What is the Best Sleeping Position for Neck and Shoulder Pain?

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Often, both neck and shoulder pain can be eased through lifestyle changes such as exercises, posture, and sleeping position.

You spend a large chunk of your time asleep and, while you may not be conscious, your body is still affected by the strains and stresses that it is put under.

An Illustration of someone in the best sleeping position for neck and shoulder pain but with a wrong neck alignment

Let’s take a look at the best sleeping position for neck and shoulder pain so that you can have a more restful night and more pain-free days.

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What Causes Neck Pain?


Sometimes it will be clear why you have pain in your neck. For example, when you suffer from an injury.

However, a lot of the time, it can feel as though your neck pain has come out of nowhere.

Neck pain is usually the result of tense muscles, and it can be exacerbated by spending a long time on a computer, getting too cold, or sleeping in an awkward position.

Most of the time, neck pain goes away after around two weeks.

It can sometimes become chronic, at which point you may be referred for physiotherapy or other treatments.

Common causes of neck pain include:[1]

  • Overused or weak neck muscles – caused by keeping the neck in a position that tenses the muscles for too long.
  • Wear and tear of the cervical spine – a normal part of ageing caused by the spinal discs becoming flatter as well as bony growths.
  • Whiplash – caused by the head jerking rapidly forwards and backwards. Usually happens during a car accident.
  • A slipped disc or a narrowing of the vertebral canal – this can put pressure on the spinal nerve and cause pain that radiates out.

It can often be difficult to pinpoint the exact cause of the neck pain.

What Causes Shoulder Pain?


The shoulder is really a collection of joints and muscles, so the cause of shoulder pain can come from various places.

The shoulder is the most movable joint in the body, but it is also the most unstable, making pain and injuries quite common.

As with neck pain, many times, the shoulder pain will go away on its own after around two weeks,

But in some other cases, it might become chronic and require further treatment.

Common causes of shoulder pain include:[2]

  • Dislocation – the shoulder joint is the most commonly dislocated joint in the human body.
  • Separation – this is when the ligaments that attach to the collarbone are torn away by the shoulder blade.
  • Tendinosis – this happens when the tendons that attach to the bicep or rotator cuff become inflamed.
  • Torn rotator cuff – this happens when one of the rotator cuff tendons becomes inflamed or torn.
  • Frozen shoulder – this is a long term condition that can last between 1 and 3 years and is when the tissue around the shoulder joint becomes inflamed and then shrinks.

Shoulder pain may not always be due to one of these conditions.

Short-term acute shoulder pain can be caused by the same issues that can trigger muscles tension in the neck – overuse, being too cold, and sleeping in an awkward position.

Why Does Neck and Shoulder Pain Get Worse When Lying Down?


If you are dealing with neck or shoulder pain, you may find that the pain is worse when you get up in the morning or have been lying down for a period of time.

There are two reasons for that:

1) Inactivity makes neck and shoulder pain worse

Even though it may be painful to move your neck or shoulder when you are in pain, it is important not to stop moving altogether.

Staying still for too long can make your neck or shoulder stiffness worse, which will only compound the problem.

Of course, if you are lying down or sleeping, then this is exactly what will happen, so you may find that your neck or shoulder pain is worse for a while when you get up and start to get better once you start moving around again.

2) Sleeping in the wrong position can make neck and shoulder pain worse

When you are experiencing neck or shoulder pain, that means that some part of the musculoskeletal system of your neck or shoulder has become tense, damaged, or inflamed.

If you sleep in a position that puts pressure on that part of the system or forces it to tense or strain, this can worsen the problem.

You could end up feeling more intense pain, or it could take longer for you to heal.

What are the Different Sleeping Positions?


You may not have given much thought to the position in which you go to sleep, but if you are like most people, you probably go to sleep in pretty much the same position every night and have done since you were very young.

The way you sleep can affect sleep apnea and snoring, reflux and heartburn, and can even affect how many wrinkles you develop.

But one of the biggest impacts it can have is on neck and shoulder pain.

Of course, human beings are quite agile, so it can be hard to categorize every possible sleeping position.

In general, however, they are grouped into three positions:

  • Back sleeping (also known as supine)
  • Side sleeping (left or right, also known as lateral)
  • Front sleeping (also known as prone)

These sleeping positions can be further divided depending on how you get yourself into each position.

Back sleeping

  • Soldier position – lying on your back with your arms straight down by your sides.
Illustration of the soldier sleep position

11% of people sleep in this position.

Illustrating how sleeping in starfish position looks like

7% of people sleep this way.

