Part of Golfer's elbow
Sleeping position and night pain with golfer's elbow
Warning signs, and when to get help
What is the best sleeping position for golfer's elbow?
There is not a tested one. We would rather say so than hand you a diagram somebody drew for a magazine.
OrthoInfo, the patient site of the American Academy of Orthopaedic Surgeons, is the main source we use for this condition, and its symptom list for medial epicondylitis is short: pain or burning on the inner elbow, shooting pain that occasionally travels toward the hand, a grip that has gone weak, and wrist or elbow movement cut down by the pain. Numbness and tingling in the ring and pinky fingers turn up in some patients. Nights are not on that list. Neither is swelling, and neither is a lump, which is why swelling, lumps and bruising at the elbow is a page of its own.
Two patient sources do say the pain can cost you sleep. The Royal Orthopaedic Hospital, an NHS hospital in Birmingham, writes that for most people the pain comes on only when the forearm is being used, and that for some people it is constant, occurs at rest and can affect their sleep. The NHS page for tennis elbow, the same kind of tendon problem on the outer side, describes pain that ranges from mild discomfort to constant pain that can affect your sleep. So broken nights belong to this family of problems even though the condition's main source does not list them.
That leaves a position with two jobs, both of them mechanical and neither of them a treatment. One is to keep your own body weight off the inner side of the elbow. The other is to stop the elbow sitting folded shut for hours at a stretch. Work out which of the two your night needs, and the set-up follows from it.
Why does golfer's elbow hurt more at night?
Nobody has measured this at the inner elbow, so what follows is reasoning from the sources plus what we see in clinic, and it is worth reading in that order.
The useful clue is when in the night it happens. A tendon that has been gripping all day tends to be sore in the evening and through the first part of the night, and that soreness is the day catching up rather than the bed doing anything. A nerve behaves the opposite way round. It needs a position held for a long time, so it tends to arrive in the second half of the night, and it wakes people with fingers rather than with pain.
OrthoInfo's cubital tunnel page gives the reason plainly. A bent elbow aggravates compression of the ulnar nerve, most people sleep with their elbows bent, and what that produces is fingers that are asleep when you wake, either in the night or in the morning.
That difference is the most practical thing on this page. If you can put a fingertip on the sore spot and reproduce it by gripping something, you are dealing with the tendon. If the ring and little fingers feel dead, thick or buzzing and the elbow itself is not especially sore, read golfer's elbow or a trapped nerve at the elbow before you reorganize the pillows, because a position will not settle the first problem and the right position is most of the answer to the second.
One more honest limit. The golfer's elbow program notes that the ache at rest and the evening soreness are usually the first things to ease, which makes a quieter night an early sign a program is working. That is a clinical observation on our own page, not a measured finding, and we give no timeframe for it because no source we could read gives one.
Can a sleeping position cause golfer's elbow?
Not according to anything we can source, no. OrthoInfo's causes are activities: overhead throwing, tennis, weightlifting, golf, and repetitive activities of daily living such as certain household chores. The Royal Orthopaedic Hospital links it to repeated or strenuous bending of the wrist. A tendon needs load to get into this state, and a sleeping arm is not loading anything.
The version of this question that does have an answer is about the nerve. A folded elbow held all night is exactly the position OrthoInfo says aggravates ulnar nerve compression, which is why "I think I slept on it" so often turns out to be numb fingers rather than a sore tendon.
If you woke with genuine inner elbow pain and cannot account for it, the day before is a better place to look than the mattress. A long drive, a weekend of hand tools, a bag carried by its handle or a first session back in the gym all show up hours later. If it is training that keeps doing it, gym, lifting and grip work with golfer's elbow goes through what to change first, and why golfer's elbow is not getting better covers the pattern when that keeps happening.
Where the arm goes if you sleep on your side or your front
Side sleeping gives you two arms in two completely different situations, and the medial elbow cares about both.
