Positions and Neck and Back Pain. Understanding the Connection Between Sleep Positions and Neck and Back Pain

Sleep PositionsBack Pain

Ah, sweet slumber. But how sweet is it when we wake up with neck or back pain? The reality is our sleep position can greatly contribute to spinal woes, according to Kaliq Chang, MD, of Atlantic Spine Center.

“Ideally, sleep is an escape from the hard stuff happening every day, not another reason we face more difficulties,” explains Dr. Chang, an interventional pain management specialist. “But sometimes the way we sleep and the positions we start the night in and those we twist ourselves into during the wee hours end up triggering disturbing neck and/or back pain.”

The Importance of Sleep Position for Neck and Back Health

If you already deal with lingering back or neck pain, whether from age, injury, or another reason, it’s important to understand that your sleep position can make this situation better or worse, Dr. Chang notes.

“There’s no question that back or neck pain can make falling or staying asleep harder,” he adds, “but changing your sleep position can also take some stress off your spine and make it more likely you’ll get restorative shuteye.”

The Best Sleep Positions for Neck and Back Pain Relief

Why does your sleep hygiene matter to your spine? For the simple reason that sleeping in certain positions places additional pressure on parts of your neck, shoulders, hips, and lower back. All these areas, of course, can end up suffering from the “wrong” position, leading to an aching neck or back and musculoskeletal disorders, Dr. Chang explains.

Finding the right sleep positions can significantly alleviate neck and back pain, ensuring a more restful and rejuvenating sleep. Sleeping on your back with a supportive pillow under your head and neck can help maintain a neutral spine alignment. Choose a pillow that adequately supports the natural curve of your neck. Placing a small pillow under your knees can also reduce pressure on the lower back. If you prefer to sleep on your side, place a supportive pillow between your knees to keep your hips, pelvis, and spine aligned properly. Additionally, use a contour or cervical pillow that fills the space between your neck and the mattress to support your neck's natural curve.

Curling up in the fetal position can be beneficial for those with herniated discs or degenerative disc disease. While sleeping on your side, draw your knees towards your chest and place a pillow between your knees for added support.

Elevating the head of your bed slightly (using an adjustable bed or wedge pillow) can help relieve acid reflux and reduce pressure on the lower back. However, ensure the incline is not too steep, as it may strain the neck.

The Worst Sleep Positions for Neck and Back Pain

The top offender? Sleeping on your stomach. The belly-down pose flattens the natural curve of the spine and necessitates rotating your neck, which can trigger pain at the base of the neck between the shoulders, he adds. Sleeping on your stomach is generally not recommended for those with neck or back pain, as it can strain the neck and lower back. However, if you prefer this position, use a thin pillow or no pillow at all to reduce stress on the neck.

On the other hand, there’s one action you can take that almost always benefits the spine: frequently changing your sleep position throughout the night.

Other Factors Affecting Neck and Back Pain During Sleep

“Sometimes we’re aware we’re moving about, rolling over or adjusting our pillow during those hazy moments of sleep,” Dr. Chang says. “Shifting position definitely helps take pressure off the spine. If you’re able, try to move your body as one unit when rolling over, not twisting or bending at the waist while your face is aimed in another direction. This too will cut down on spine strain.”

Tips to tackle position-related pain

Beyond those basics for modifying sleep position to avoid aggravating your back or neck, Dr. Chang offers these tips for less pain:

  • Back sleeper? You can place a pillow under your knees to help maintain your spine’s natural curve.
  • Side sleeper? “Pull your legs up slightly toward your chest and sleep with a pillow between your knees,” Dr. Chang suggests.
  • Stomach sleeper? Place a pillow under your lower belly to ease back strain.

If you’re noticing that a well-placed pillow can help optimize spine position regardless of sleep style, then it’s also wise to understand how much your pillow choice matters when in its normal place, under your head. Along those lines, Dr. Chang recommends choosing a pillow that’s not too high or too low but feels as if it’s simply supporting the natural curve of your neck. Some people achieve more comfort by using two pillows or taking one away, he adds.

Pillow Choice and Its Impact on Neck and Back Pain

Choosing the right pillow can have a significant impact on neck and back pain, as it directly affects the alignment of the spine and the support provided to the head, neck, and shoulders during sleep. The right pillow can promote a more neutral spine position, alleviate pressure points, and reduce strain on the neck and back muscles. Here's how pillow choice can impact neck and back pain:

  • Proper Spinal Alignment: A supportive pillow helps maintain proper alignment of the spine while sleeping. Whether you sleep on your back, side, or stomach, the pillow should support the natural curve of your neck and keep your head and neck in line with your spine.
  • Neck Support: A pillow that provides adequate neck support can help relieve neck pain and stiffness. Contour or cervical pillows are designed with a shape that fills the space between the neck and the mattress, providing proper support to the cervical spine.
  • Pressure Relief: The right pillow can distribute weight evenly and reduce pressure points on the head, neck, and shoulders. This can help alleviate discomfort and prevent the development of pain in these areas.
  • Comfort and Sleep Quality: A comfortable pillow ensures better sleep quality, as it provides good ergonomics, it allows you to rest peacefully without constantly adjusting your position due to discomfort or pain.
  • Preventing Strain and Injury: The wrong pillow, such as one that is too high or too flat, can strain the neck and back muscles, leading to pain and potential injury over time.

“It’s a red flag when you wake up with neck or back pain,” Dr. Chang says. “If you do, pay close attention to your sleep position and pillow use, as those are huge elements leading to aches and pains. Since we spend about a third of our lives asleep (or hope to!) tweaking these factors is time well spent.”