Side sleeping

  • Fetal position – lying on your side with your knees curled up to your chest. This is the most popular sleeping position – 47% of people sleep this way.
  • Yearner position – lying on your side with both arms stretched out in front of you. 13% of people sleep in this position.
  • Log position – lying on your side with your arms and legs straight down. 6% of people sleep this way.
Illustration of 3 variations of the Best sleeping position for sleep apnea variations

Front sleeping

  • Freefall position – lying on your stomach with your arms tucked under your pillow and your head to one side.
Illustration of the freefaller sleep position

17% of people sleep in this way.

What is the Best Sleeping Position for Neck and Shoulder Pain?


If you are dealing with neck or shoulder pain, examining your sleeping position and modifying how you sleep could help you recover more quickly and experience less pain.

Even though most people sleep on their side, many individuals who suffer from shoulder pain prefer to sleep on their back because there is no pressure on the shoulder in this sleeping position.

One study looked at patients with shoulder pain and found that 67% of them were sleeping on the shoulder that hurt.[3]

Therefore, whenever I suffer from neck or shoulder pain, I prefer to sleep on my back.

In a study that looked at how sleep position affects neck and shoulder muscle activity, the researchers divided back sleeping into three ways:[4]

  • Both arms down by the side (soldier position)
  • Both hands on the chest
  • The dominant hand on the forehead

They found that sleeping with the dominant hand on the forehead was associated with more activity in the neck muscles, which means that it put more strain on them during the night.

It also forced the shoulder into a rotated position, which could cause shoulder pain.

There was no real difference between sleeping with the hands by the side or on the chest.

Being symmetrical is, therefore, also important when it comes to sleeping on your back.

Keep your neck aligned

Another factor that influences the neck when sleeping on your back is your pillow.

If you have a pillow that places your neck much higher or lower than the rest of your spine, it can compress or extend the neck muscles in an unnatural way.

An illustration of what is the right size of pillow for supine sleepers should look like

Some studies have found that using an ergonomic pillow can help to relieve neck pain.[5]

My favorite pillows are:

  • Iunaoo Bed Pillows – Contains a high-quality filling which provides a very good support for the neck and head.
  • Utopia Bed Pillows – Very soft and breathy, and provides a great support.
  • YourFacePillow  – Designed to alleviate pressure on your face and skin. If you sleep on your back, however, it won’t benefit you much

Keep your back straight

It’s important to check whether there is a gap between the mattress and your lower back.

Lye on your back in your bed and try to place one of your hands between the mattress and your lower back.

If you realize there is a big gap, fold your knees until there is no gap.

For that reason, it is recommended to place a pillow below the knees.

An illustration of how a pillow under the knees can help to have a comfortable sleep

The Everlasting Comfort Bolster Pillow was designed especially for that purpose.

This half-moon pillow fits below your knees, which keeps your spine aligned.

The Worst Sleeping Position for Neck and Shoulder Pain


Front sleeping is the worst sleeping position for neck and shoulder pain, in my opinion.

When you sleep on your front, you are forced to move your head to one side.

That makes the pressure on your cervical spine (the part of your spine that is in your neck) asymmetrical, placing more of the load on one side.

It also means that one of your shoulders will have extra tension placed on it.

So if you are dealing with neck or shoulder pain, it may be better to avoid sleeping on your front.

Summary


  • Both neck and shoulder pain can be caused (or made worse) by awkward sleeping positions.
  • Front sleeping is generally the worst sleeping position for neck or back pain.
  • Sleeping on the same side as your shoulder pain can make shoulder pain worse.
  • Side sleeping with your neck and back curved can make your neck pain worse.
  • Sleeping on your back with your hand on your forehead can make your neck and shoulder pain worse.
  • Sleeping with a pillow that’s too low or high can make your neck pain worse.

The best position to sleep in for your neck and shoulder pain is either on your back with your arms down by your side or on your chest or sleeping on your side with your spine in a neutral and symmetrical position.

It is worth remembering, however, that your sleep quality is also important.

Poor sleep quality has been found to make a recovery from neck pain slower.[6]

So if you find that forcing yourself into a different position stops you from sleeping, it may be better to modify your usual position instead.

  • If you sleep on your front, try sleeping on your side with a body pillow to mimic front sleeping.
  • In case you sleep on your back, make sure that your pillow is the right height to keep your neck in line with the rest of your spine.
  • If you sleep on your side, place a pillow between your legs and use a taller pillow to keep your neck and spine aligned.
Illustration of the adjustments required for sleeping in the best sleeping position for sleep apnea with a straight back

The Bottom Line


Neck and shoulder pain is widespread, and simple lifestyle changes can help to reduce your pain and speed up your recovery.

One effective way to reduce neck and shoulder pain is to adjust your sleep position.

The best sleeping position for neck and shoulder pain is either on your back with a supportive pillow or on your side with your spine and neck aligned.

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