Article written by: Jim Storhok DPT, ATC
Have you ever gotten up in the morning with a raging headache or pain in your neck? Most people attribute this scenario to “sleeping wrong”. It is actually quite a common complaint heard in physical therapy. Many people have a certain amount of “wear ‘n tear” with regards to their neck joints, and it is very important to preserve joint integrity at all times, including at night. What I would like to discuss today is the importance of proper neck posture at nighttime, and discuss a couple of sleeping positions that can help you get a better night sleep.
Probably the easiest position to maintain a neutral neck is sleeping on your back with a small to medium sized pillow under you head. If the pillow is too big, the head gets pushed forward, and that can cause more neck pain in the back. When using a small to medium sized pillow make sure the small bump at the base of back of your head is positioned up the pillow. You can obtain this position by giving yourself a double chin. You should feel a lengthening feeling in the back of your neck. Once you feel this, relax the double chin and you should be all set. If you have any shoulder pain accompanying the neck pain, you can put the shoulders in what we call the resting position by hugging a pillow under both armpits. This position should relax the muscles across the back of the shoulders and the muscles around the back of the neck.
Many people have a habit of sleeping on their side frequently, and while this is ok, there are a few more variables that need to be accounted for in order to support the spine properly. First, there needs to be the proper amount of pillow that can fill the space between the outside edge of the shoulder and the side of the face, so that the spine can be in neutral alignment, and not side bent to one side or the other. The next thing that needs to be addressed is whether or not the head is pulled back, like in the “double chin” position, or if it is forward, which tends to be common when people curl up into the fetal position. Sometimes it’s difficult to feel if you are in a neutral posture, so it may be beneficial to have someone else look at you before you go to bed to make sure everything looks lined up if that is feasible for you.
My least favorite position is stomach sleeping, due to the fact that we tend to see more incidences of low back and neck pain. In order to breathe, the head needs to be significantly rotated to one side or the other, which can cause pain if there are arthritic changes in the neck. Maintaining neutral in side lying or preferably on your back is most recommended.
Of course, check with your physical therapist for specific recommendations for your particular situation.
Take care and we’ll talk again next month!