Find the Best Sleep Position for Upper Back Pain

Written by: Ed Salazar



Time to read 7 min

Ed Salazar Sleep Consultant and CEO

Ed Salazar

With over 20 years of experience in healthcare, Ed Salazar is a trusted sleep consultant and esteemed writer for the Good Night Blog. His medically-reviewed work and profound expertise make him a go-to resource for achieving quality sleep. Let Ed Salazar guide you on a transformative journey to restful nights and rejuvenation. 

We spend roughly a third of our lives sleeping. This indispensable activity is not just essential for mental alertness and mood stabilization but also for the body's physical well-being. Upper back pain, a common complaint among adults, can significantly impact one’s quality of life. This pain can be the result of various factors such as poor posture, muscle tension, herniated discs, or arthritis. While medication and physical therapy are common treatments, adjusting sleep positions can also be remarkably effective. This article will delve into the best sleep positions for upper back pain and how you can optimize your night's rest for a pain-free day.

The Importance of Proper Sleep Position

Upper back pain can be exacerbated by the way you sleep. An awkward sleep position can strain the muscles and ligaments in the back, causing pain and stiffness. Additionally, the alignment of the spine during sleep is critical, as it impacts the natural curves of the back. An improper alignment can result in additional pressure on the back muscles. Conversely, maintaining a neutral spine position can minimize stress on the back and promote a pain-free sleep experience.

The Anatomy of the Upper Back

Understanding the basic anatomy of the upper back is crucial. The upper back, or thoracic spine, consists of twelve vertebrae that are attached to the rib cage. It plays a significant role in supporting the upper body and safeguarding the internal organs. The muscles and ligaments in this region are prone to strain and tension, especially if they are not properly supported during sleep.

anatomy of the spine

Side Sleeping: A Natural Pain-Reliever

Side sleeping, also known as lateral sleeping, is often touted as the best sleep position for upper back pain. When practiced correctly, this position can naturally align the spine and reduce the strain on the back muscles.

correct alignment for sleeping on side

Using a Pillow for Support

When sleeping on your side, using a pillow that provides adequate support to the neck and head is important. The pillow should fill the space between the shoulder and neck, ensuring that the head is neither too high nor too low. This helps in maintaining the natural alignment of the spine. Placing a pillow between the knees can further enhance spinal alignment and reduce pressure on the hips and lower back.

Back Sleeping: The Supine Wonder

While side sleeping is highly beneficial, back sleeping or sleeping in the supine position is also an excellent option for people with upper back pain. In this position, the weight of the body is evenly distributed across the spine, minimizing pressure points and allowing the back to relax.

correct alignment for sleeping on back

The Use of Adjustable Beds

For back sleepers, using an adjustable bed can be particularly helpful. Elevating the head and legs slightly creates an angle that helps to reduce the tension in the upper back. It also helps in maintaining the natural curve of the spine. For those without an adjustable bed, placing a pillow beneath the knees can mimic this effect.

Pillow Talk: Choosing the Right One

The choice of pillow is also pivotal in back sleeping. A pillow that is too high can force the neck to bend unnaturally, while one that is too low can strain the upper back. A medium-firm pillow that keeps the head in a neutral position relative to the shoulders is ideal.

The Fetal Position: Curled Comfort

The fetal position, where you sleep on your side with your legs curled towards your chest, is another position that can be beneficial for upper back pain. This position can take pressure off the spine and may be particularly helpful for those with a herniated disc or degenerative disc disease.

Perfecting the Fetal Position

While adopting the fetal position, make sure not to curl too tightly, as this can restrict breathing and cause stiffness. Maintain a relaxed curl and use a pillow to support your head and neck. Similar to the side sleeping position, placing a pillow between the knees can help align the spine and reduce strain on the back.

Caution: Stomach Sleeping

It is imperative to note that sleeping on your stomach is often considered the worst sleep position for upper back pain. This position can cause the neck to twist and the lower back to arch excessively, putting strain on the spine and back muscles. If you are a habitual stomach sleeper and find it difficult to change positions, try gradually transitioning to side sleeping by using pillows for support.

