The Best Sleep Positions to Avoid Pain & Stiffness

Why Do So Many People Wake Up Feeling Stiff and Sore?

I hear it every day in my office:

"I wake up feeling worse than when I went to bed."

And most of the time, it’s not the mattress... it's sleep posture that's the real culprit.

Proper sleep posture is critical for allowing your spine to decompress, your muscles to relax, and your joints to recover overnight.

When your body isn't properly aligned during sleep, small problems can stack up—and before you know it, you're waking up stiff, achy, and frustrated.

At Walsh Chiropractic and Physical Therapy of Hagerstown, I help patients make simple changes that lead to better sleep, less pain, and healthier movement.

Why Sleep Position Matters for Pain and Stiffness

The Role of the Spine During Sleep

When you sleep, your spine has a chance to unload, replenish disc fluid, and reset posture patterns from the day.

But if you're collapsing your curves—or twisting your neck for hours—you’re working against your body's natural healing system.

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It eliminates the point in which you're raised because when you use pillows, then what happens is if I'm laying down, it's this position, right?

With this, you're keeping that proper posture in the cervical and thoracic spine, and you're flexing at the waist.

So I always say—you want to be in the position that you're supposed to be standing in, right? Head, ears over shoulders, over hips, over ankles.

When you use multiple pillows, you're like this, right? And you've seen people like this. Those are the people that also work on a computer all day long—horrible posture. They go home, they need more support because now their posture is this way.

It's kind of a circular issue here because one feeds the other, and they keep feeding each other.

So actually, this is a great opportunity for people to get into a better position—and not so much sleeping on each side—because as you get older, other issues happen when you sleep on your side.

Common Problems Linked to Poor Sleep Posture

I often see patients who struggle with:

• Neck or shoulder tightness

• Lower back pain in the morning

• Numbness or tingling in arms or legs

• Hip stiffness or uneven walking after sleep

If you’re waking up feeling tight, twisted, or stuck, it's time to check your sleep posture.

The Best Sleeping Positions for Spinal Health

Sleeping on Your Back (Best Overall)

If you're looking for the best sleeping position overall, back sleeping is my first recommendation.

Here's why:

• It evenly distributes your body weight

• It maintains the natural curves of your spine

• It promotes better breathing and circulation

Pro tip: Use a pillow that supports the curve of your neck—not one that pushes your head forward.

You can also tuck a small pillow under your knees to take pressure off your lower back.

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When you bring this up, it tends to keep you on your back longer, correct? It's harder for you to get on your side, right?

So that's even a better position for sleep. You're breathing better, you're more at ease, you're not putting yourself in bad posture—because you're actually flexing from around the waist, not the neck.

Sleeping on Your Side (Still Great—with the Right Setup)

Most people are natural side sleepers—including many of my patients.

Side sleeping can be excellent for spinal health if you support yourself properly:

• Keep your head aligned with your spine using a pillow that fills the space between your shoulder and ear.

• Place a pillow between your knees to level your hips and prevent pulling on your lower back.

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If you take a look at the spine from back here, it's more in alignment than if you had that—not that pillow that's cut out.

Now you're up on the shoulder—she would have her head more flexed. So this actually puts you more into a true neutral position, rather than having that pillow jammed in between the shoulder, the arm, and the neck, because her head would be flexed more up.

Which is also a bad position too—because then what happens is the levators...

My patients—I can tell if you side sleep, just because there’s a muscle called the levator. That’s also the muscle that doesn’t allow you to turn your head when you wake up with torticollis.

So this is an optimal solution for when you're going to get on your side.

The majority of people do sleep on their side, and they actually need to have one of these kinds of pillows too—to aid in keeping the spine and the neck in better posture.

Bonus Tip: Sleeping on your left side is ideal for circulation, digestion, and even reducing acid reflux.

Positions to Be Cautious About

Sleeping on Your Stomach (Not Ideal)

I'll be honest:

Stomach sleeping is the toughest on your spine and neck.

Why?

• It forces your head into extreme rotation.

• It flattens your lumbar curve, straining your lower back.

If you absolutely must sleep on your stomach:

• Use a very thin pillow (or no pillow) under your head.

• Place a pillow under your pelvis to take stress off your lower back.

But if you can train yourself onto your back or side... your spine will thank you.

How I Help Patients Set Up a Better Sleep Environment

Choosing the Right Pillow

Your pillow needs to match your sleeping style:

• Back sleepers need gentle neck support.

• Side sleepers need a taller, firmer pillow to keep the head level with the spine.

Cervical pillows are a great option for most back and side sleepers who struggle with neck or shoulder tightness.

Choosing the Right Mattress

I've seen huge improvements when patients switch to a medium-firm mattress:

• Too soft = sagging and misalignment

• Too hard = pressure points and stiffness

Sleep Hygiene Tips for Better Rest

Beyond the mattress and pillow, here’s what I coach patients on:

• Stick to a consistent sleep schedule

• Stretch gently before bed

• Create a calm, screen-free environment 30–60 minutes before sleep

These small habits add up fast.

When to See a Chiropractor About Sleep-Related Pain

If you’re waking up stiff, sore, or feeling worse after a full night of sleep—it’s not normal, and you don't have to live with it.

It could be a sign that:

• Your sleep posture needs adjustment

• There’s an underlying spinal misalignment

• Nerve irritation or muscle tension is building overnight

At Walsh Chiropractic and Physical Therapy of Hagerstown, I use gentle adjustments, posture coaching, and personalized sleep strategies to help you wake up feeling refreshed and ready.

Frequently Asked Questions About Sleep Posture

Is it bad to sleep on one side all night?

Not necessarily—but you need the right pillow and hip support to avoid twisting your spine.

Can a bad pillow cause headaches?

Yes. Poor neck support can strain muscles, irritate nerves, and contribute to tension headaches.

How do I train myself to sleep on my back?

Start by adjusting your pillow setup to make back sleeping more comfortable. Small wedge supports can help you stay put.

Will stretching before bed help my lower back?

Absolutely. Gentle hip and lumbar stretches can release tension and improve sleep quality.

Ready to Wake Up Pain-Free?

A few small changes to your sleeping position and bedroom setup could be the key to feeling better every day.

If you’re ready to wake up rested, aligned, and ready for anything, schedule your spinal health and posture evaluation today.

I’d love to help you sleep better—and move better too.