The arm underneath is the one that gets pressed. Roll onto your side and the inner elbow can finish up flat against the mattress, and that is the funny bone side, where the ulnar nerve runs closest to the surface. OrthoInfo's advice for that nerve is to avoid leaning on your elbow or putting pressure on the inside of your arm, and a night on a mattress is leaning. Slide that arm out in front of you so the forearm takes the contact instead of the elbow point.
The top arm curls. Left to itself it comes up toward the face with the elbow shut, which is the shape most people describe when they wake with dead fingers. Something solid in front of you at about chest height, long enough to carry the whole forearm, is what stops it. The cubital tunnel syndrome page has the towel method for keeping the elbow long, and if it is your wrist and thumb side that wake you rather than your elbow, how to sleep with carpal tunnel is the page for that.
Front sleeping is the position nobody asks about and the one most likely to shut both elbows. Hands under the pillow, hands under the head, arms folded up beside the head: every version of it bends the elbows and often presses one of them as well. If you sleep face down and wake with numb fingers, start there before you change anything else.
Lying on your back is the easiest way to keep an elbow long, because a forearm resting beside you on the mattress or on a thin pillow has nowhere to fold to. From about 28 weeks of pregnancy the NHS advises going to sleep on your side rather than on your back, because it says sleeping on your back after that point can double the risk of stillbirth. So use the side set-up above, with the forearm carried on a pillow in front of you, and leave lying on your back until after the birth. The NHS also says not to worry if you wake up on your back: settle onto your side again and carry on.
Does a night splint, a strap or an elbow pad help?
They are three different objects and only one of them is aimed at the tendon, which is why people end up wearing the wrong one to bed.
A forearm strap is for activity. OrthoInfo puts a forearm strap, also called a counterforce brace, and a wrist brace among the early treatments a doctor might offer, and the golfer's elbow program records that research on straps for this condition is limited, so it is a support for the exercises rather than a replacement. Take it off if your fingers start to tingle. Nothing in the sources we use asks anyone to wear one asleep, and a device aimed at a hard grip has little to do with an arm that is not gripping anything.
A splint or pad that keeps the elbow straight at night belongs to the nerve. OrthoInfo's version for ulnar nerve symptoms is a towel wrapped loosely around the straight elbow, or an elbow pad worn backward, and it adds that loosely wrapping a towel around the arm with tape helps you remember not to bend the elbow during the night. What the one trial of a night splint found, and what it did not find, is on the cubital tunnel syndrome page rather than here. We give no wearing time for either device, because that is a decision for the clinician who has looked at your arm.
What to do when it wakes you
Unfold the arm before anything else. Straighten the elbow, get the inner side of it off the mattress and off your own ribs, and let the forearm lie flat somewhere with the hand free.
If the fingers are the problem, give them a minute or two with the elbow long before you decide anything. Numbness and buzzing that clear once the elbow opens tell you what the night was doing, and that is information worth having in the morning.
Resist the urge to run a session at two in the morning. The staged exercises and their numbers live on the golfer's elbow program, where you can judge them against the next day, and a set done half asleep tells you nothing about either. That program is written for an elbow managed without an operation. If you have had surgery on the elbow, follow the program your surgeon or physio gives you rather than this one.
What to write down takes ten seconds and settles the question this page opened with. Note whether it was pain or numbness, which fingers if any, what the arm was doing when you woke, and how long it took to settle. A week of that is more use to a physio than any attempt to remember it in the appointment.
Why the first hour of the morning is the sore one, and what that tells you
The morning is where the two stories separate most clearly, so it is worth paying attention to the first hour rather than resenting it.
Soreness that eases as you start moving about, and comes back as soon as you grip something firmly, is behaving like a tendon. Numbness or pins and needles that clear within a few minutes of straightening the arm are behaving like a nerve that was folded all night. Both can be true in the same arm, because the nerve runs just behind the tendon, and the golfer's elbow program asks you to tell your physio if you have pain and tingling together.
