Optimal Sleeping Positions for Chronic Pain

Tompfeiffer
6 days ago
3 min read

If your chronic pain is greatest upon waking up, one likely cause is your sleeping posture. Finding the right sleeping position can ease discomfort and improve sleep quality. Among various options, side-lying and back-lying positions stand out as the most supportive for those dealing with persistent pain. This post explores why these positions work best and how to adjust them for maximum comfort.

Choosing the Right Pillows and Mattress

The right bedding can make a significant difference in comfort and pain relief. If your bed is too soft it can cause back pain, but if it's too hard it can cause shoulder pain. Most people benefit from a firmer mattress and a softer pillow top to provide underlying support while maintaining comfort. Generally, side-sleepers prefer a softer bed as this reduces pressure on the shoulder. If you move a lot when you sleep then a harder mattress would serve you better as it more easily allows you to change positions without excess effort.

Pillows should support natural spinal alignment. Memory foam or contour pillows work well for neck support. If your pillow is too tall it can cause you to have chronic neck pain.
Body pillows can help maintain side-lying posture and reduce rolling during sleep.

Experimenting with pillow placement and mattress types can help find the best combination for your pain relief.

Why Sleeping Position Matters for Chronic Pain

Sleeping posture directly affects the spine, muscles, and joints. Poor alignment during sleep can increase pressure on sensitive areas, worsening pain. For example, stomach sleeping often forces the neck to twist and the lower back to arch unnaturally, which can intensify discomfort in those regions.

Choosing a position that supports natural spinal curves helps reduce strain. It also promotes better circulation and muscle relaxation, which are essential for healing and pain management.

Benefits of Side-Lying Position

Side-lying is widely recommended for people with chronic pain, especially those with back, neck, or hip issues. It's the best option for a majority of people, so if you're not already doing it, I recommend giving it a try. This position keeps the spine aligned and reduces pressure on the lower back.

Man in palm tree shirt demonstrates side sleeping on a bed with a pink sheet, using pillows. Text: Side sleeping position.

Diagrams showing spine alignment while lying sideways. Top: no pillow, spine twisted. Bottom: pillow between knees, spine aligned. Text explains.

How to Make Side-Lying More Comfortable

Use a firm pillow under your head to keep your neck aligned in a neutral position.
Place a pillow between your knees to prevent the top leg from pulling the spine out of alignment.
Place a small towel under your waist if your hips are wider than your waist.
Keep your legs slightly bent to reduce tension in the hips and lower back.
Keep your hips slightly behind to promote hip mobility and a neutral spine

This setup helps maintain a neutral spine and reduces muscle strain. Side-lying also improves breathing and reduces acid reflux and snoring, which can disrupt sleep.

Advantages of Back-Lying Position

Sleeping on your back evenly distributes weight across the body and supports the natural curve of the spine. It prevents unnatural twisting of the neck and reduces pressure points.

Man on bed with striped pillows, wearing palm tree shirt. Left: Incorrect neck posture with red X. Right: Correct posture with green check and "Elongate the neck" text.

Man in floral shirt lying on bed with pillow under legs, text warning against this position. Red X mark. Room has soft pink tones.

Man in a palm tree shirt lies on a pink bed, one leg out, resting on a pillow. Text reads about reducing stress on spine, improving mobility.

Tips for Comfortable Back Sleeping

Use a supportive pillow under your head that keeps your neck aligned without pushing it forward.
Avoid thick pillows that elevate your head too much, as this can strain the neck.
Place a small pillow or rolled towel under your knees to maintain the natural curve of your lower back, but avoid using a large pillow under the knees as this can tighten up the hamstrings.
Placing one leg bent to the side can reduce stress on the low back and help to maintain hip mobility.

Back-lying is especially helpful for people who find side-sleeping intolerable.

Why Stomach Sleeping Should Be Avoided

Sleeping on the stomach is the least recommended position for chronic pain sufferers. This posture forces the neck to turn sharply to one side, which can cause neck strain and stiffness. It also flattens the natural curve of the spine, putting extra pressure on the lower back.

People who sleep on their stomach often experience increased pain in the neck and lumbar regions. If stomach sleeping feels most natural, try transitioning to side or back sleeping gradually by adjusting pillows and mattress firmness. If you need, you can also search for a stomach-sleeping pillow that helps to make this position less harmful.

Changing Positions When Sleeping

Man demonstrating abdominal bracing, pressing fingers inward and pushing out laterally, in a room with brick walls. Text describes actions.

Diagram of human respiratory process showing diaphragm contraction, glottis closing, and intra-abdominal pressure. Labels with arrows indicate action.

Some people experience pain when changing positions. If this is the case, learn how to brace your core before moving to avoid the strain on your back.

Additional Tips for Better Sleep with Chronic Pain

Check out this article for more tips on improving your sleep quality.

Maintain a consistent sleep schedule to improve overall sleep quality.
Practice gentle stretching or relaxation exercises before bed to reduce muscle tension.
Keep your bedroom cool and dark to create a restful environment.
Avoid caffeine and heavy meals close to bedtime to prevent sleep disturbances.