Let’s chat about sleep positions. Firstly, there is no wrong way to sleep. However you rest and find comfort, that’s great! If you’re having pain, waking often, noticing numbness, or just find it’s difficult to get comfortable, you may benefit from one of the ideas contained in this article. As always, these are meant to be educational, I have not evaluated your individual needs and it’s best to speak with a licensed medical professional for personal tailoring.
Sleep is when our body does its best recovery. You remodel cells, transfer memories into long term storage, and get nutrients into joints. The discs in our spines imbibe with fluid overnight which can commonly cause pain or soreness in the morning for those with a disc bulge or stenotic changes. It’s also the reason you’re taller in the morning! We need these hours of recovery and it’s important they be as un-interrupted as possible.
When we sleep, it’s ideal for our spine to be in a neutral- or relatively straight position. This means that we don’t want the neck bent too far up or down, and we don’t want the rest of the spine super twisted or with exaggerated curves.
Let’s isolate out some of the common reasons people have pain in the night, and small changes that may help.
Low Back Pain
If you’re waking up during the night or in the morning with low back pain or stiffness, it may be due to sleep position. You don’t necessarily have to change your sleeping position all together, but if some modification of that position isn’t helping, it could be worthwhile to change, even if temporarily.
The Stomach Sleeper
This can be a tough position for the spine since often we increase the lordosis (curving in) of the lumbar (lower) spine in this position.
Try placing a pillow (not too puffy) under your hip bones and lower core which helps raise your hips slightly to be more comfortable for longer durations.
The Side Sleeper
Sleeping on your side can be great for low back pain, it lets you get some space into the joints if you curl your legs in slightly. However, for some with wider hips, smaller legs, or a small waist and wide hips and shoulders it may cause some low back or hip pain.
Try placing a regular bed pillow (not a couch pillow, and not too flat of a pillow) between your legs fully from the knees to the ankles- the pillow will be longways- to help even out the space between your legs and take some tension out of the low back. If you have a small waist, you can put a pillow or rolled up towel under your waist to help decrease the space.
The Back Sleeper
Sleeping on our backs can pull our hips forward slightly increasing the lumbar lordosis and causing pain at night.
Try putting a pillow under your knees or calves- be aware of the potential for increased pressure on the heels- to alleviate some of the lumbar lordosis and help relax the back muscles. Adjust up or down slightly to your comfort.
Neck Pain
Waking during the night from neck pain or numbness and tingling can be frustrating. It may also be difficult for you to find a comfortable position to fall asleep in. By using these simple tricks with a bath towel or hand towel you can rest more comfortably!
Let us begin by discussing pillow position- YES! There is such a thing!- Your pillow belongs under your head and neck ONLY. The pillow should not come down underneath the shoulders. Say it with me now- head and neck only!
Side Sleeper
If you sleep on your side on a flat pillow, sometimes the bottom of the pillow isn’t fluffy enough to fill the space between your shoulder and head and keep a neutral spine alignment.
Try taking a bath towel (the larger ones) and folding it so it’s the size of your pillow lengthwise. Then roll up the towel on the long side (so it stays as long as the pillow) and then push it into the bottom of your pillowcase. It will sit in front of the actual pillow inside the casing. Now, when you lie on your side, you should feel more support under your neck.
Back Sleeper
If you’re someone who sleeps on their back, you may have questions about how many pillows to use. While this is a multifactorial issue (sleep apnea, congestion, GERD, thoracic kyphosis, etc…) the goal is still to keep your spine in a neutral position. If you feel like your pillow is just too flat, but two pillows is too high…
Try folding a bath towel to be the same size as your pillow. You can use one, or even two towels depending on the height you need. Place these towels inside the pillow case on the bottom side of your pillow. This will raise the entire height of the pillow slightly while keeping some firmness underneath.
When changing any of the above, if the changes make anything worse, stop right away. That’s not the goal here! If it’s just hard to get used to, but it helps you feel better, give it a few nights to try and adjust. Prolonged pain, numbness, or severe pain are all causes to seek medical help, as a pillow or positional adjustment alone may not be enough. Having a through evaluation to seek out the root cause will also help you dial in any changes that need to be made.
Did they help? Have you tried any of these in the past? Often these changes are temporary while we work on the long term solution that lets you sleep soundly and wake up without stiffness or pain.
Be resilient to the finish.
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