Whole body and everyday aches

Pain that wakes you at night: when it is positional and when to get checked

Written by Lance Peterson, GOsC-registered osteopath · Last reviewed October 2026

Why aches are often worse at night, how to tell positional pain from pain that needs a medical check, and practical steps for sleeping with pain.

Many aches feel worse at night, because you are still, and because pressure on a sore shoulder, hip or back in certain positions can keep irritating it. Positional pain that eases when you change position is common and usually mechanical. Pain that is constant, severe or wakes you whatever position you are in is different, and should be checked by a doctor.

When to get urgent help

Call 999 or go to A&E straight away if night pain comes with any of these.

Chest pain or pressure, breathlessness, sweating or feeling faint
A drooping face, weakness or numbness in an arm, slurred speech or sudden confusion
Numbness around the genitals, buttocks or inner thighs, loss of bladder or bowel control, or weakness in both legs
Severe pain with a high temperature, shivering and feeling very unwell

What it can feel like

Pain when lying on a particular side, which eases when you turn over
Waking with a stiff, achy back, hip or shoulder
Numb or tingling hands at night or on waking
Pain that wakes you and does not ease when you move, or constant pain unrelated to position, which needs checking

Common contributors

Lying on the painful side. NHS trust leaflets note that lying on the sore shoulder or on the outer hip can aggravate rotator cuff-related shoulder pain and outer hip pain, and suggest pillows to support the arm or between the knees
Osteoarthritis flare-ups and general stiffness after lying still
Nerve irritation, such as carpal tunnel syndrome, which commonly causes tingling and numbness at night
Long-term pain and poor sleep reinforce each other, as the NHS says long-term pain can disrupt sleep
Less often, an inflammatory condition or another medical cause. An NHS leaflet describes inflammatory back pain as waking you at night and improving on getting up

General self-care

These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.

Experiment with positions and pillows. For shoulder pain, rest the arm on a pillow or put a pillow behind your back. For outer hip pain, put a pillow between your knees, or try sleeping on your back
Stay active in the day and avoid long periods of sitting, as movement helps stiffness
The NHS suggests keeping a regular sleep routine, getting up at the same time every day, avoiding caffeine, alcohol and nicotine for six hours before bed, relaxing for an hour before bed, and not exercising within four hours of bedtime
A warm bath or heat pack before bed can help some people relax tight muscles
If you use over-the-counter pain relief, follow the packet instructions or ask a pharmacist

When to see your GP

See your GP promptly, or call NHS 111, if you have any of the following:

Pain that is constant, severe or getting worse, and does not ease whatever position you are in
Pain that wakes you every night, or is not easing with rest
Unexplained weight loss, a lump or swelling, or feeling generally unwell
A history of cancer and new, persistent pain
A hot, red, swollen joint

Consider seeing your GP if:

Call 999 for chest pain, breathlessness, signs of a stroke, numbness around the genitals, loss of bladder or bowel control, or weakness in both legs
Pain that is constant, severe or getting worse, does not ease with rest or when you change position, or wakes you every night. The NHS lists pain that is worse at night or does not ease with rest as a reason to see your GP for back pain
Night pain with unexplained weight loss, a fever, feeling generally unwell, a lump, or a history of cancer
A hot, red, swollen joint, or pain and morning stiffness lasting longer than 45 minutes with aching in both shoulders or hips, particularly if you are over 50

Where an osteopath fits in

There is limited good-quality research showing that hands-on treatment changes the course of pain that wakes you at night, so I do not claim that osteopathy treats it.

What an osteopath can usefully do is ask about the pattern, examine the area, work out whether the pain looks positional or mechanical, advise on positions and sleep, and recommend that you see your GP promptly if the pattern does not fit. I would not treat constant night pain that is unrelated to position until it has been medically assessed. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.

If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.

Book an appointment

Common questions

Why is my pain worse at night?

When you lie still, pressure on a sore shoulder, hip or back, and stiffness from lying in one position, can aggravate it. Fewer distractions at night can also make pain feel more noticeable. If the pain is constant, unrelated to position or getting worse, see your GP.

When is night pain a worry?

The NHS lists back pain that is worse at night or does not ease with rest as a reason to see your GP. Night pain with unexplained weight loss, fever, feeling unwell or a history of cancer should be checked promptly.

How can I sleep with shoulder or hip pain?

NHS trust leaflets suggest resting the arm on a pillow or putting a pillow behind your back for shoulder pain, and a pillow between the knees, or sleeping on your back, for outer hip pain.

Sources and further reading

Links open in a new tab. Sources were checked in October 2026.

Related guides

This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.