We spend 8+ hours a night in bed (or at least we should do) so it's important to think about what position you're in and how this might be causing pain, preventing you from making the full recovery you want, affecting your posture, spinal, physical and mental health.
We’re all aware that good posture when working or standing is important, but when was the last time you thought about your sleeping posture? The good news is that the position you sleep in is just a habit, meaning it can be changed (hurrah!) It might take a little work, a few nights of struggling to switch off as you get used to the new position, and maybe the odd relapse, but making the change is worth it.
The poor sleeping position might be one of the causes of your pain, or preventing you from making the full recovery and allowing you the freedom to move and function freely as it can put unnecessary stress on your low back, neck and shoulders.
We hear from our practice members every day that changing sleeping position had huge benefits for them from sleeping through the night pain-free, waking up without a cricked neck or sore lower back. For the first time, they're waking up feeling refreshed and well rested.
All from changing sleeping position. Pretty great news ey!
So what position should you sleep in?
The gold standard of sleeping posture is to maintain and support e natural curves of your spine when lying in bed. You can do this by keeping your head, neck, shoulders and hips in alignment so you’re getting no nasty twists or curves in your spine. The easiest way to do this is to sleep on your back, but for some people in chronic pain, or who snore this can be an issue so we’ve laid out the best sleeping postures, and the ones to avoid below.
Let's start off with which position you shouldn't sleep in…
Your front. We know. This is terrible news, it feels so great but it’s so naughty too!
So what's the issue with sleeping on your front?
It places your lower back into what Chiropractors call: lumbar hyperextension. This means that the bit where your lower back curves in is exaggerated beyond what's considered a normal curve.
This compresses the (facet) joints in your lower back and increases the pressure on the nerves too. It also shortens your lower back muscles meaning you're more likely to feel stiff in the morning and it may contribute to you having this posture when standing also. This is what we call a forward pelvic tilt.
Your neck is also usually in maximum rotation and extension - this is a cricked neck waiting to happen!
If you really can’t shift from this sleeping posture (remember it’s only a habit!!) then sleep with a pillow under your hips and chest, and either one thin pillow or no pillow at all under your head.
Learn to sleep on your side with a pillow between your knees
A good in-between posture between sleeping on your front and making the switch to sleeping on your back is to sleep on your side. Sleeping on your side with a firm pillow between your knees is best for your back. We find using big square cushion is great as it isn’t as easy to accidentally kick it out of the bed during the night. A normal pillow can be a little too flimsy.
This sleeping position raises your top leg and prevents yours from rotating your spine, allowing you to maintain a neutral position. What does this mean we hear you asking?
If you sleep on your side with one leg hooked up towards your chest and the other straight down like most people, you're spine is all twisted and is no longer parallel to the mattress (the gold standard in sleep posture).
When your spine is all twisted up like that, it puts pressure on some of the joints in the lower back, this can result in increased pressure on the nerves and a tightening of the muscles - neither of which anybody who wants a pain free and mobile low back are looking for.
Something we hear quite often is that people still feel that their shoulders are collapsing towards the mattress or in on their chest. So the easiest way to get around this is to hug a pillow.
Place one or two pillows in front of your chest where your top arm can rest on them. Spooning a partner also helps!
Big U shaped pregnancy (or boyfriend pillows according to some people) can be helpful if you struggle with that collapsing shoulder feeling.
Checklist:
Once in bed gently roll onto your side
Pull a pillow in closely to your shoulder supporting your head
Pull the knees up slightly and put the pillow between them
Place a pillow in front of your chest and allow your top arm to rest on it
For extra support, you can place a small pillow behind you which will help you from feeling like you’re rolling onto your back
Sleep on your back with knee support
Sleeping on your back is considered the best sleeping position for your neck and back. Place a pillow or cushion UNDER the knees this time. That little bend in the knees reduces stress on the lower back and helps maintain a neutral spine supporting its natural curves.
People who sit a lot often have tight hamstrings and hip flexors which pulls the pelvis into a forward tilt - this can contribute to an uncomfortable feeling in the lower back when lying flat on the back with straight legs. They should find this tip extra helpful!
Place one pillow under your head so that your neck and head aren't sticking forward. Be conscious to tuck the chin downwards so the head isn't tilting right the way back - this can cause a shortening of the neck muscles and an increase in pressure on the joints at the top of the neck. You want to think about having a long elongated back of your neck.
Checklist:
Lie flat on your back looking up at the ceiling without the head twisting to the side
Place a low pillow under the head and neck
Place a pillow under your knees
Tuck the chin down elongating the back of the neck
Allow the legs to lay straight, toes pointing up or slightly outwards, not opening out the hips or bending the knees up to the chest
Allow your shoulders to relax and the chest to open
What pillow should I use?
So this really depends on a couple of factors:
a) What position you're in
b) How big you are or how wide your shoulders are
If you’re on your back (well done!) try one, quite a low pillow. This won’t force your head into that forward head position we’re all so conscious of avoiding when standing up.
If you're on your side, you don't want the pillows so low that the neck is scrunching up towards the mattress or so fat that your neck is bending away from the mattress towards the ceiling. Make sure to pull the pillow down to the shoulder to support the neck - your neck and head should be on the pillow, not just your head.
If you still haven’t managed to shift from sleeping on your front, one very thin or no pillow at all under your head is kindest on your neck.
If you're one of these mystical people who don’t tend to move a lot during your sleep you may find it helpful to sleep with an orthopaedic pillow. Specially designed memory foam pillows can be a good option as they’re moulded to the shape of your neck and head. Just remember to replace them when needed as they do lose their firmness.
There's no one size fits all here, if you're a bigger guy or gal you're going to need more pillows or firmer pillows than a smaller petite person. Which pillow to use, really is a personal preference in our experience!
Top Tip: Get a friend or partner to have a look at you when you're in position, no it's not weird at all!
What about my mattress?
A good mattress is built to last 7-10 years. Every week I talk to people who, once they work it out, are horrified at how long they’ve had their mattress - it’s crazy how time flies when you’re having fun! It’s always worth checking with the manufacturer for how long your specific mattress is built to last.
If you inherited the mattress when you moved into your rental property you might want to consider investing in a new one which you can take with you when you move on.
The general rule is: a firmer mattress is better than soft for your back. You might want to opt for a medium firm if you’ve had long term back pain.
If you’re a side sleeper who has particularly wide hips or shoulders you might want to opt for a slightly softer mattress as this will allow your shoulders or hips to sink into the mattress allowing the weight to be distributed evenly. If you are particularly slim, again a softer mattress might be the best option for you.
Most mattress companies do a 100-day free trial these days, so try before you buy!
Is there any pain I should be concerned about?
If you have changed mattress and are still experiencing pain in the morning speak to your Chiropractor. If the pain is keeping you awake at night or preventing you from switching off then again speak to your Chiropractor.
Seek immediate advice from a health care provider if the pain is accompanied by:
Arm, leg or groin numbness or weakness
Fever
Night Sweats
Chest pain
Loss of bladder or bowel control
Difficulty passing urine
Pain or throbbing in your abdomen
Unexplained weight loss
Or if the pain comes on suddenly
We hope you’ve found this helpful if you have any feedback, questions or suggestions please let us know!
