Shoulder pain when sleeping on your side

Your pain pattern,
What aggravates it,
How to get relief,
and more…

How People Describe This Pain Pattern

People complain of pain that disturbs their sleep when lying on the painful shoulder or on the opposite shoulder. It is a deeper pain than the illustration suggests. They have spent most of their time sleeping on that shoulder with that hand in front of them. It usually comes on gradually over months and eventually gets difficult to ignore.

Often, the afflicted has tried many sleeping positions and would just like to get back to sleeping on their side, which is most restful.

There are other symptoms that are common but not always present, The grip is weak on that hand and they have learned to be careful with things like a coffee cup. They may have pain in the back of the neck but usually don’t complain about that, at first. They may also have pain when reaching high overhead.

How You Activate and Intensify This Pain Pattern

Tucking in a shirt or reaching to the back seat is painful and aggravates the trigger point. It can be sharp when you extend their arm out to put something on the nightstand.

This pain pattern may come on quickly when there is a trauma to the shoulder. Common incidents include when the shoulder gets twisted against the front of the body in a fall. The shoulder may also get overstretched by a dog that jerks the shoulder forward on a leash.

If the trigger point is already mildly aggravated and the shoulder joint is binding, it can be intensified by reaching back suddenly or having the arm forced back. This can also happen when catching yourself in a fall or reaching back quickly to attend to a child in the car.

The trigger point is activated at night because sleeping on that shoulder has chronically pushed the humerus in the shoulder socket and the muscle has tightened to stabilize the shoulder. Just a trigger point doing its job.

Testing to Assess the Trigger Point

There are tests to see if the infraspinatus has active trigger points. They will produce pain in the shoulder when trigger points are active.

The first test involves placing the forearm across the low back. It usually produces pain in the shoulder. Pain worsens as you reach up the middle of the back. It is notable that this may also indicate trigger points in the coracobrachialis with a different pain pattern.

In the second test, one’s reach is restricted when reaching around the back of the head. You cannot reach the edge of your mouth without pain in the shoulder when there are trigger points in the infraspinatus.

The Musculoskeletal Anatomy Behind Your Pain

Effective relief starts with an understanding of the anatomy.

About the coloring of the illustrations…

This rotator cuff muscle externally rotates the glenohumeral joint. You can read more about that in this post about infraspinatus.

Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.

Treatment Notes for Therapists

Better Bodywork
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

Weekly Featured Post

Pain relief that is
quicker and more effective
than traditional stretching.

This post covers the basics of Ice-and-Stretch, a toll that is used extensively in these posts combined with Active Isolated Stretching and Yoga poses.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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