The morning after is also the measure the program itself uses. Rather than restate the rule here, use the one on the golfer's elbow program, which sets out in full what discomfort is accepted during a session and what a worse morning means for the load. If your nights and your mornings are both going backward over weeks, why golfer's elbow is not getting better is the page to read next.
When night pain means more than a bad night
Everything above is written for pain that answers to a position or to what the day held. A few patterns do not, and they are the reason this page carries a warning list instead of only a set of pillows.
One of them has nothing to do with the elbow and belongs at the top of any page about an arm that has gone numb or weak overnight. A face that droops, an arm you cannot hold up, speech that has gone slurred or muddled, or weakness or numbness down one side of the body means calling emergency services, even if it passes off. The list below gives the full set of signs.
Pain that is there at night or at rest and keeps getting worse is the first. If you are being treated for cancer now, that means contacting your cancer team the same day. If you have had cancer at any point, or you are losing weight without trying, it means seeing your doctor sooner, within a day or two, and saying so. Without either of those, it still needs a doctor within a few days. All three sit on the list below in their own words.
An elbow that is hot, red and swollen, or elbow pain with a high temperature or feeling hot, cold or shivery, needs medical advice the same day and an emergency department if you feel very unwell. If it is swelling you have noticed rather than pain, swelling, lumps and bruising at the elbow sorts out what the different kinds point to.
Then there is the hand. Pins and needles that do not go away once you have straightened the arm and got up, or part of the arm or hand that stays numb, needs medical advice the same day rather than another night of moving pillows about. A hand that is getting weaker, fingers that feel clumsy, dropping things, or muscle that looks thinner or hollow next to the other hand needs a doctor within a few days, and the same day if the weakness is getting worse day by day. For symptoms in the ring and little fingers that come and go, OrthoInfo advises seeing a doctor if they are severe, or if milder symptoms have lasted more than 6 weeks. The reason it puts a time limit on that is on the cubital tunnel syndrome page: muscle lost to a nerve that has been squeezed for a long time does not come back.
For everything else, the ordinary route is the right one. The NHS asks you to see a GP if elbow or arm pain has not gone after a few weeks, and nights that keep waking you are part of that picture rather than a separate complaint. The other problems in this area that can keep you awake are on the elbow pages. Anything on the list below needs acting on at the timing its own line gives.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
- Chest pain or tightness, which may spread to your arm, neck or jaw, or shoulder or arm pain that comes with shortness of breath, sweating or feeling sick. This can be a heart attack. Call emergency services straight away.
- Your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
Get help today
- The elbow is hot, red and swollen, or you have elbow pain with a high temperature or feel hot, cold or shivery. Get medical advice the same day, and go to an emergency department if you feel very unwell. This can be a sign of infection in the joint, which needs treatment quickly.
- The pain is there at night or at rest and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.
- Pins and needles in your arm or hand that do not go away after you stop, or part of your arm or hand goes numb. Get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
Book an appointment
- The pain is there at night or at rest and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
- The pain is there at night or at rest and keeps getting worse. See your doctor within a few days.
- Your hand is getting weaker, you keep dropping things, your fingers feel clumsy, or the web of muscle between your thumb and index finger, or the little finger side of your palm, looks thinner or hollow compared with your other hand. This can mean the nerve behind the elbow is being squeezed. See a doctor within a few days. If the weakness is getting worse from day to day, get medical advice the same day.
- You have numbness, tingling or pins and needles in your hand or fingers, most often the ring and little fingers. Stop any exercise that brings it on and see a physio or doctor. For the ring and little fingers, OrthoInfo advises seeing a doctor if the symptoms are severe, or if milder symptoms have lasted more than 6 weeks.
Common questions
How do you sleep with golfer's elbow?
