Sleeping Positions and Your Back

The Spine's Natural Curvature

The spine is designed to follow a particular path from the base of the skull to the pelvis. The picture shows the different spinal regions and their natural curvature. Maintaining this curvature is often difficult. As the body ages, the shoulders and pelvis tend to round and tilt forward, exaggerating the thoracic and lumbar curvature. The head also drifts forward, causing strain in the cervical vertebrae. With the rate of obesity in the U.S. and the amount of time human bodies now spend at desks, these changes are very commonplace even in the younger population. Being conscientious of your sleeping positions can save your posture.

Sleeping on your Back

This is probably the easiest position in which to best protect your back.

  • If you sleep with your head on a pillow, use only one relatively flat pillow. A cervical roll can allow a more natural cervical curve during sleep.
  • Place a pillow or two under your knees, allowing them to bend. This allows the pelvis to rest in a natural position and removes strain from the lower back.
  • Keep your arms by your sides. Sleeping on your back with your arms over your head can cause nerves in your shoulder area to be pinched and you may wake frequently with numbness or tingling in your arm(s) or notice that you have developed some of these symptoms during the day. Try changing this habit.

Sleeping on your Side

While this can be a comfortable position for most, it comes with pros and cons. Sleeping on your side can help with upper airway disorders during sleep, but it can also impact your shoulder, neck and upper back alignment. Try these tips to protect your joints.

  • Be sure to have a pillow thick enough to take up the space between the end of your shoulder and your cheek to reduce the pressure placed on the shoulder structure and thoracic/cervical vertebrae.
  • Place a pillow in front of you (along your chest) and place your top arm on that pillow. This prevents your arm from crossing your mid-line and further rounding your shoulders.
  • Place a pillow between your bent knees. It should take up the space between your thighs, knees and ankles. If you have long legs, get a king-sized pillow or body pillow for this. Sleeping in this position keeps your legs aligned with your hip joints.

Sleeping on your Stomach

Stomach sleeping is generally not recommended. Sleeping on your stomach puts your spine in an awkward position. The lumbar curve exaggerates, putting increased pressure in the low back. The neck has to be rotated 90 degrees to the right or left, and on a pillow this not only places the neck in an extreme position for a prolonged period of time, but adds pressure to the head/neck. Add to it that the arms usually go above the head for this position, impinging nerves, and you have a less-than-ideal situation.

  • The number one recommendation is to try to change this habit.

  • The next best thing is to find a stomach-sleeping pillow that will better support spinal alignment.

  • Sleeping on your stomach with your pillow under your hips instead of your head can help somewhat.

Sleeping Elevated

People with health problems, like breathing difficulty or digestive troubles, often sleep better in an elevated position. Keeping your head elevated at least 30 degrees can help with breathing, lessen snoring, and aid in reducing reflux. Use a wedge pillow to support your vertebral column, instead of laying on a pile of pillows. An adjustable bed or hospital bed can achieve the same function.

If you or a loved one are on a feeding tube or oxygen therapy at home, a wedge pillow could make a world of differnece in the quality of sleep.

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Comments 15 comments

John Chancellor profile image

John Chancellor 8 years ago from Tennessee

Very useful information. I think the older we get the more we become aware of the need to take care of our backs.


Kat07 profile image

Kat07 8 years ago from Tampa Author

Thanks, John! I agree. My back tells me when I need to adjust my sleeping position, especially if it's been recently strained. In my line of work that happens frequently.


stephhicks68 profile image

stephhicks68 8 years ago from Bend, Oregon

Great Hub! I am a stomach sleeper (Yikes), but I had to break the habit, obviously, during pregnancy. Still, I find comfort that way. Perhaps I'll try a hip pillow. I'm still young enough not to worry about back issues, but we do have some that run in the family.


Kat07 profile image

Kat07 8 years ago from Tampa Author

Yikes is right! I have treated many patients in the clinic that come in with nerve problems that stemmed from stomach sleeping. It's really the position of the neck that is the biggest problem with stomach sleeping, and I have not figured out how to adapt that position for anyone yet!


Isabella Snow profile image

Isabella Snow 8 years ago

Hmmm.. what's this stomach sleeping pillow?? I sleep on my stomach mostly. Can't imagine sleeping with a pillow under me??


Kat07 profile image

Kat07 8 years ago from Tampa Author

Isabella - stomach-sleeping pillows are hard to find sometimes. You can just use a regular pillow, somewhat flat, under your pelvis to take the extra curve out of your low back while sleeping on your stomach. Sometimes you can find low-grade wedge pillows that have face cut-outs, too. Every body is different, and your needs may not be the same as that of someone else - maybe you don't need one.


