During sleep, your body works to regenerate and repair itself. Your sleeping position and the pillow you use can either help or hinder this process, depending on how effectively it supports the natural curvature of your spine. It’s also common for people to wake up in the morning with a whole new set of aches and pains, sometimes due to their sleeping position. What is the best sleeping positions to reduce back and neck pain?

Best sleeping positions to reduce back pain

We spend a third of our lives sleeping or resting. Therefore, it is important to choose a sleeping position that helps your body recover physically. A proper sleeping position can take pressure off your spine, while an unhealthy position can increase pain or stiffness in your back, arms or shoulders and contribute to poorer sleep quality.


What is the best sleeping position? 

The best sleeping position is one that promotes healthy spinal alignment from hips to head. What that looks like for you depends on your personal health situation and what you find comfortable.

However, there are some positions that are considered healthier than others.


Benefits of sleeping in the correct position and using the right pillow 

Different sleeping positions offer different benefits that may be helpful to you if you are dealing with back pain, pregnancy, allergies, acid reflux or another condition. In these cases, it may be worth trying a new sleeping position to achieve more restful sleep. 

Adjusting to a new sleeping position takes time, but it can be done. Be patient with yourself and use pillows to help your body get used to the new position.


Sleeping on your side 

The flexibility of our spine decreases as we age, so the side position may be more comfortable for older adults. Sleeping on your side promotes healthy spinal alignment and is the sleeping position least likely to cause back pain, especially when supported with pillows. Sleeping on your side can also reduce heartburn and snoring, making it a better sleeping position for people with sleep apnea or acid reflux. 

Sleeping on your side may be particularly beneficial for: 

  • Pregnant women
  • People with acid reflux
  • People with back pain
  • People who snore or have sleep apnea
  • Older people


Best sleeping position when pregnant 

Experts recommend that pregnant women sleep on their sides with their knees bent. The side sleeping position relieves pressure from the growing belly and allows the heart to pump and blood to flow easily through the body. In particular, the left side is recommended because it prevents pressure on the liver and promotes healthy blood flow to the fetus, uterus, kidneys and heart.

If you feel uncomfortable sleeping on your left side during pregnancy, you can switch to the right side occasionally to relieve pressure on the left hip. You can also relieve tension by placing pillows under your belly, between your legs and on your lower back.


Best sleeping position for back pain 

The best sleeping position for lower back pain is on your side with a pillow between the knees. Side sleeping can also relieve symptoms for those with neck or back pain.


What kind of pillow is best for sleeping on your side? 

When lying on one’s side, a pillow should support the head and neck so that the spine maintains a straight and natural horizontal line. A thicker pillow is needed for sleeping on your side than for sleeping on your back.

Bending the knees and placing another pillow between the knees will keep the spine in the neutral position. If there is no support between the legs, the top leg will rotate down, pulling the pelvis down and distorting the natural line of the spine. A firm pillow between the knees usually prevents this downward rotation better than a softer pillow.


Sleeping on your back 

When you lie flat on your back, it’s easy to keep your spine in a straight line and distribute your body weight evenly, preventing potential neck and back pain. Sleeping on your back can also relieve the congestion of a stuffy nose or allergies, as long as you put yourself in an upright position. 

Sleeping on your back may be particularly beneficial for: 

  • People with lumbar spinal pain
  • People worried about wrinkles
  • People with neck pain
  • People with nasal congestion

 Sleeping on your back is not recommended for: 

  • Pregnant women
  • People who snore or have sleep apnea
  • People with certain types of back pain
  • People with GERD or acid reflux
  • Heavier adults
  • Older adults 


What kind of pillow is best for sleeping on your back? 

When lying on your back, a pillow should support the natural curvature of the cervical spine and provide adequate support for the head, neck and shoulders. The height of the pillow should be lower than for side sleepers. 

Placing another pillow or two under the knees will provide additional relief for the back. The pillows tend to flatten the lumbar curve, reducing pressure on the facet joints in the back of the spine. 


Best sleeping position for neck pain 

Sleeping on your back is the best sleeping position for neck pain because it prevents the misalignment that can occur when sleeping on your stomach. To prevent neck pain, use a pillow that supports the neck and allows your head to sink lower. Pillows made of memory foam or pillows with a depression for the head are good choices. Alternatively, you can roll a towel under your neck and use a flatter pillow for your head. 

If you sleep on your back, make sure your arms are in a similar position. For example, it is better to have both arms at your sides rather than one resting on your forehead, as this causes an unevenness in your spine that can lead to shoulder or neck pain.


Sleeping on your stomach 

The stomach is the least popular sleeping position. Research has shown that we spend less than 10% of our nights in this position. However, stomach sleep has some advantages. Namely, the stomach sleeping position can alleviate snoring by opening your airway. However, your ribs have to work against gravity to breathe in this position. This can cause you to expend more energy, making your sleep less restful. 

The stomach sleeping position has several disadvantages and is not recommended for most people. In particular, the following people should avoid sleeping on their stomach: 

  • Pregnant women
  • People with neck or back pain
  • People worried about wrinkles 

Sleeping on your stomach provides the least support for the back of all sleeping positions and increases pressure on the spine, sometimes resulting in pain upon waking. To sleep on your stomach, you must sleep with your head to one side, which inevitably causes your neck and head to become out of alignment with the rest of your spine. If your mattress is not firm enough, your stomach and hips will sink into the mattress, throwing your spine out of alignment in an uncomfortable way. This type of asymmetrical sleeping posture can negatively affect your spine over time.


What kind of pillow is best for sleeping on your stomach? 

Without the right pillow and mattress, the stomach sleeping position can easily cause discomfort and pain. However, it is possible to sleep well in this position. If you like sleeping on your stomach, try using a very thin pillow or no pillow at all. This way you can avoid your neck from tilting backwards and upwards, which will further misalign your spine and cause discomfort. Place a thin pillow under your hips to further balance your spine and reduce pressure.

A firm mattress can also prevent some of the spinal alignment issues that come from sleeping on your stomach. If your mattress is firm, you are unlikely to sink deeply into the mattress surface and throw your spine out of alignment.



The best sleeping position for you is the one that allows you to have a restful night’s sleep without interruption and wake up refreshed and without pain in the morning. If this is true of your current sleeping position, do not feel compelled to change it. However, if you feel that a new position might make your sleep more comfortable, try a different position. Be patient and use the above strategies to get used to the new position.

Your sleeping position plays a crucial role in the quality of your sleep. Changing your sleeping position is just one of many strategies you can try for better sleep.


If you are having trouble sleeping due to an illness or injury, or are experiencing joint and muscle pain due to your current sleeping position, contact The Back Clinic. The clinic’s therapists specialize in helping patients identify, manage and treat their pain and underlying conditions. Contact them at 0630975603 or by email at info@thebackclinic.co.za

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