The Best Pillow for Side Sleepers With Shoulder Pain

Your shoulder doesn't stop hurting just because you've fallen asleep. Most nights, it never really gets to rest.

You have experienced the cycle of persistent pain. You may try sleeping on your left side, and an ache may emerge. If you choose to rotate to your right side, your shoulder might start to throb, and within minutes, you may find yourself in pain again. You may place a pillow between your arms and another behind your back and eventually drift off out of sheer exhaustion. Regardless of your efforts to adjust and find a distraction to sleep, you awake with the pain again.

While many people believe the problem is side sleeping, the larger problem is likely the pillow. If the pillow is too tall, it will push your head up and away from your spine. If it is too flat, your head will sink and your neck will become misaligned. Your neck will be out of alignment for the entire night, while your shoulder will be carrying a weight.

That is why changing positions rarely solves problems. Your head, neck and spine will be misaligned, and all the pressure will be transferred to your shoulder on the side you are lying on.

The truth is, you should not have to stop sleeping to start feeling amazing. You just need a good pillow!

This article goes over the features that make a pillow work for side sleepers and how to pick a pillow that actually lets you rest instead of causing soreness.

Why side sleeping loads the shoulder

Assessing this requires looking at how the body is positioned. When resting on the side, the shoulder becomes the base of a column. The head along with the neck and upper body, rest on top of the shoulder(s) causing the resting shoulder joint to compress under the body weight.

A shoulder pillow can alleviate the pain caused by an underlying frozen shoulder, arthritis or a rotator cuff injury. A pillow can reduce pain caused by compressive joints by preventing the shoulder joint from being unnaturally pinched by the body weight and posture. Although a shoulder pillow may not eliminate the pain, it should alleviate it.

Getting the height right

This is the most useful thing to fix, and also the easiest. Lie on your side with your regular pillow and have someone observe you from behind. Your nose must point straight ahead and your neck should be aligned with your spine, not tilted up to the ceiling, nor hanging down towards the mattress.

Almost all side sleepers require more loft than back sleepers, because there is a larger gap to fill between the ear and the bed. Even more loft is required for broader shoulders. If you have been stacking two pillows for years, then this is a clear indication that your single pillow is too thin. Not to mention, stacked pillows tend to shift and collapse unevenly throughout the night, and this is also the reason why the fix never lasts until the morning.

Firmness that lasts until morning

If a pillow feels perfect when you lie on it but flattens by 2 a.m., then it is not supporting you; it is just delaying the problem. For this reason, memory foam and latex tend to be better at retaining their loft than fibre-fill. Under constant pressure, fibre pillows compress and require constant fluffing.

The firmness of the pillow should also be aligned with the mattress. If the mattress is too soft, your shoulder sinks in, which reduces the gap your pillow needs to fill; so a slightly lower pillow is better. The opposite is true for a firm mattress.

The benefits of contoured pillows for side sleepers

A flat rectangular pillow does not offer support for your neck, so it must find support on its own. In contrast, a contoured pillow provides that support. Most contoured memory foam pillows feature a lowered central portion that cradles the head, while the outer sections are elevated on both sides. This design also helps maintain the cervical curve which prevents the head from rolling too far forward (the painful position that typically causes stiffness and soreness that people report after waking).

The AGEasy Cervical Pillow, like many other similar pillows, is designed this way. It has a contoured shape with the goal of providing support for the neck and shoulders to relieve muscle tension. According to the brand, it works for side and back sleepers. If you are moving from a soft pillow, anticipate an adjustment period; several users report that it takes a few nights before it feels normal.

The pillow most side sleepers forget

Your head pillow solves only half of the problem. The other half is your top arm.

When you sleep on your side, the top arm drifts forward and down, which pulls the shoulder blade into a rounded position and stretches the joint capsule for hours. By hugging a pillow to your chest, you support the top arm and rest it level and roughly parallel to the mattress. This takes the pull off the shoulder blade, and many find it more relieving than the head pillow itself.

A wedge pillow would also be worth considering. When the upper body is elevated, the direct pressure through the lower shoulder is reduced. Reviewers of the AGEasy wedge pillow often mention it as a substitute for the 3-4 pillows they had stacked to achieve the same effect. It may also help if reflux or breathing problems are contributing to restlessness.

What else helps with the pillow

Changing bedding is most effective when paired with daily routine improvements.

Before sleeping, some individuals find that relieving tension in their shoulders makes it easier to drift off. Techniques such as gentle warmth, and slow rolling of the shoulders, or massaging percussion in the muscle region of the shoulders (not directly at the shoulder joint) can help reduce muscle guarding that may make lying down unpleasant. AGEasy offers a compact massage gun perfect for evening use since it is quiet and comes with muscular attachments designed for the larger muscle groups, including the shoulder and back.

Posture during the day is also important. In the evening, a desk job with hours of forward-hunched shoulders will have already caused an irritated shoulder joint, which will make this experience painful. AGEasy's ErgoLift is a posture support belt that has been designed to gently shift the shoulders and upper back into a more upright position while sitting or standing for extended periods. This will not be a fix, but it can be a reminder while you develop the habit.

When a pillow won't be enough

When should you consider going to see a physician? You should consider going to see a physician if your shoulder pain is so bad that it wakes you up, you have difficulty lifting your arm up over your head or reaching behind you, you experience numbness and tingling that travel down your arm, or the pain started after you fell or were injured. These are all indications that there are more serious issues at play, such as a frozen shoulder or a ruptured rotator cuff. These conditions will not get better with a gentle supportive pillow.

Chronic pain can disrupt sleep, and sleep disruption from pain can over time result in a person's blood pressure increasing. Moreover, the long-term use of arthritic pain relieving medications that are classified as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can further concomitantly elevate blood pressure. Add elevated blood pressure to the list of potential negative consequences that could occur if your sleep problems are chronic and you use pain-relieving medication frequently. If you are one of those persons, consider monitoring your blood pressure at home and discussing the results with your principal care doctor.

A wrist blood pressure monitor is a simple and probably the most comfortable method to do so. The AGEasy BP Monitor has a one-button operation and a voice feature that reads the numbers out loud. This is especially useful for people who find traditional blood pressure cuffs to be either bulky or difficult to use. The results are only accurate if the same technique is followed. The wrist needs to be kept at exactly the same height as the heart at the same time every day.

How to Tell if Your New Pillow Helps

New pillows should be given two weeks for the body to adjust to them. After two weeks, the amount of stiffness you feel after waking should lessen. You should ideally be changing positions less throughout the night. When you are on your back, your shoulder should settle down. If nothing has improved at that point, the height is most likely the issue. Change the height to the next size before giving up completely on that dimension.

Summary

Choosing the right pillow is very important for side sleepers. They should choose a pillow that has the right height, remains supportive throughout the night, as well as supports the side sleeper's neck at a level position in line with their spine.

Adding a second hug pillow may be helpful to support the top arm as well as the top shoulder. Muscle relaxants may provide some relief. Keep in mind that changes should be given 2 weeks, but if pain is severe enough to require pain relief medications, to limit your daily activities, to disrupt your sleep, seek medical attention.

A good pillow will not fix the underlying issue, but will help some pain.