May 25, 2023/Chronic Pain

Best Sleeping Positions for Pain

Finding a neutral position can ease stress on your back, neck and shoulders

woman in bed shoulder pain

Does your lower back ache when you get out of bed in the morning? Or maybe your neck or a shoulder starts the day creaky? If so, this might be why: You’re overworking muscles when they should be off the clock.

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Awkward sleeping positions can put stress and strain on your body as you’re catching ZZZs, leading to pain when you should be rising and shining. But you can rest easier with a few modifications.

Chiropractor Andrew Bang, DC, has some advice to put you in the best position for sleep.

Why sleeping position matters

Your body takes a beating during the day. “As you move around, you put a lot of stress on your ligaments, muscles, tissue and joints,” says Dr. Bang. “Sleeping provides the opportunity for everything to recover and reset.”

But that recovery doesn’t take place as it could and should if you lie down in a position that puts tension on your body while you slumber. The result? Hello, aches and pains in the a.m.!

“Your goal should be to find a neutral posture when you sleep so those ligaments that stretched out during the day can shrink and creep back to their normal position,” states Dr. Bang. “Let your body truly rest and recover.”

Here’s how to find the restful position you need if you’re dealing with certain pain points:

Best sleep positions for back and neck pain

Good posture isn’t just important when you’re standing or sitting, notes Dr. Bang. It’s also key when you’re lying down.

Aligning your head, shoulders and hips puts your body in a neutral posture that eases stress. Your goal should be to find a position that maintains and supports the natural curves in your back and neck.

Let’s look at the three ways people sleep and what those positions do to your back and neck. (Spoiler alert: One is NOT ideal.)

Sleeping on your side

The side (or lateral) sleeping position is the most popular — and it’s loaded with opportunities to get your body out of line. Dr. Bang offers these tips to get it right:

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  • Avoid tucking in your chin. Try to sleep looking forward to maintain the natural curve of your neck. The goal is not to dip your head, a problem-causing pose during the day that’s the source of “tech neck” pain.
  • Use a leg pillow. Placing a pillow between your legs can help prevent your upper leg from pulling forward and twisting your torso. The pillow also works to keep your hips and spine aligned.
  • Stretch out. Getting longer can help reduce pressure on your lower back. Keep your thighs aligned with your torso and bend your knees back only slightly. (And as mentioned above, keep your head looking forward.)
  • Avoid the fetal position. Consider this an add-on to the last tip but one that deserves extra emphasis given how often folks curl up.
  • Alternate sides. Imbalances can develop if you only sleep on one side. “You’ll eventually end up causing yourself issues,” says Dr. Bang. The solution? Train yourself to sleep on both sides and switch regularly.
  • Pillow talk. Your pillow also should be thick enough to support your head and neck without letting it droop down. (Learn more about selecting the right pillow for you.)

Sleeping on your back

Want to put the least amount of pressure on your spine? Sleeping on your back is the way to go, says Dr. Bang.

But if you do sleep in this position, consider slipping a small pillow under your knees. This little lift works well with your spine’s natural curve and helps take a bit of pressure off your lower back.

“If your legs are flat, it can cause your lower back to arch too much,” he adds. “That’s especially true if you have tight hamstrings (the muscles at the back of your thigh), which is pretty common given how many hours a day most of us spend sitting.”

For your pillow, look for a height that keeps your head in a neutral position to reduce strain on your neck. A pillow that’s too low will send your jaw pointing toward the ceiling; too high, and your jaw aims toward your chest.

Sleeping on your stomach

Snoozing on your stomach doesn’t get the seal of approval from Dr. Bang. The reason? Lying face down on your bed can put you in an awkward position for long periods of time, putting pressure on your neck and lower back.

“If people come in with pain and they know it’s related to sleep, it’s usually stomach sleeping that’s the culprit,” he says.

Best sleep positions for shoulder pain

Let’s start with a basic fact if you’re trying to avoid an aching shoulder from sleeping: Gravity isn’t your friend. “You want to avoid your shoulder dipping down to meet the bed,” Dr. Bang advises. “That’s when you feel the pain.”

And it doesn’t take much. Just lying on your back, for instance, can leave your shoulder sagging a teeny bit. It’s enough to add strain to the joint, especially your rotator cuff.

A possible solution for back sleepers? Try resting your arm on a folded blanket or low-lying pillow to support your shoulder and keep it better aligned with your body. “All you’re trying to do is take a little bit of pressure off,” he adds.

If you sleep on your side with your bad shoulder up, you can minimize stress on the joint by using a pillow or pillows to keep that arm in a straight and more neutral position. (Switch sides less often if one shoulder is giving you more trouble.)

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Sleeping on your stomach once again comes with a caution sign. (Notice a trend here?)

“If you sleep facing down, it’s common to put your arm under your pillow,” notes Dr. Bang. “That is shoulder problem city. You’re really setting the stage for rotator cuff problems.”

Other tips to sleep pain-free

Getting your body ready to sleep also can set you up for a successful slumber. Dr. Bang suggests trying these bedtime tips if you’re regularly waking up with pain in the morning:

  • Stretch before bedtime. Taking a few minutes to stretch before bedtime can ease muscle tension that built up during the day. It’s a good way to avoid nighttime muscle cramps, too. (Interested? Try this bedtime yoga routine.)
  • Shower at night. An evening shower can relax and calm your body and move it into restoration mode. “It gets you into a resting state,” notes Dr. Bang.
  • Temperature control. A bedroom that’s too hot or too cold can make you twist, turn and contort — not the recipe for a restful night. “Temperature can lead to poor positioning and bad sleep,” he continues. So, focus on creating a comfortable environment.

Trial and error

The best advice when it comes to sleep position is simple: Do what works for you.

This is especially true if you’re dealing with sciatica, where the cause — be it a slipped disk, compressed nerve, spinal stenosis or other reason — may bring different needs for sleeping position. (Learn more about sleeping with sciatica pain.)

Bottom line? There isn’t one “right” sleeping position that guarantees a restful night and a pain-free morning. Experiment with positions and pillows until you find what works.

But one rule always applies: “If something leads to pain,” stresses Dr. Bang, “don’t do it.”

Learn more about our editorial process.

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