How should I sleep to prevent shoulder and elbow pain?

Rick Olderman
Physical Therapy Specialist

Essentially, this boils down to experimenting with propping up or supporting your arm, shoulder, or wrist with towels or pillows to relieve stress to your shoulder or elbow. When doing so, begin with your favorite sleeping position as this is the one you are most likely to return to while asleep. Try the following recommendations to fix your sleeping habits:

  • Lying on your side makes your bottom shoulder slide forward underneath you (abduction). This should be avoided—especially if you've found that your scapula (shoulder blade) is sitting too far from your spine. The best way to manage this is to try to position the scapula underneath and behind you, so it doesn't slide forward. If that fails, try sleeping on the other side and resting your top arm on a pillow to prevent excessive shoulder blade abduction.
  • If you are used to sleeping on the painful shoulder, then experiment by propping up the affected side's wrist on pillows (bringing it off the bed) and note whether this decreases your pain. This essentially brings it into more internal rotation and should reduce stress to the shoulder joint.
  • When sleeping on your back, tight chest muscles or biceps muscles can pull your arm bone forward in your shoulder socket, contributing to an anterior glide (when a bone in a joint slides forward in a socket more than it should normally slide). To reduce this stress and correct this, place your arm on a pillow.
  • If you sleep on your stomach, place pillows underneath each shoulder to reduce the forward pull of gravity. This will also put the head of the humerus (upper arm bone) in a better position in the shoulder socket.
Fixing You: Shoulder & Elbow Pain: Self-treatment for rotator cuff strain, shoulder impingement, tennis elbow, golfer's elbow, and other diagnoses.

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Fixing You: Shoulder & Elbow Pain: Self-treatment for rotator cuff strain, shoulder impingement, tennis elbow, golfer's elbow, and other diagnoses.

The shoulders are a floating system on the trunk, held in place and moved by muscular control. The foundation of shoulder movement is the shoulder blade which has precise resting and moving...
Dr. Matthew F. McCarty, MD

We spend about a third of our life sleeping. That’s a lot of time and certain positions can worsen neck pain. The most important thing to remember is to sleep with a pillow supporting the neck in an anatomically correct position. When sleeping on the back a cervical traction pillow can help people who have a neck and arm pain. This pillow provides support just above the shoulders and below the base of the skull giving a mild traction effect. The right size pillow can make a difference but too large a traction pillow can make sleep difficult.

For side sleepers it’s important to think about maintaining alignment of the neck with an imaginary line drawn right down the center of the face and shoulders. Some people have osteoarthritis or stenosis and don’t allow a lot of room for the nerves to exit the spine. When they lay on their sides with the head elevated above or below this imaginary line they can get symptoms. Usually a right size mildly firm pillow can fix this problem. Buy several and give them a try.

People with neck pain often cannot tolerate sleeping on their stomachs. This is because the neck is forced to be extended in a non-anatomically correct position throughout the sleep cycle. Certain cervical disease states become more symptomatic in these positions.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.