A woman sleeping on her stomach

The best sleeping positions to reduce back and neck ache, according to experts

Posted by for Wellbeing

Sleep should help to repair your muscles, yet many of us wake up feeling sore. Here’s how to sleep to prevent morning aches. 

Waking up feeling stiff, achy and sore is incredibly frustrating – especially given that we sleep in order to wake up feeling rested and recovered. Morning soreness is common, and can simply be due to your post-workout DOMS (delayed onset muscle soreness) kicking in or the fact you’ve been lying still for hours.

But it could also be down to the fact that you’re sleeping in the wrong position. Just like the rest of our day – whether we’re working out or sitting at a desk – we need to be thinking about our posture when we’re asleep. Only, our bedtime positioning is a little more tricky – not only because we can’t control how we toss and turn when we’re unconscious, but also because falling asleep in a position that isn’t the default you’ve come to love can feel impossible.

Why your sleep position matters

“While it’s very rare to cause real damage to a healthy body during sleep, it is very likely that adopting a bad sleeping position over a long period of time can exacerbate underlying issues that you may or may not have been aware of,” says physiotherapist Joy Ogude, founder of virtual clinic The London Physio

These can include neck and back pain and stiffness, nerve irritation to the neck and spine, and even digestive issues (for example, a 2002 study found that sleeping on the right can cause more acid reflux than sleeping on the left).

Ogude sees our sleeping positions as a form of prehab – the preparation you do to limit your risk of injury. “How you sleep, the positions you sleep in and even the pillows and the mattress you use can affect your joints. Even if you’re only sleeping for five hours a night, that is a long time to be in a position. And waking up with pain or discomfort has such a knock-on impact on your productivity and mental health,” she says. 

A woman waking up in pain and covering her face with her arms
Waking up in pain isn't great for motivation, says Joy

What are the worst sleeping positions?

It’s bad news for the stomach sleepers, as snoozing on your front is considered to be the least beneficial position for your muscles and joints. “Front sleeping with a thick pillow under your head, while turning your head sideways, puts your neck in a very awkward position,” says Ogude. 

“It can sometimes lead to inflammation of the small joints of the neck with potential nerve irritation. Sometimes people wake up with pins and needles or numbness in their arms or hands, as well as back and neck pain,” she explains.

According to virtual physiotherapy clinic PhysioMed, side sleeping in the ‘foetal’ position – with your knees tucked to your chest – can also be problematic for those with pre-existing back pain. According to their digital guide on sleeping positions, “this is because most back problems occur in the structures at the back of your back (they are in the posterior structures of the spine). 

“Lying in this position opens up these structures allowing more space for the nerves – which account for a lot of the pain in back problems. Although lying in this position feels good as the pain is reduced [in the moment], the actual structures can be made worse by maintaining this position.” 

What is the best sleeping position?

“The reality is that there is actually no evidence to show that one particular sleeping position is better than another – what’s right for someone won’t work for another,” says osteopath Anisha Joshi, founder of Osteo Allies.

There are some obvious suggestions for people with pre-existing pain, like avoiding sleeping on irritated or injured sides. Pregnant women and those with sleep apnea may also be provided with sleeping position guidance from their doctors.

However, both Joshi and Ogude recommend these two sleeping positions to limit back, neck and shoulder aches.

1. Back sleeping with pillows under the knees and a pillow under the neck

2. Side sleeping with a pillow between your knees and under your neck

“These two positions are the most favoured by physiotherapists and doctors because the spine remains in the most neutral position overnight,” says Ogude. On your back, the pillow under the knees supports the natural curve of your lower back, while on your side the pillow stops your top knee from pulling your spine into hyper-flexion. 

A pillow
Your pillows can help you more supportive sleep

Of course, holding these positions is easier said than done when you are unconscious. If you are regularly rolling onto your stomach or side, you can support your position by placing pillows to your side to limit movement – tucking yourself in really does have a benefit.

You still need to support your body with movement in the day to counteract the night’s stillness. “Focus on the good things you can do during your waking hours to keep your joints and muscles healthy. For example, stretches, mobility, flexibility and strengthening exercises,” says Ogude.

Both Joshi and Ogude recommend doing a stretch before getting out of bed to loosen everything up. “Start by gently tucking your knees to your chest and twisting side to side in bed will start to get the synovial fluid moving around to stop you feeling stiff when you get up,” recommends Joshi.

Given sleep is so crucial for our bodies to repair muscles – why waste your eight hours making them more sore? 

Images: Getty

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Chloe Gray

Chloe Gray is the senior writer for stylist.co.uk's fitness brand Strong Women. When she's not writing or lifting weights, she's most likely found practicing handstands, sipping a gin and tonic or eating peanut butter straight out of the jar (not all at the same time).