A question we get in the clinic often is about sleeping with pain. Specifically, is there an optimal sleeping position for someone with back pain, neck pain, etc. If you are sleeping in a position that is promoting tightness or putting excessive strain on the joints or surrounding tissues, you are likely exacerbating your injury. In this article we will explore some optimal positions to minimize strain on your injury site and allow for the most comfort while sleeping.
An important factor in the healing process of any injury is avoiding aggravating healing tissue. If you continue to flare up the injury and do not allow the body to repair the injured tissues, you’re likely to feel pain for much longer. Primarily, this applies to things you do while awake. The low hanging fruit is making appropriate activity modification and avoiding motions that increase pain. (Sitting at a desk or in the car with poor posture, bending poorly through the back, etc) Once you have identified and eliminated those triggers, we can begin to look at things you are doing overnight.
Changing the way you sleep can be difficult and often even with the best of intentions, you’ll wake up in a different position. We will talk about some tricks to help you modify your position, but often it can take a bit of repetition.
In a lot of conditions, you are typically feeling or noticing your pain more as you begin to lay still and attempt to fall asleep. Part of this is taking away any distractions while part may be due to your position.
In nearly all conditions keeping you awake, placing ice on the painful area before bed can help to numb the area. Place ice on the area for no more than 15-20 minutes. Any longer will not make the tissue less sensitive. You will likely get an ice burn if you exceed the appropriate time.
Neck Pain
If you are suffering from neck pain, we want to put the spine in a neutral position while sleeping. One thing we certainly want to avoid - sleeping on your stomach. Stomach sleeping is the hardest position for your neck as you stretch one side of your neck to full rotation and you hold that position for a long period of time. This pulls on joints and stretches the ligaments and capsules of the neck.
We also want to avoid sleeping with multiple pillows under your head. If you place too many pillows, you will have your head pushed too far up towards the sky placing excessive strain on your neck. Whether you sleep on your side or your back, one pillow is likely enough to keep your neck in a neutral position.
Try keeping your neck in a neutral position allowing for the normal curve of the cervical spine (a reverse C) by sleeping on your back and placing support under your neck. To do this, take a small towel and roll it up. Get rid of your pillow and substitute the roll. This roll should be placed behind your neck horizontally, in the middle of the normal curve of your cervical spine (usually in the middle of your neck).
Shoulder Pain
If you are suffering from shoulder pain, you’ve likely already realized that sleeping on your side with the bad shoulder down is not a good position. We want to avoid putting too much stretch on your rotator cuff and shoulder by avoiding side sleeping.
Instead, transition to sleeping on your back. This will allow you to keep the shoulders in a neutral position.
If you are struggling to sleep on your back, try to sleep on your side, on your “good shoulder” with your top arm behind your back.
Another alternative is to sleep on your side with your “good shoulder” down with a pillow behind you. This allows you to lean back on the pillow so you can sleep on angle instead of flat on your back.
Back pain
Lower back pain can be caused by quite a few conditions. Some of these conditions are relieved with you bending forward while some are relieved with bending backwards. You typically are going to want to avoid sleeping in a curled up position. Being severely rounded in the lower back is going to place excess tension on the ligaments, joint capsules, and discs.
If you are suffering from a pain that is relieved by bending forwards or staying in a neutral position, try sleeping on your back. Typically placing a pillow beneath your knees allows you to take some tension off the lower back. You may also benefit from placing a rolled up towel beneath the small of your lower back to support the normal curve of the lumbar spine.
Some lower back pain is going to be relieved with bending backwards. If this is the case, try laying on your stomach. Typically this is the type that starts in the lower back and radiates down the leg.
If you find yourself struggling to stay on your back and prefer the side position, be sure to place a pillow between your knees with your legs straight. This will keep the pelvis in normal alignment and keep the tension on the ligaments and discs down.
IT Band Pain, Hip Pain, or Knee Pain
If you are experiencing pain in your hip or outside of your knee, you likely will benefit from sleeping on your side with a pillow between your legs. Some people experience less pain with their legs straight, while others prefer their legs bent slightly.
All of these sleeping positions have exceptions. No two injuries are the same. This may lead to variance in the above recommendations. Experiment with positions to find your preferred position. For more specific advice on your specific situation and to get neck pain relief or back pain relief in Boulder, Colorado, come in today for an appointment. If you’ve read this article, you’re in pain. No amount of pain is normal. Get evaluated today for fast pain relief.