How to Prevent Back and Neck Pain While You Sleep

The Best and Worst Sleeping Positions Depend on Your Pain

The first thing to know is that the best sleeping position to ward off pain varies from person to person. It’ll take some experimenting to find out what works best for you, but you can narrow down positions to avoid based on the body part that’s giving you trouble.

“Generally, if you have neck pain, the worst position would be sleeping on your stomach, because when you’re sleeping on your stomach, you have a preferential side where you’re rotated,” Pham explains. Spending the entire night with your head turned to that same side can lead to neck issues over time, even if it feels comfortable as you’re falling asleep.

If your back is the issue, particularly your lower back, sleeping on your back can often make it worse, especially if you have a softer mattress.

“Most people’s center of mass is more around their hip area. That makes the mattress crease down,” Pham says. “So essentially, when you sleep on your back, you’d be sleeping in a low-angled V.” If you already have back pain, that angle could exacerbate it because it puts your lower spine in a flexed position.

Whether you have low-back or neck pain, the position where many of Pham’s patients find the most success is on their side. But, of course, there’s a catch: This strategy tends to work best when you rotate the side you sleep on regularly.

If you consistently sleep on one side, you may find that one side of your body is tighter over time—it’s an issue you can get ahead of, but more on that later.

Again, each person’s anatomy and specific issues are different, but if you’re normally a back or stomach sleeper and struggle with back or neck pain, you might want to start with trying to sleep on your side.

Think About How You Spend Most of Your Day

No, we’re not talking about mindfulness. Taking the way you spend your day into consideration when you get in position to sleep can help you figure out how to keep your body balanced and your muscles moving well.

“You essentially want to do the opposite of what you do during the day,” Pham says. ”So for example, let’s say you’re a boxer and you’re always rotated to the left or you’re golfing and always swinging to one side. It’s most likely going to be better to sleep in the opposite rotation.”

The same goes for desk jockeys. If you sit down in a chair for eight hours, lay on your back in bed for eight hours with your hips in the crease of your mattress, and don’t do any exercises or stretches that include extending your back, your lower back’s range of motion won’t be stellar.

You may not care now, but you’ll care when you blow out your back trying to spike a volleyball or dazzle your kids with a dunk on the driveway basketball court. Trying to sleep on your side or stomach might be a better option to keep things neutral.

Another simple way to balance out your body, particularly if you’re a gym rat, is to foam roll your abs. Yes, your abs. It’s probably the last thing you’d think to do, but Pham swears by it.

“Most lifters do crunches, constantly bring their rib cage closer to their hips, nonstop—then all of a sudden, they have back pain and neck pain,” he explains. “The response to that is to foam roll, stretch, and sleep in positions that allow you to open up more space in your rib cage area.”

A pro tip from Pham is to try using a product like ASYSTEM’s Radical Relief Gel Roll-On, which includes menthol, methyl salicylate, and USA-grown hemp-derived CBD as active ingredients, before you get to stretching or foam rolling.

“I’ll roll on the areas where I’m feeling sore, then go through my stretching routine,” he says. “By the end of it I feel great, and it can help you focus on the areas that you do want to pay extra attention to, ‘cause you’re gonna feel it a lot more.”

Try Adding Some Accessories

When it comes to sleep, your biggest accessory is the mattress you spend eight hours each night on. And like a best friend or significant other, you want your mattress to be supportive.

“Generally, a firm mattress is better,” Pham says. “It comes down to it not collapsing in, no matter how your body mass is distributed.” Soft mattresses may feel like a bed of clouds at first, but in the long-term, they have the potential to cause more aches and pains because they fold more easily under your center of mass.

Coming in close second to your mattress are pillows, and there’s a variety of ways to use them to relieve back and neck pain.

Pham’s top suggestion is getting yourself a cervical roll—you know, those special neck alignment pillows you’ve definitely seen in an infomercial. But put your credit card down, because you can make your own by simply rolling up a towel if you don’t want to spend money.

If you sleep on your side or back and have neck pain, you’ll want to place the cervical roll under the bottom half of your neck for more support. You can use it with your regular pillow, and Pham’s pro tip is putting the rolled up towel right into your pillowcase.

If your back is killing you but you can’t help but sleep on it, Pham suggests adding pillows under your lower back and under your knees. Those with back pain who sleep on their stomachs can try adding a pillow beneath their hips to alleviate some pressure.

Even side sleepers can benefit from some pillow action. A cervical roll, a pillow under your oblique, and a pillow between your knees to prevent your body from rotating are all good options. Try one, two, or go for all three and find the combination that keeps you feeling good.

Again, this is all about trying things out until you find out what works best for you.

Start Your Morning With a Stretching Routine

No matter how you sleep, it’ll do you some good to work on mobility as soon as you’re up in the morning. Pham recommends focusing on stretches that open up your rib cage. That phrase may conjure stills from Alien, but in this case, opening up your rib cage basically means keeping it upright so your neck and back stay aligned.

“When you sit slouched, your neck kind of comes forward, and your head kind of comes forward. So you essentially cannot have a straight neck without a straight rib cage,” Pham says. “If your foundation—your rib cage—is crooked, then everything above it is also messed up.”

And it’s not just your neck that’s affected. When your ribcage leans forward as you slouch, your back muscles have to work overtime to keep you from flopping all the way forward. This—say it with us, now—can make back pain worse.

Below are a few movements Pham recommends doing in the morning to open up your rib cage, along with video demos of each exercise: