How you sleep may cause shoulder pain!

Shoulder pain can make a simple act like grabbing something overhead seems like a monumental task. In this report by Sade Oguntola, experts say its causes are numerous, aside from sleeping on the side.

You might wake up in pain, thinking, “What did I do to my shoulder yesterday?” Well, the real reason could be how you sleep. Experts  say sleeping on the side is not always the best.

Without doubt, most people have a favourite sleeping position, but sleeping on the same side every night may be the reason for waking up with an aching shoulder.

Unfortunately, shoulder pain can make a simple act like brushing teeth, combing of hair, reaching behind your back to fasten your dress or grabbing something overhead seem like a monumental task.

Shoulder pain is a common issue due to the complexity of that region of the body. Uneven pressure due to overuse, disuse, sprain or strain can be strong enough to cause inflammation and pain in muscles and tendons.

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With age, individuals are more likely to experience shoulder pain from a variety of common conditions.

“Shoulder problems are very common. At least, one in five patients in the orthopaedic clinic will complain of a shoulder pain which may be due to different factors,” said Dr Diamond Tamunokuro, an orthopaedic consultant, University of Port Harcourt Teaching Hospital, Rivers State.

He stated that causes of shoulder pain are age-related. Younger people experience more trauma and rotator cuff injuries but older people experience more shoulder pain due to degenerative changes such as arthritis of the shoulder.

Rotator cuff injuries are typically caused by injury, tissue degeneration, or shoulder impingement. A group of muscles and tendons stabilise the ball-and-socket joint of the shoulder with a “cuff.” These muscles and tendons can be injured from a fall or accident or chronic causes (repetition or overuse).

According to him, “Generally sleeping position can cause pain or stiffness in the joints. An awkward sleeping position, particularly among drunks, can cause aching shoulder, even though this is not the major cause of pain in the shoulder or upper outer part of the arm.”

Dr Tamunokuro said that major causes of shoulder pain are from shoulder problems such as injury, degenerative problems like arthritis, nerve problems, and other soft tissue injuries like a shoulder sprain or SLAP tear.

He adding that sometimes the cause of the painful shoulder may be as a result of a problem in the neck or other parts of the body.

Unfortunately, several of these common sources of shoulder problems cause increased pain at night or during periods of rest. The pain in the shoulder makes it difficult to get a good night’s sleep.

However, he warned that people with shoulder pain need to seek medical care promptly. According to him, treatment of shoulder pain will be determined by its cause.

More worrying signs that may present with shoulder pain include weakness, loss of movement or instability. These additional symptoms warrant more expedient investigation.

Although, many people with shoulder pain resort to massaging the aching shoulder or applying menthol balm, he said the temporary relief derived will not allow them to go promptly to the hospitals for treatment.

According to him, “where the pain is caused by something more sinister, the temporary relief will prevent its proper evaluation and treatment. After seeing an orthopaedic surgeon, its cause will be clearer and then appropriate medications can be given.”

Professor Kolapo Hamzat, a consultant Clinical Neurophysiotherapist at Department of Physiotherapy, University of Ibadan, however, stated that sleeping posture has nothing to do with shoulder pain unless there is an underlying problem in that shoulder joint.

He declared that such an underlying problem may be in the neck region.  According to Professor Hamzat, “Spondylosis of the neck in its early stages can cause pain in the shoulder. If the individual now sleeps and positions the neck in an arkward manner, the pain will spread from the neck to the shoulder. Sometimes, the pain may spread towards the elbow or wrist.”

He declared that with correct sleeping position and placement of the pillow, it is possible to prevent the pain in the neck transferring to the shoulder.

Professor Hamzat said when experiencing stiffness in the neck region, they should see a doctor or a physiotherapist so that the problem can be addressed promptly.

He said, “That is why you see many people wearing a neck or cervical collars. The pain starts gradually or abruptly, and it may range from mild to excruciating. It can spread to the arm, tips of the finger and so on as it advances. Some people experience a peppery or burning sensation around their shoulder or arm region.”

Research suggests that not just sleep position, but sleep itself, can play a role in musculoskeletal pain, including neck and shoulder pain. During sleep, the concentration of weight on one side of the body may be the direct cause or aggravating factor, often resulting in a stiff shoulder or arm.

In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with and without sleeping problems. Sleeping problems included difficulty falling asleep, trouble staying asleep, waking early in the mornings, and non-restorative sleep.

They found that people who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who that reported little or no problem with sleep.

One possible explanation is that sleep disturbances disrupt muscle relaxation and the healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.

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