How to Sleep With a Frozen Shoulder

One of the worst things about frozen shoulder is the lack of sleep. Sleep is crucial for healing and recovery, so not getting enough quality sleep can be detrimental to your rate of recovery. In this article we share some key advice of how to sleep with a frozen shoulder. 

 

Using a Massage Gun for better sleep with frozen shoulder

Massage can be done by self through massage guns or a lacrosse ball. Massaging the small muscles of the shoulder like the pectorals, deltoid, and trapezius, with a massage ball can be painful in the inflammatory phase of the frozen shoulder. In this case, a low-intensity massage with a flat device head can help to soothe the muscles, improve flexibility for a short time and flush out the inflammatory metabolites. 

 

Best sleeping position for the frozen shoulder:

Sleeping on the other side of the affected shoulder with a pillow under the armpit of the affected one. This is the easiest solution, but if you are turning frequently in sleep, the painful side gets compressed intermittently and that again disturbs the sleep.This can be managed by sleeping on a recliner or using the support of pillows on the affected side.

Using pillows and cushions to improve your sleep:

Sleeping in supine or on the straight back position: 

This position can also be supported well with the pillows under the arm.

 

Sleeping in a quarter-turn reclined/side-lying position by keeping the pillows under the affected side:

This position elevates the affected side up and even if you tend to turn sides, the pillows would be there to block it.

 

Modified Foetal Position

Most of us tend to sleep in this easy-to-go position. Sleeping on the non-affected side in this position can be well supported with the pillows between the knees, under the head, and one supporting the arms.

 

In case of acute pain and swelling, biofreeze spray can be the preferred modality. But for any muscle spasm and fascial tightness issue, moist heat or a heating pad before you sleep generally works the best

 

Sleeping Positions to avoid:

  • Sleeping side lying on the aching shoulder gives the utmost pain. 
  • Also sleeping on the stomach frequently puts the shoulder in an elevated position which further strains the upper trapezius and increases the shoulder pain

Using a TENS Machine for better sleep

TENS machine helps in numbing down the pain by blocking the thinner pain carrying neural fibres. It is not a treatment modality but definitely can help to tone down the pain just before one sleeps. 

 

Read more about TENS machines for frozen shoulder

 

Magnesium Oil:

Magnesium has been used to relieve muscle cramps and facilitate recovery of the overworked muscles.Transdermal application of magnesium oil, helps in rapid absorption and  avoids any gastrointestinal distress symptoms which come with oral ingestion.  A warm water ipsum salt bath combines the dual benefits of magnesium and heat therapy and gives full body relaxation. Magnesium supplementation can also help in easing pain, but it should be taken according to the recommended dietary allowance along with a physician consultation.

 

THC/Cannabis Edibles:

Depending on where you live and applicable laws, THC, the active ingredient in cannabis, can help with sleep and pain management. 

THC edibles are not approved by FDA and frequently the composition of the compounds are not stringently regulated by the sellers.THC a derivative of Cannabis is the main psychoactive substance responsible for sense of giving a high. Used as a potent sedative and pain reliever in neuropathic pain and intractable cancer, it may have a longer sleep inducing effect.It has potential side effects of varying intensities on those who consume it. The research on use of THC edibles, specific to shoulder pain is lacking and may have some benefit in chronic cases not responding to other modalities of treatment. It is very important with regards to safety  to take any psychoactive substance with a prior consultation with a doctor in accordance with the legal laws of the country.

 

CBD (Cannabidiol):

Cannabidiol (CBD), also a derivative of cannabis, does not contain any psychoactive substance giving a high. CBD oil, through its anti-inflammatory effects, can be used as an adjunct to improve sleep and reduce pain. Though high-level evidence lacks for the use of CBD, specific to the frozen shoulder, it can be used with precaution and as an adjunct  when available as a well-regulated product.

 

Melatonin:

Melatonin is a sleep inducing hormone naturally produced by the body through the pineal gland in the night when the darkness sets in. Melatonin is available as a supplement and not controlled as drug by FDA and also as a drug Ramelteon, which is basically a melatonin receptor agonist.  Both of them influence the melatonin action and help in sleeping.Melatonin has a fewer side effects like drowsiness, headaches and dizziness and are seen when it is overdosed. It can be a good supplement for short term use for sleep induction.

 

Medications:

Anti-inflammatory/OTC Drugs:

Naproxen and acetaminophen, the OTC drug helps in controlling inflammation and blocking the pain and also have some effect on relaxing the muscles.

 

Muscle relaxants:

Muscle relaxants are generally not sold over the counter and when prescribed by the physician can surely help.

Timing the medications:

These medications especially in the inflammatory phase should be taken an hour before the sleep. Medications taken too early can lose their effect in the middle of the night due to their short half-life and bring back the pain. Hence the medications need to be timed well with the sleep schedule, following with the dosage and physician’s advice.

 

Cortisone:

A steroid shot coupled with physiotherapy has been shown to reduce the inflammation and pain with a long term effect. It is important to avoid repetitive steroid shots in shoulder as it affects the tendon health in long term, hence the use of exercise is important to sustain the effects of the steroid and maintain the pain free range of motion. Getting a cortisone shot isn’t a decision you make before going to bed tonight, but getting a shot can help you reduce pain and inflammation for several weeks, helping you get some sleep. 

You can find out more about Cortisone Injections and Frozen Shoulder here. 

Hydrodilatation:

Hydrodilatation is the infusion of combination of saline, steroid and local anaesthetic in the shoulder joint capsule to distend it and cause micro-ruptures. It can help in giving good short term results and improving function, but long term evidence for its use is inconclusive and deficient.

 

Sleep Hygiene:

Good sleep hygiene which incorporates environmental and behavioral modifications helping to facilitate a deeper sleep. Like:

  1. Following regular sleep timings which affect your circadian rhythms
  2. Reducing the use of bright lights and screen time
  3. Abstaining from caffeine use near sleep time 
  4. Avoiding alcohol use to facilitate sleep as it slows down the healing
  5. Managing stress well and not ruminating at night by following relaxation techniques, mindfulness, and breathwork techniques like box breathing before you sleep.
  6. Avoiding noise and making use of soothing music or the podcast  of choice to fall asleep.