Sleeping positions for back, neck and shoulder pain

Which sleeping position eases lower back pain?

Side sleeping with the knees slightly bent and a pillow between them, or back sleeping with a pillow under the knees, eases most lower back pain. MedlinePlus recommends both for acute low back pain, because each keeps the pelvis and spine in a relaxed middle position rather than twisted or arched.

On your side, the pillow between the knees stops the top leg from dropping forward and twisting the pelvis. A small rolled towel under the waist helps if you have a wide pelvis and the spine sags toward the mattress. On your back, a pillow or two under the knees flattens the low back slightly, which many people with stiff morning back pain find soothing.

If you can only sleep on your stomach, place a thin pillow under your hips and lower belly to reduce the arch in the low back, and use a very flat pillow or none under your head.

How should I set up pillows for neck pain at night?

Use a pillow that fills the space between your ear and the mattress on your side, or supports the curve of your neck on your back, so your head stays level with the rest of your body. The NHS recommends a low, firm pillow and advises against sleeping on your front with neck pain.

Too many pillows push the head forward or sideways all night, and too few let it drop; either can leave you with a stiff neck in the morning. Side sleepers with broad shoulders usually need a thicker pillow than back sleepers. Some people tuck a small rolled towel into the bottom edge of a pillowcase to support the neck curve. The neck pain after sleeping page explains why a single awkward night can cause days of stiffness.

How can I sleep with a painful shoulder?

Lie on your back or on the pain-free side, and support the painful arm on a pillow so it does not fall forward across your body or get trapped under you. On your back, a pillow under the elbow and forearm keeps the shoulder in a neutral, relaxed position.

On the good side, hugging a large pillow lets the sore arm rest at chest height instead of hanging down. Lying directly on a painful shoulder compresses the irritated tendon or joint and is a common reason people wake at 3 AM. Some people with severe night pain, for example during the freezing stage of frozen shoulder, sleep propped up in a recliner for a while; that is fine as a short-term measure.

After shoulder surgery, follow your surgeon’s instructions about the sling and sleeping position, which take priority over general advice. The shoulder pain at night page covers the common causes of night-time shoulder pain.

Does my mattress matter for back and neck pain?

A mattress matters less than position, but it should support you without sagging. The NHS suggests a firm mattress for neck pain, while very hard surfaces can be uncomfortable for side sleepers, so medium-firm is a common compromise.

A mattress that has developed a dip will tilt your spine every night; rotating it or adding a firm topper is a cheaper first step than replacing it. Test any new mattress by lying in your usual position for several minutes, and remember that many retailers offer trial periods. If you share a bed, a partner’s heavier weight can tip you toward the middle, which side sleepers with hip or shoulder pain often notice. People with hip pain when sleeping on their side frequently do better with a softer top layer.

How do I get out of bed with back, neck or shoulder pain?

Roll onto your side first, drop your legs off the edge, and push up with your arms while your legs swing down, keeping your head and trunk moving together. This avoids the sit-up motion that strains a sore back and neck.

If one shoulder hurts, roll toward the good side and push up mainly with the good arm. Morning stiffness that eases within 30 minutes of moving is common with back and neck pain and usually improves with a short walk, a warm shower and a few gentle movements such as the cat-cow. If stiffness lasts much longer every morning, mention it to a clinician, because prolonged morning stiffness can point to inflammatory conditions.

When should night-time pain be checked by a professional?

Get checked if pain wakes you every night regardless of position, if you cannot find any comfortable position, or if night pain comes with fever, weight loss you cannot explain, or a history of cancer. Those patterns need a physician first.

For mechanical pain that eases when you change position, a physical therapist can find which movements and positions provoke it and build a plan around them. In Indiana you can see a therapist directly for up to 42 calendar days. Through the network, pick your main area in the questionnaire for neck, back or shoulder pain and a person on the matching team proposes an independent therapist near Carmel. The neck pain physical therapy page explains what treatment usually looks like.