With the elbow as long as you can keep it, and with nothing pressing on the inner side of it. No source names a position for this condition, so treat that as the principle rather than a prescription. Lying on your back with the forearm resting beside you, on the mattress or on a thin pillow, is the easiest way to keep an elbow from folding, because a straight arm on a flat surface has nowhere to go. On your side, bring the top arm forward onto something at about chest height so the forearm is carried along its length and the hand does not travel up toward your face, and slide the lower arm out in front of you rather than leaving its inner elbow pressed into the mattress. From about 28 weeks of pregnancy the NHS advises going to sleep on your side rather than on your back, because it says sleeping on your back after that point can double the risk of stillbirth. So use the side set-up above, with the forearm carried on a pillow in front of you, and leave lying on your back until after the birth. The NHS also says not to worry if you wake up on your back: settle onto your side again and carry on.
Is golfer's elbow worse at night?
For some people, yes, and there is a patient source that says so plainly. The Royal Orthopaedic Hospital's golfer's elbow leaflet says that for some people the pain is constant, occurs at rest and can affect their sleep. The NHS page for tennis elbow, which is the same kind of problem on the other side of the elbow, describes pain ranging from mild discomfort up to constant pain that can affect your sleep. OrthoInfo's medial epicondylitis page is the odd one out: its symptom list covers pain or burning on the inner elbow, shooting pain toward the hand now and then, a weak grip, and movement at the wrist or elbow reduced by the pain, and it does not mention nights. So a sore night is not unusual, and it is also not the part of this condition anyone has studied. Pain at night or at rest that keeps getting worse is a different matter, and the warning list on this page gives it a timeframe.
Should I wear a brace or a night splint for golfer's elbow?
Those are two different devices with two different jobs, and only one of them is about the tendon. A forearm strap is an activity device: OrthoInfo puts a forearm strap, also called a counterforce brace, and a wrist brace among the early treatments a doctor might offer, research on straps for golfer's elbow is limited, and the golfer's elbow program says to use one alongside exercise rather than instead of it, and to take it off if your fingers start to tingle. Nothing in the sources we use asks you to wear one in bed. A splint or pad that holds the elbow straight at night is nerve advice, not tendon advice. OrthoInfo's version for the ulnar nerve is a towel wrapped loosely around the straight elbow, or an elbow pad worn backward, and what the one trial of a night splint actually found sits on the cubital tunnel syndrome page. Ask your own physio or physical therapist before you buy either, because the two are not interchangeable.
How do you rest golfer's elbow?
In bouts, rather than by putting the arm away. The Royal Orthopaedic Hospital leaflet puts it in those terms: let the elbow and wrist rest between spells of activity, or stop your sport for a few weeks, and it says that helps, because the tendon needs time. An activity that causes pain is worth changing if you are able to and avoiding if you are not. The same leaflet suggests spreading the load to the larger muscles of your shoulder and upper arm, and using the least force you can or a bigger grip size. None of that is the same as rest in the sense of doing nothing: OrthoInfo describes exercise as the main treatment, and the staged program and its numbers are on the golfer's elbow program. Your physio will adjust the loading to your elbow.
References
- American Academy of Orthopaedic Surgeons. Medial epicondylitis (golfer's elbow). OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/medial-epicondylitis-golfers-elbow/
- American Academy of Orthopaedic Surgeons. Cubital tunnel syndrome (ulnar nerve entrapment at the elbow). OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/ulnar-nerve-entrapment-at-the-elbow/
- Royal Orthopaedic Hospital NHS Foundation Trust. Golfer's elbow/medial epicondylitis. https://roh.nhs.uk/services-information/therapy/golfers-elbow
- NHS. Tennis elbow. Page last reviewed 31 May 2024. https://www.nhs.uk/conditions/tennis-elbow/
- NHS. Elbow and arm pain. Page last reviewed 26 January 2024. https://www.nhs.uk/symptoms/elbow-and-arm-pain/
- NHS. 27 weeks pregnant: the best sleeping positions during pregnancy. Best Start in Life week by week guide. https://www.nhs.uk/best-start-in-life/pregnancy/week-by-week-guide-to-pregnancy/2nd-trimester/week-27/
- NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.