Understanding the Connection Between Sleep Positions and Neck and Back Pain

By Kaliq Chang, MD

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.

Ideally, sleep is an escape from the hard stuff happening every day, not another reason we face more difficulties. But sometimes the way we sleep – 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.

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.

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

How sleep position affects the spine

Why does your sleep position 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 of these areas, of course, can end up suffering from the “wrong” position, leading to an aching neck or back.

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.  

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.

Sometimes we’re aware we’re moving about, rolling over or adjusting our pillow during those hazy moments of sleep. 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, I offer 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.
• 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, I recommend 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.

It’s a red flag when you wake up with neck or back pain. 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.

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com, www.atlanticspinecenter.nyc

Kaliq Chang, MD, is an interventional pain management specialist board-certified in anesthesiology at Atlantic Spine Center.