Being able to sleep through the night without waking from pain is often determined by your sleeping position and how well supported your body is. For example, if you have tight hip flexors, sleeping on your back may predispose you to have more back pain. Similarly, sleeping on your sides may increase your shoulder and or hip pains.
Good quality sleep is absolutely essential to creating the best healing environment for your body. Most of my patients generally do not sleep in the optimal positions for their body based on their limitations or dysfunctions and end up waking up with pain, feeling lethargic and just plain crappy.
If you are limited in sleep by areas of pain in your body, here are some general guidelines to follow.
If you prefer sleeping on your back, consider putting 1 flat-medium thickness pillow under your head/neck for support and to minimize excessive bending or flexing of the neck. Place 1-3 thicker pillows under your knees to keep your back from arching or hyperextending. Using a wedge under the entire leg can also be very helpful for most of my patients. If you have upper extremity/shoulder pain, you may benefit from placing a flat pillow under that arm/shoulder blade.
If you prefer sleeping on your sides (the majority of my patients do), consider putting 1-2 medium size pillows between the entire leg to support the leg and protect your spine. Additionally, you will need 1-2 thicker pillows under your head/neck to support your head/neck and fill the space between your neck and the bed. Depending on the size of your waist, you may or may not need some support under your waist too. Additionally, if you have shoulder pain, I would definitely use a medium-sized pillow under my top arm to unload the weight of the arm and keep it a neutral position.
As per my previous blog, I generally do not recommend sleeping on your stomach, but if you must, then ideally put 1-2 medium-sized pillows under your belly button/hip region to protect your back and another medium-sized pillow under your ankles to minimize the strain on your back/ankles. The major limiting factor is your neck in this position. Once you are on your stomach, you will need to turn your head/neck in either direction to end range in order to breath causing rotation all the way down the entire spine. This position compromises the joints, muscles, blood vessels and nerves in this area. Sometimes a flat pillow strategically placed under the face may help minimize the total end range rotation requirement.
There are also modified positions like 3/4 positions on your sides that you can use with the support of multiple pillows to help you sustain the sleeping position. Additionally, some of my patients really need to be inclined (possibly in a recliner or with a small wedge) due to sleep apnea, excessive snoring, reflux, post-op shoulder surgery, and severe kyphosis of the mid-back.
Whatever sleeping position you choose, if you are experiencing any discomfort or pain don’t wait until the pain starts affecting your function and quality of life before seeking help from your PT. Most insurances allow direct access for you to seek help for sleep at Kintsugi Physical Therapy!
