Are you tossing and turning at night, waking up with a stiff neck or achy back? Did you realize that not sleeping in the right positions can actually keep your back from healing and prevent your chronic back pain from ever going away?  It’s true!  Our patients often tell us that they are surprised that changing the positions they were sleeping in could actually make such a big difference in healing their back or neck pain.   (Check out Oliver’s testimonial on how sleeping differently helped his disc related back pain. )   In this blog, we’ll delve into the importance of proper sleeping posture and how it can contribute to a night of peaceful, rejuvenating sleep.

The Pillow Puzzle


Your choice of pillow is an essential component of maintaining good sleeping posture, but picking the perfect pillow for your neck is not as easy as you might think. The right pillow will provide support for your head and neck, helping to align your spine properly. Your ideal pillow will depend on your unique spine and your preferred sleeping positions.  There is no magic pillow that works for everyone.  

Some general guidelines to consider for proper neck support:

Back Sleepers: Opt for a medium-thick pillow that supports the natural curve of your neck and the space between your neck and shoulders.

Side Sleepers: A firm pillow is recommended to keep your head and neck aligned with your spine. You might also consider a second pillow between your knees for added hip and spine support.  Be careful with pillows that are too fluffy and cause your neck to bend too much (i.e. bringing your ear too close to your shoulder).  This typically leads to pinched nerves in your neck.   

Stomach Sleepers: While this position can potentially be more straining on necks, I don’t discourage patients from sleeping in this position if that’s how they have been sleeping for a long time.  There are ways to adjust pillows to reduce the amount of strain on the neck.  


The Mattress Matters


The type of mattress you sleep on also plays a crucial role in maintaining proper posture. A mattress that is too soft or too firm can disrupt your spinal alignment. Your ideal mattress will depend on your body type and sleeping position.  Over the last 24 years, I’ve tried to figure out the perfect mattress to recommend to my patients and I’ve concluded that there is no one-sized-fits-all solution. What I have noticed though in myself and others that have had disc issues in their low backs, is that firm mattresses (How firm completely depends on the patient) are better at promoting postures needed to keep the discs in the correct position so they can heal.  My patients with stenosis / nerve root irritations tend to prefer softer mattresses. 

Before you invest a lot of money in a new mattress, you may want to consider that it is much easier to make a firm mattress softer (by using some type of foam mattress topper) than making a soft mattress more firm.  I’ve yet to find a way to make a soft mattress more firm.  This seems like a good case for the sleep number bed – something that is adjustable.  While the sleep number bed has never worked for me (because it doesn’t get firm enough), I have had patients that loved their sleep number mattress. 

Taco beds:  If you have one, it’s time to replace your mattress.  We’ve all slept in one of these beds that are worn out and have a large crevice where our body sleeps.  If you have a disc issue in your low back, this type of bed will not work for you and will keep your disc from healing.  If you have spinal stenosis or other type of nerve irritation, you actually may find relief sleeping in this type of a bed.  While you may find them comfortable, I don’t recommend this type of bed as it can lead to other postural issues, such as kyphosis.    


Sleeping in postures to heal your back:


 With back pain, it is important to sleep in ways that put the damaged or irritated tissues in positions where it isn’t being strained all night, so healing can occur.  What are those positions?  That completely depends on what type of injury you have.  If you don’t know the root cause of your pain, you could be sleeping in positions that may lessen your pain but are actually keeping the tissue from healing.  We see this often where a patient has been told by their doctor or chiropractor to sleep in a certain position that does help lower the patient’s pain some, but that position is what is keeping their backs from healing- sometimes for years.  When we tell these patients to stop sleeping in those positions and sleep in positions that initially don’t feel as comfortable, they are a little reluctant but very surprised to wake up feeling less pain and stiffness.  As they continue to sleep in the correct postures for their specific injury, their backs begin to heal and they sleep better, getting deep and restful sleep and their pain during the day begins to go away. Many are shocked with how quickly their daytime symptoms improve just by changing how they sleep.  

Can you ever return to positions you are use to?

Sure, once the pain is gone, patients can return to old, familiar sleeping positions if they choose.  They just know that if their pain begins to return, they will need to go back to sleeping in the positions they were taught until the pain goes away again. Quite often though, the positions they learn in our clinic that initially didn’t feel comfortable for them become very comfortable and often times become the sleeping positions of choice for our patients. 




The position you sleep in will not only significantly affect the quality of your rest but can prevent your back or neck pain from fully resolving. If you’re experiencing persistent sleep-related discomfort or pain, set up an appointment today with one of our highly specialized therapists that understand the forces acting on your spine and can coach you on postures that help your spine heal and leave you feeling refreshed and ready for your day. They can provide personalized guidance on posture, recommend exercises to alleviate tension, and offer strategies for a more comfortable night’s sleep.

If you have a bulging or herniated disc in your low back, you will want to check out our video – Tips to Heal Your Discs While You Sleep.

This video will teach you detailed positions that are specific to disc related back pain.  These sleeping postures will put your discs in neutral positions so your discs can repair themselves while you sleep.

At Spine PT, we’re here to support your journey towards better sleep and improved well-being. Contact us at 801-709-4772 to schedule a consultation. Let’s work together to ensure you wake up feeling refreshed and ready to tackle the day!