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Sleeping Positions

Chiropractors see patients with neck & low back pain every day. These aches and pains can be caused by several different reasons. Some of the most common reasons for the pain are poor sleeping posture, and old or low-quality pillows, and mattresses. Symptoms while sleeping may include; pain, numbness, and tingling sensations in your arms, legs, neck, & back. In this blog post we will focus on the best possible positions for sleeping with neck and low back pain in mind.

Sleeping positions, pillows, and mattresses all play a role, so let’s take a closer look at each.

Sleeping on Your Back (Supine)

Getting yourself in a comfortable position can be one of the most challenging aspects of getting to sleep & staying asleep. According to the University of Southern California’s School of Medicine, sleeping on your back is the top rated position for pain in the general population with a few exceptions.

Here are a few reasons why sleeping on your back is the preferred method of sleeping for pain when done properly.

Neutral Spinal Alignment
When you sleep on your back, your spine can be in a neutral position. Which means, it is neither curved or twisted around. This can help reduce the risk of neck & back pain as well as other affiliated spinal disorders.

Reduced pressure on joints
Sleeping on your back side also reduces pressure on your joints, particularly your hips & shoulders. This is especially beneficial for patients with osteoarthritis & other pain disorders.

Better Circulation
Back sleeping may promote effective breathing in the airways & could reduce the risk for snoring or sleep apnea. This is due to your head being in a neutral position, allowing for air to flow through your nose and throat.

Proper back sleeping should look like this

The patient’s neck is supported, creating the natural lordotic curve in her neck. A small pillow is also placed underneath their knees to help alleviate the forward hip rotation that will result if not supported. 

Side Sleeping

Side sleeping was the next best sleeping position recommendation. By placing a pillow between your legs, you help eliminate some of the spinal pressures and misalignments created when our knees are knocked together. Side sleeping was encouraged for patients with gastric reflux problems and pregnant females as sleeping on their back may decrease circulation to themselves and the baby.

Here is an example of sleeping on your side correctly.

Note the patient’s pillow has an indentation providing additional support of the neck. She also has a pillow in between her legs to reduce some of the pressures that are created when knees are up against one another.


A pillow is more than just something to rest your head on. It supports the cervical spine and helps maintain proper alignment throughout the night. This image to the right provides us with a description of how our neck should look when using pillows for proper support. Here are some benefits of using a proper pillow;

Pillow positions for sleeping

Reduces neck pain
A pillow that is too high or too low can cause neck pain. The correct pillow height will depend on the individual’s sleeping position and body type.

Reduces headaches
Tension headaches can be caused by poor sleeping posture. A proper pillow can help alleviate this issue by reducing stress on the neck and upper back.

Reduces snoring & sleep apnea
A pillow that positions the head correctly can help open the airways and reduce snoring and sleep apnea.


A proper mattress is essential for maintaining proper spinal alignment during sleep. Here are some benefits of using a proper mattress;

Reduces low back pain
A mattress that is too soft or too firm can cause or worsen back pain. A proper mattress should support the spine in a neutral position.

Reduces pressure points
A good mattress distributes body weight evenly, reducing pressure points that can cause pain and discomfort.

Improves sleep quality
A comfortable and supportive mattress can improve sleep quality, leading to better overall health.

Overall, sleeping on your back is considered by many professionals to be the best anatomical position for getting some rest. This is because it helps promote proper spinal alignment and reduces pressure on joints. However, it’s important to understand that everyone’s body is different, and some people may find other sleeping positions more comfortable. Try what position feels best, and consult with your chiropractor and other pain doctors for concerns regarding your predominant sleeping patterns. 

To conclude, a proper pillow, mattress, and sleeping position are essential for maintaining good spinal alignment during sleep. By reducing pressure points, improving sleep quality, and alleviating neck and back pain, these factors can lead to better overall health and well-being. As a chiropractor, I recommend patients invest in quality sleep products to support their musculoskeletal health.

Please take a look at our How should I sleep? blog posting  if you would like some more information regarding correct resting positions.


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