We have had a string of real bad shoulders roll into the office in December (most often accompanied by their owners). Rotator cuff problems are extremely common and everyone can expect at least one bad episode in a lifetime. For some, the problem will be more chronic.

In previous posts, we have talked about shoulder treatment, but today I wanted to give you a tip for a very common quality of life issue for chronic should pain sufferers: Sleep. If you have any sort of narrowing in the area of the lateral shoulder (shoulder impingement syndrome), any pressure over the area, or anything that even slightly pushed the shoulder upward will make sleep very elusive, with a domino effect on the rest of your life that is pretty ugly.

The obvious long term solution is to correct the problem (neck/blade alignment, shoulder alignment and muscular balance). But even so, some shoulder soft tissue damage can be semi-permanent and so will the limitations associated with how much pressure it can tolerate. The questions about sleeping position, pillow, and mattress remain. The generic recommendation is to have a thick enough pillow to support the full distance between your head and shoulder, as well as 2-3 inches of soft top layer on the mattress to cradle the shoulder tip. In most extreme cases, there is a sleep system that will allow you to sleep on your side in an elevated position while completely taking off the pressure from the shoulder by distributing on a wedge supporting your trunk and head and letting your shoulder dangle through an opening. With a price tag over $200 it is certainly an investment that should be reserved for the people who have serious long-term sleeping disruption from an unresolvable shoulder issue, but in that case it could make a difference in quality of life.