7 Sleep Positions That Can Tame Your Pain

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March 21, 2019
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Improving your nighttime posture can relieve discomfort and keep your joints healthy and strong.

Best and Worst Sleeping Positions

Your favorite sleep position comes down to one factor: comfort.

Problem is, what’s comfortable tonight may lead to considerable discomfort tomorrow: a crick in your neck, a tingling arm, maybe even heartburn.

That’s because we naturally shift our bodies during the day to avoid discomfort, says Scott Bautch, D.C., president of the American Chiropractic Association’s Council on Occupational Health.

But when we’re out cold, we can stay stuck in an odd position until it causes enough pain to wake us.

Odd sleeping postures become more common as we age, because we tend to have less “range of motion” in our joints.

In other words, it’s really important to rethink—and rearrange—your sleep position to ensure you get the rest you need.

Shift into Neutral at Night

Fixing your sleep posture, says Bautch, can not only relieve pain right away—it can prevent it.

The key is to put your body into a “neutral” position, or where no part of the body is stretched, wedged, squashed, or twisted, says physical therapist Kathleen Walworth, P.T., D.P.T., of Athletico Physical Therapy in Brooklyn, Michigan.

What that looks like: Your skeleton is properly aligned with your spine in a healthy c-shape curve, your head isn’t too high or low on the pillow, and your limbs are in a position that you could hold comfortably for hours.

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Sounds simple, right? Trouble is, the best neutral position changes with certain health conditions.

Here are some healthy ways to adjust your sleep position based on any current aches, pains, and health problems—plus some extra pillow placement tips to make it easier to stay in the right sleep posture all night long.

Your Condition: Back Pain
Best Sleep Position: Your Back

According to W. Chris Winter, M.D., author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It, your spine is happier when you sleep on your back.

Resting on the belly accentuates the curves in your lower back and neck, making them go up and down in an s-shape like a roller coaster. Sleeping on your back, he says, allows your lower back to remain in the natural c-shape curve you were born with.

To take pressure off your lower back, slide a pillow under your knees. If you’re a habitual side sleeper, slip a pillow between your knees for a more neutral posture.

If you simply can’t break the habit of stomach sleeping, lay on top of a pillow (place it from chest to hips), which will straighten those back curves.

Your Condition: Neck Pain
Best Sleep Position: Your Back or Side

When you sleep on your stomach, you have to rotate your head to breathe, putting your neck in a dangerously awkward position.

And if your most beloved sleep companion is an overly fluffy pillow, you might want to consider parting ways. It may be putting your neck and spine alignment out of whack.

For an easy way to check the suitability of your current pillow, lie on your bed on your back with your head on your pillow—then take a selfie or look in a hand mirror. If the photo shows the skin on your neck bunching up, you need a thinner pillow.

Your Condition: Shoulder Pain
Best Sleep Position: Your Back or “Good” Side

The shoulder joint has a greater range of motion than many other joints, making it easier to move and also easier to overextend—and injure.

If you have a shoulder that’s injured or otherwise tweaked, you’ll be better off lying on your back or “good” side, using a pillow to support your “bad” shoulder.

For side sleepers, try tucking a pillow under your bad arm to stabilize it on top of the side of your body. This will keep your arm in a neutral position and prevent it from falling forward—and further extending your shoulder. For back sleepers, prop your bad shoulder up on an extra pillow to keep it from slipping back.

Your Condition: Heartburn
Best Sleep Position: Your Left Side

Heartburn (or acid reflux) happens when stomach acid backs up into the esophagus instead of staying where it belongs.

Like sleep apnea, heartburn is a condition that’s worsened by sleeping on your back. Interestingly, thanks to your body’s internal layout, lying on the right side of the body can make it worse.

If you can, elevate the head of your bed by at least 30 degrees. An easier approach might be sleeping with a wedge pillow. In any case, elevating your entire torso is important for preventing acid backwash.

The best results, according to studies, come from elevating the bed and lying on the left side of your body.

Your Condition: Hip or Knee Pain
Best Sleep Position: Your Back or “Good” Side

If you sleep on your back, placing a pillow behind your knees takes pressure off the hips and creates a slight bend in the knees, which also takes pressure off of these joints.

If you sleep on your side, the pillow between the knees keeps the knees from stacking (with the top leg’s bones digging into the bottom leg). It also prevents the hips from rotating or sagging during the night.

Choose a medium-firm pillow. Women may need a thicker pillow than men, as most women’s hips are wider––but be sure to experiment with what is most comfortable for you.

And if you keep winding up on your bad side during the night, try putting a supportive foam mattress topper on your bed. This can help distribute pressure more evenly across the sore joint.

Your Condition: Sleep Apnea
Best Sleep Position: It Depends

Obstructive sleep apnea is a condition that happens when the airways collapse during breathing. As you suck in a breath, the airway “seals off” and air can’t reach your lungs, which makes you “gasp” for breath and (often) snore.

Lying on your back only makes matters worse, as gravity helps pull the airway shut and lets your tongue slide back to further block the opening.

If you suspect you have sleep apnea, don’t try to self-diagnose or self-treat. This can often lead to serious health problems, so be sure to consult with your doctor before deciding what sleeping position is right for you.

Your Condition: Sore Wrists
Best Sleep Position: Your Back

The worst way to sleep if you have carpal tunnel syndrome is to curl up on your side with your wrist bent and tucked underneath you.

That’s because you already have extra pressure on the nerve that runs through the carpal tunnel—a passageway that leads from the wrist to the hand.

Wearing a wrist splint at night on your affected hand can help limit wrist movement. If a splint is bothersome, just try to keep your wrist as straight as possible without it—and don’t tuck or twist it underneath yourself.

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