Tips for Transitioning Away from Stomach Sleeping

For those who are accustomed to stomach sleeping, it can be challenging to transition to a different sleep position. Using body pillows to keep yourself semi-reclined or placing a flat pillow under the stomach to reduce the back arch can be effective interim measures as you adjust to a new sleep position.

Sleep Environment: Setting the Stage for Relief

Your sleep environment can also play a vital role in managing upper back pain. The mattress you sleep on should provide good support and conform to your body's natural curves. In the following article here:10 Steps to Create Your Perfect Sleep Environment we dive into even more detail.

Choosing the Right Mattress

A medium-firm mattress is often recommended for individuals with back pain. However, personal preference should also be considered. Some people find relief with a slightly softer or firmer mattress. It is essential to find a balance between comfort and support.

The Temperature Factor

Maintaining an optimal room temperature can also contribute to better sleep. A cooler environment is generally conducive to sleep, and it can help in relaxing the muscles, which can be beneficial for upper back pain.

Lifestyle Adjustments: Complementing Sleep Positions

Adopting the right sleep position is just one piece of the puzzle. Making lifestyle adjustments can significantly complement the benefits of proper sleep positioning.

Exercise and Stretching

Engaging in regular physical activity, especially exercises that strengthen the back and core muscles, is highly beneficial. Stretching exercises can also improve flexibility and relieve tension in the upper back.

cobra pose to help with upper back pain

Practicing Good Posture

During waking hours, be mindful of your posture. Sitting or standing with a reclined back can contribute to upper back pain. Aim to maintain a straight back with the shoulders relaxed.

Seeking Professional Help

If upper back pain persists despite changes in sleep position and lifestyle, it is advisable to consult a healthcare professional. A physician, physical therapist, or chiropractor can provide specialized guidance and treatment options.

Conclusion: Sleep Your Way to a Pain-free Back

Upper back pain can be debilitating, but how you sleep can profoundly impact how you feel. By optimizing your sleep position, using the right pillows and mattresses, and making beneficial lifestyle changes, you can create the perfect synergy for alleviating upper back pain. Remember, a good night’s sleep is not just a luxury; it’s a vital component of overall health and well-being. Take charge of your sleep environment and position, and pave the way to a more comfortable and pain-free life.

Is sleeping on the floor good for upper back pain?

The effect of sleeping on the floor for upper back pain varies among individuals. While some may experience relief due to improved spinal alignment, others may find it uncomfortable and potentially exacerbate their symptoms. Stiffness and discomfort when sleeping on the floor are likely due to inadequate cushioning around the joints. It is important to consider individual factors and consult with a healthcare professional for personalized advice. Alternative options, such as a firm or medium-firm mattress with proper support, can provide a balance between comfort and spinal alignment for individuals with upper back pain.

How do you decompress your spine while sleeping?

To decompress your spine while sleeping, there are a few simple techniques you can follow. First, use a supportive pillow that keeps your spine aligned in its natural curve. Additionally, choose a medium-firm mattress that provides both comfort and support. If you're a side sleeper, placing a pillow between your knees helps align your hips and spine. For back sleepers, consider using a small pillow or rolled-up towel to support the natural curves of your spine. Finally, incorporating gentle stretching exercises or relaxation techniques before bed can help release tension in your back muscles, promoting spinal decompression during sleep. By adopting these practices, you can optimize your sleep position and promote a healthier spine.

Why is my upper back hurting so bad?

There are several common reasons why your upper back may be hurting. Poor posture, especially from prolonged sitting or slouching, can strain the muscles and ligaments in the upper back, leading to pain. Muscle tension and tightness, often caused by stress or overuse, can also contribute to upper back pain. Additionally, conditions like herniated discs, arthritis, or muscle imbalances can cause discomfort in the upper back region. To determine the exact cause of your pain and develop an appropriate treatment plan, I recommend seeking a consultation with a healthcare professional, such as a chiropractor or physician, who can perform a comprehensive evaluation.