Best Sleeping Positions for Back, Neck and Shoulder Pain

Finding a neutral position and the right mattress and pillow helps your body rest and recover
woman in bed shoulder pain

Does your lower back ache when you get out of bed in the morning? Or maybe it’s your neck or a shoulder that starts the day creaky?

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If so, this might be why: You’re overworking muscles when they should be off the clock.

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. And your mattress and pillow might be adding to your agony.

You can rest easier, though, with a few modifications. Let’s get some tips from chiropractor Andrew Bang, DC

Why your sleeping position matters

Your body takes a beating during the day. “You put tension on your ligaments, muscles, tissue and joints,” says Dr. Bang. “Sleeping provides the opportunity for everything to recover and reset.”

But if you lie down in a position that maintains tension on certain body parts while you slumber, that recovery doesn’t take place like it could and should. The results? Hello, aches and pains in the a.m.!

The problem only grows as you age, too, as the cartilage that cushions your joints wears down. (That’s why getting out of bed at age 60 sounds vastly different than when you spring up at age 20.)

“Your goal should be to find a neutral posture when you sleep,” says Dr. Bang. “The idea is to avoid adding any fatigue. Let your body truly rest.”

Best positions for back pain

Good posture isn’t just important when you’re standing or sitting, says 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.

Here’s how.

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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  • Try to avoid tucking in your chin. Instead, focus on maintaining the natural curve of the neck. Your pillow should be thick enough to support your head and neck without letting it droop down.
  • Put a pillow between your legs to 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. Keep your thighs aligned with your torso and bend your knees back slightly, which can help reduce pressure on your lower back. Keep your head looking forward.
  • Avoid the fetal position.
  • Switching sides can help reduce the chance of imbalances developing.

Sleeping on your back

If you sleep on your back, consider slipping a small pillow under your knees, says Dr. Bang. This little lift works well with your spine’s natural curve and helps take some pressure off of your back.

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.

Avoid sleeping on your stomach

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,” says Dr. Bang.

Best positions for shoulder pain

Let’s start with basic if you’re trying to avoid an aching shoulder from sleeping: Gravity is not your friend. “You want to avoid your shoulder dipping down to meet the bed,” says Dr. Bang. “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.

The solution for back sleepers? Rest 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,” notes Dr. Bang.

If you sleep on your side with your bad shoulder up, use a pillow (or pillows) to keep that arm in a straight and more neutral position to minimize stress on the joint.

What type of mattress is best?

Appropriately, a bedtime story offers the best game plan for selecting a mattress. Basically, take the Goldilock’s approach: Not too soft and not too hard, but just right. That’s typically a mattress that carries a medium-firm designation.

“Starting on the firmer side of things allows you to make adjustments as needed,” says Dr. Bang. “You can add softness to a mattress by using a foam topper.”

One word of caution, though: Manufacturers use their own methods to rate and describe firmness, as there’s no set standard for the industry. That means a medium-firm from one company might feel vastly different from a medium-firm from another.

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So when you’re buying a mattress, take the time to test it out in a showroom to see if it feels right, says Dr. Bang.

How often should you replace your mattress?

It’s possible to buy a mattress with a 20-year or 30-year warranty. The product may even hold up that long for you. Here’s the issue, though: Your body can change a lot over a few decades, notes Dr. Bang.

“What you’re looking for in a mattress will probably change as you age,” says Dr. Bang. “What’s right for the 30-year-old you might not be the best choice for the 50-year-old or 60-year-old version of yourself.”

Given that, it’s best to change mattresses about every eight to 10 years — especially if you’ve experienced physical changes such as an injury or a significant weight gain or loss.

Picking the right pillow

Remember “memory foam” when you’re pillow shopping. The sponge-like material contours to your body, combining the comfort you crave with ample support for your head and neck, says Dr. Bang. (Fun fact: Memory foam was developed by NASA.)

Memory foam pillows come in multiple forms, with the top three being contoured, shredded and block (in order of most used). “At that point, it comes down to personal preference,” says Dr. Bang.

As for other options:

  • Feather pillows offer little in the way of through-the-night support for your head and neck. “They don’t hold their shape,” notes Dr. Bang. “By morning, they’re smushed and there’s almost nothing under your head.”
  • Synthetic fill pillows tend to break down quickly, says Dr. Bang: “They lose their fluff to the point where you’re not getting the support you really need. They’re just not that durable.”

Whatever choice you make, though, watch to make sure the pillow maintains its shape and support. Memory foam pillows can last up to three years.

Trial and error

The best advice when it comes to sleep position is simple: Do what works for you. There isn’t one “right” position that guarantees a restful night and a pain-free morning. Experiment with positions and pillows.

And the No. 1 rule? “If something leads to pain,” says Dr. Bang, “don’t do it.”

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