Impingement syndrome: Which sleeping position helps with shoulder pain caused by impingement syndrome? How can I get relief from impingement pain?

Shoulder problems while sleeping are a major burden for many people suffering from impingement syndrome .

The pain often worsens at night, especially in certain sleeping positions. Anyone who wakes up in the morning with a numb arm, throbbing pain, or a stiff neck knows the frustration that comes with disturbed sleep.

In this article, we explain what impingement syndrome is , why it often gets worse at night , and which sleeping position really helps so that you can finally sleep peacefully and pain-free again.

What is impingement syndrome?

Shoulder impingement syndrome occurs when tendons—usually those of the rotator cuff , especially the supraspinatus tendon or the bursae— become constricted at a narrow point under the bony shoulder roof (acromion) . For anatomical reasons, the humeral head is rotated in the socket, which can pinch the rotator cuff tendons and soft tissue, placing additional pressure on the shoulder. This constriction causes friction, inflammation, and pain in the shoulder, leading to immobility , especially when raising the arm or twisting.

Common causes are:

Overhead loads (e.g. during sports or at work)
Wear and tear with age
Muscle imbalances
Poor posture
Calcium deposits or bone changes

Impingement syndrome can occur unilaterally or bilaterally . Particularly distressing: The pain often worsens when lying down, especially at night.

🌙 Why is impingement pain often worse at night?

Many sufferers report that they suffer from shoulder pain primarily at night , even though they hardly have any problems during the day. Why does impingement syndrome have anything to do with sleeping position? There are several reasons for this:

1. Pressure on the tendons while lying down

Lying on your back or side can cause increased compression of the affected tendons. Lying on your side, especially on the affected shoulder, often places direct strain on the inflamed tissue.

2. Inflammatory processes

When at rest, blood circulation is reduced, which leads to inflammatory substances breaking down more slowly – the pain subjectively increases.

3. Tense muscles

After a long day, especially if you don't move much or sit for long periods, you may experience tension that leads to pain at night - especially in the neck and shoulder area.

4. Unsuitable mattress or pillow

A mattress that is too hard or sagging, or an unsuitable pillow, can disrupt the natural alignment of the shoulder and increase pressure on the joint.

The correct sleeping position for impingement syndrome. What I can do as a stomach sleeper to ensure restful sleep.

The good news: With the right sleeping position, the discomfort can be significantly alleviated—in many cases, even avoided altogether. Sleeping on your side or on your back: Should you sleep on your back if you have shoulder pain to avoid damage?

1. Back sleeping with pillow support

The best sleeping position for impingement syndrome is lying on your back . This places the least strain on the shoulder. It's important to position the arm slightly flexed – for example, with a flat pillow or a towel under the elbow. This keeps the space under the shoulder roof open, and the tendons are relieved.

💡 Tip: A small neck pillow or an ergonomic neck roll can help maintain the natural position of the cervical spine and avoid tension.

2. Side position – but correctly

If you prefer to lie on your side, avoid lying on the affected shoulder . Sleep on your healthy side and support the affected arm on a pillow in front of your body . This relieves pressure on the shoulder joint and prevents it from being pulled into the painful position.

Lying on the painful side increases the pressure and usually worsens the symptoms.

3. Avoid lying on your stomach

Sleeping on your stomach is generally not recommended for shoulder problems as it causes an unnatural twisting of the shoulder and cervical spine.

This can further worsen symptoms – especially in cases of impingement or rotator cuff irritation.

If you want to avoid shoulder and back pain associated with shoulder impingement syndrome, you should change your sleeping position. We recommend sleeping on your back!

🧘 More tips for better sleep with shoulder pain. Exercises for rotator cuff muscle relaxation and impingement syndrome.

In addition to the sleeping position, there are other measures such as special exercises that you can use to reduce your nighttime shoulder pain and promote regeneration :

Heat or cold applications

Applying warmth before bedtime can help relax tense muscles and relieve pain.
In cases of acute inflammation or nighttime stinging, cold (e.g. a cooling pad) can have a soothing effect.

Gentle stretching exercises before bed

Light mobilization exercises, stretching, or shoulder pendulum exercises can help improve mobility and relieve pressure on the tendon. This reduces pressure on the affected shoulder, allowing the tendons and bursa to relax, and can help relieve discomfort.

Avoid strong stretching or overhead movements – these often irritate the shoulder further.

Ergonomic sleeping environment

Make sure you choose a medium-firm mattress that provides good support for your shoulders and spine.
If necessary, use orthopedic pillows to properly support your head and neck.
Avoid pillows that are too high – they tilt the shoulder forward.
Try sleeping on your back without a pillow so you can wake up easily in the morning.

🩺 When should you seek medical advice?

Not all shoulder pain goes away on its own. If you...

have pain when sleeping for more than two weeks , or can no longer sleep on the affected shoulder without pain.
the arm is no longer properly mobile ,
or you suffer from significant loss of strength ,

...you should definitely consult a specialist in shoulder disorders . At our Munich practice, we perform a targeted shoulder examination – including modern imaging diagnostics such as ultrasound or MRI .

This way we can determine with certainty whether impingement syndrome , rotator cuff irritation or another cause is responsible for your symptoms – and initiate the appropriate treatment .

Treatment of impingement syndrome. What treatment options are available for shoulder impingement?

Conservative therapy:

Physiotherapy with targeted muscle building and improvement of mobility
Manual therapy to improve joint mechanics
Injections with anti-inflammatory drugs
Shock wave therapy for chronic irritation
Kinesiotaping for relief

Surgical therapy:

If conservative measures are insufficient, arthroscopic surgery may be beneficial. This minimally invasive procedure expands the space beneath the acromion , allowing the tendons to glide freely again.

In the vast majority of cases, however, surgery is not necessary if treatment is started early and if the sleeping position is adjusted .

Conclusion: Sleeping position is crucial for impingement syndrome

Proper sleeping position plays a crucial role in relieving shoulder pain caused by impingement syndrome .

In particular, lying on your back with pillow support or lying on your side on the healthy shoulder can significantly reduce the symptoms.

Combined with targeted physiotherapy, pain management and an adapted daily routine, the shoulder can often be completely stabilized and relieved without surgery .

📅 Do you regularly wake up with shoulder pain?

Let us determine whether impingement syndrome is the underlying cause. At our shoulder practice in Munich, our shoulder specialist Prof. Ockert, a specialist in orthopedics and trauma surgery, will provide you with personal, individualized advice.

He will help you confirm the diagnosis, rule out damage to the rotator cuff, prevent damage to the shoulder area, and explain how you can achieve pain relief and inflammation reduction – so that you can finally sleep peacefully again and start the day pain-free.

Make an appointment now with our specialist :