Neck and Low back pain are the most common complaints seen by Family Physicians in Canada. 

As Physiotherapists we often get asked…

What position should I sleep in?

What pillow should I use, do I need more than one?

A sore neck can worsen with poor sleeping habits, however, it can the very cause as well. 

After all, we spend about 1/3 of our life either sleeping or trying to do so. Making minor adjustments to the way you sleep can really help manage and prevent neck pain.

Let’s discuss which sleeping positions are most likely to help you manage your neck pain. As well as, what else you can do before bed to help minimize discomfort.

Ideal sleeping positions for neck pain

The position that you sleep in will greatly affect your quality of your sleep. If you’re dealing with neck discomfort, the best positions to sleep in are on your back or side. These are both much less stressful on your spine than sleeping on your stomach.

Sleeping on your back

Sleeping on your back helps maintain your spine’s natural curves. You can use a thinner pillow in this position than you would when sleeping on your side. Your head position should be only slightly raised so that it’s at a similar angle as when you’re standing. Your ears should be in line with your shoulders. Use your camera phone to look at yourself from the side to see if this is the case!

Using a cervical pillow (these have a minor curve on the bottom of the pillow to support the natural curve of the neck) a memory foam pillow can help support your head or neck as well. Typically, some women and/or children who are a smaller stature, memory foam or can overcorrect your neck position. This is because the neck is shorter and the head smaller ( lighter) thus leaving the head a bit forward (ear would be in front of shoulder not in line). This is where you can take a photo or ask a loved one to do so. If you drew a straight line from the middle the ear to the middle of your shoulder it should be parallel to the bed NOT diagonal. 

If you have sleep apnea or snore you may want to try sleeping on your side instead of your back.

Sleeping on your side

Sleeping on your side is one of the best ways to keep your head neutral (maintain ideal curvature), with your chin straight ahead. If your chin is poking upwards, it’s as though you are looking up. This causes compression in the neck. Try and think of tucking you chin down a bit, as though you are trying to give yourself a double chin. When sleeping in this position, it’s a good idea to use a pillow high enough to keep your neck neutral but not so high that your upper ear is forced toward your shoulder. If looking at you from the back the spine should be parallel to the bed. Not side bent up or down.

Avoid sleeping on your stomach

If you’re dealing with neck or low back pain, it’s very important to avoid sleeping on your stomach. When laying on your stomach you end up “extending” your low back (this causes back pain). Extending your low back means you are arching or doing a back bend. This causes much compression of the spine and doing so for a prolonged period is problematic for your back health.

For your neck, when sleeping on your stomach you end up having to turn your head completely to one side. Then you add a pillow, or two, or maybe even your hand under the pillow +/- your arm as well. This will also extend or compress your spine. Sleeping on your stomach your neck endures a prolonged rotation stress (often to the end of the neck’s range, thus further torsion pressure, like wringing a towel). Then you add in the compression of extension, and it is that much worse on your spine.

Best way to sleep with neck pain

Your spine naturally arches in three places. It curves forward at your neck and lower back. It curves the other way in your upper back. Setting up your bed to best maintain these natural curves can help you minimize neck or back pain.

It may be difficult to change your sleeping position since your preferred position is often determined early on in your life.  However, over time with practice you’ll become much more comfortable as the new position becomes familiar and reduces your pain. You will also get a more restful sleep as well because you won’t be waking up during the night in discomfort. It can just take some getting used to. Practice makes perfect!

You can also try using a soft feather pillow that forms to your head better.

If you sleep on your back: 

If you sleep on your side:

Physiotherapy can be an effective treatment option for individuals experiencing neck and back pain. Visit our physiotherapy centre on Henderson today to book an appointment.

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If you cannot find an appointment time that best suits you please contact the clinic OR email your physiotherapist and we will do our best to accommodate you!