Nicole Winter profile image

Nicole Winter 8 years ago from Chicago, IL

Kat07: I'm also a stomach sleeper, as well, the last three months of pregnancy were hell for me because I couldn't break myself of the habit. I have often wondered how I could improve the health of my back without giving up the habit entirely, thank-you for the mention of stomach-sleeping pillows / face cut-outs.

However, I have often wondered if it would be possible to by a second hand padded chiropracter table for sleeping purposes? I know this makes me sound like a lunatic, but I found the one at my doctor's office so comfortable I would regularly fall asleep with the heat-packs on my back before she came in to adjust me. Would they be safe for sleeping on?


Kat07 profile image

Kat07 8 years ago from Tampa Author

A massage table might offer some comfort.  I'd go with an extra-padded version so you get the cushioned support your body needs.  Often, the stomach sleeping pillows with face cut-outs mimick this apparatus.  Massage tables can be narrow, though, so be sure not to roll off!  Oakworks makes a great, extra-wide, extra-padded table that is as comfortable as any mattress I've ever slept on!


amanda_kate08 8 years ago

i am almost 24 yrs of age, have 2 kids and i wake up EVERY morning with this incredible pain in my pelvic region. It feels like I was kicked "down there" and it goes away after about an hour, but I can't figure out what is going on!!? It feels like the bone is so sore, and pressure almost helps.(temporarily) does anyone know if it has to do with how i sleep? I have a VERY small area to sleep in because i am staying with my inlaws and my husband and i share our bed with my son (4 month old) and sometimes my 4 yr old sneaks in early in the am.. so i have maybe a foot wise space to try and sleep in EVERY night.


Kat07 profile image

Kat07 8 years ago from Tampa Author

Amanda - are you mostly sleeping on your side then?


Jessica 6 years ago

The last 3 nights I've woken up from back pain in my upper area. I can barely sleep from it. I try and only lay flat or on my sides but the pain starts a few hours after I am asleep and continues through the night and morning. My posture is bad. I have an old bed. I'm overweight and I have a child I constantly pick up...but why is it happening now? Can you help?


Gurabah 5 years ago

Dawud :: Book 41 : Hadith 5022

Narrated Tikhfat al-Ghifari:

Ya'ish ibn Tikhfat al-Ghifari said: My father was one of the people in the Suffah.

The Apostle of Allah (peace be upon him) said: Come with us to the house of Aisha. So we went and he said: Give us food, Aisha. She brought hashishah and we ate. He then said: Give us food, Aisha. She then brought haysah as small in quantity as a pigeon and we ate. He then said: Give us something to drink, Aisha. So she brought a bowl of milk, and we drank. Again he said: Give us something to drink, Aisha. She then brought a small cup and we drank. He then said: If you wish, you may spend the night (here), or if you wish, you may go to the mosque.

He said: While I was lying on my stomach because of pain in the lung, a man began to shake me with his foot and then said: This is a method of lying which Allah hates. I looked and saw that he was the Apostle of Allah (peace be upon him). !!


Gurabah 5 years ago

Dawud :: Book 41 : Hadith 5022 !!

Narrated Tikhfat al-Ghifari:

Ya'ish ibn Tikhfat al-Ghifari said: My father was one of the people in the Suffah.

The Apostle of Allah (peace be upon him) said: Come with us to the house of Aisha. So we went and he said: Give us food, Aisha. She brought hashishah and we ate. He then said: Give us food, Aisha. She then brought haysah as small in quantity as a pigeon and we ate. He then said: Give us something to drink, Aisha. So she brought a bowl of milk, and we drank. Again he said: Give us something to drink, Aisha. She then brought a small cup and we drank. He then said: If you wish, you may spend the night (here), or if you wish, you may go to the mosque.

He said: While I was lying on my stomach because of pain in the lung, a man began to shake me with his foot and then said: This is a method of lying which Allah hates. I looked and saw that he was the Apostle of Allah (peace be upon him). !!


bisnisdigital profile image

bisnisdigital 5 years ago from beautiful country

Nice information thank's for it


smcopywrite profile image

smcopywrite 5 years ago from all over the web

this is wonderful information all around. i was a stomach sleeper but have back problems, specifically my neck and have become a side and back sleeper. great information and voted up. thanks for sharing.

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