or warped slats can cause the mattress to lose its form
• Sleeping only on one side - while this might be comfortable, it could be putting additional strain on one shoulder, causing pain when you wake up in the morning
• Irregular sleeping patterns - not getting enough sleep can have a negative impact on your overall health, and that includes the bones and joints

Common symptoms of shoulder pain as a result of sleep position:

• A dull aching sensation around the shoulder joint that becomes increasingly painful with movement
• Trouble with mobility when attempting to stretch or move the arm
• Sharp pain upon lifting the arm
• A weaker grip than usual
• Getting dressed is difficult than usual, along with other morning activities such as brushing your teeth

Frozen Shoulder

A frozen shoulder, also known as adhesive capsulitis, is another leading cause of shoulder pain in the morning. This often causes stiffness and pain around the shoulder joint, which can become worse in the mornings due to a lack of movement while sleeping. This is usually treated using motion exercises, and can also be alleviated by pain relief medication.

Osteoarthritis of the shoulder

Osteoarthritis is a common type of arthritis that occurs when the cartilage layer that protects the ends of bones becomes worn down. The layer of cartilage provides a smooth surface for joints to move without tension or difficulty. So, when this is worn down as a result of osteoarthritis, the shoulder joints can become painful and stiff in the morning.

If your shoulder pain is ongoing throughout the day, it is possible that your symptoms are occurring as a result of a medical condition, such as shoulder osteoarthritis. It might feel worse in the mornings due to your reduced mobility while sleeping.

Rotator cuff tear

Another possible source of shoulder pain when waking up is a rotator cuff tear. This is when one of the tendons of the shoulder's rotator cuff becomes damaged or torn, and will usually result in pain when the shoulder is moved in different directions.

It's common to experience shoulder problems in sports. This is more likely to occur due to injury or overuse of the shoulder, for instance, swimmers and tennis players are more susceptible to this kind of injury; since these activities involve lifting the arm over the head a lot.

Pinched nerve

A pinched nerve, sometimes known as a trapped nerve, is another possible cause of shoulder pain in the morning. This can occur when too much pressure is put on the nerve that comes down from the neck to the shoulder. The symptoms of nerve pain tend to be slightly different from other causes of morning shoulder pain, with pinched nerves usually causing muscle weakness, tingling (pins and needles), numbness, and sometimes neck pain.

Scapular Dyskinesis

Another possible culprit of your morning shoulder pain is Scapular Dyskinesis, which is characterised by a loss of normal range of motion and unstable shoulder blades. One of the most common signs of this condition is shoulder blades that stick out. The condition itself is not usually painful, but it can result in a greater risk of injury.

If you are experiencing shoulder pain in the mornings, the good news is that there are several medicine-based treatments available to help alleviate your symptoms. Some of these include:

• Pain relief medication - common pain relief medication, such as ibuprofen and paracetamol can help alleviate joint pain in the morning. One of the most common forms of paracetamol is Panadol.
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Joint pain gels - some of the most common joint pain relief gels include Flexiseq and Voltarol.

There are several home remedies you can try out to help alleviate your morning shoulder pain. These include:

• Ice - ice packs or deep freeze can be used to alleviate the pain. It works by reducing the blood flow, which in turn reduces pain and inflammation. Apply for 15 to 20 minutes every 2 to 3 hours.
• Heating pads - heat patches can be used to help treat rheumatoid arthritis and osteoarthritis. They work by increasing blood flow to reduce stiffness.
• Resting your shoulder - your shoulder may be hurting from overexertion. Make sure to rest your shoulder if you find it hurts during movement.
• Slow return to regular exercise - if you exercise regularly, avoid overexerting your shoulder joints by exercising too much or too often.
• Stretching - a physiotherapist may recommend some stretching exercises for you to carry out at home.

You should seek advice from your doctor if your morning shoulder pain is persistent, or if it is causing you a lot of pain. Your doctor will be able to advise on the best solution, and may potentially recommend physiotherapy or medicinal treatments to help reduce and manage your symptoms.

Shoulder pain in the morning can occur from a number of causes. From sleep position, osteoarthritis, a pinched nerve, and several other possibilities. It's an area that is prone to strain and injury, and can be very noticeable when something is wrong. If you are experiencing pain, this can be managed with pain relief medication and joint pain gels. Though, if your pain persists, it is advisable to speak to your doctor.