You may already intuitively know that you shouldn’t sleep in a certain position, or maybe you have no idea what positions you are in during the night…  but one thing is for sure, certain sleeping positions can do more harm to your body than good!  Here is my take on the best and worst sleeping positions from a chiropractor’s perspective (biomechanically speaking), and what you can do to modify them!

1.  On your stomach: This is by far the worst position to sleep in.  Sorry for those of you who do it (I used to as well).  It can cause a lot of problems.  And when I say problems, I am speaking about biomechanical problems (or problems with your muscles and joints), which is how I evaluate things as a chiropractor.  If you choose to lie with your arms up by your head, this can lead to adaptive shortening of the rotator cuff muscles, which may eventually lead to irritation of the biceps tendon, causing you pain in the front of your shoulder. If you already have lower back problems, this position forces your back into an exaggerated curve, which may cause zygopophyseal joint (or facet joint -joints in between your back bones) irritation. If you also sleep on your stomach with your knee up on one side, this can lead to adaptive shortening of the hip external rotator muscles (piriformis, etc) and may lead to pain in your sciatic nerve, tight hip flexors, and low back pain. Yuck. If you already have any of these aches and pains, please do yourself a favor and transition out of sleeping in this position. Eight hours at night is a long time to put your body into a stressful and damaging position.

sleeping position

2.  On your side: This position can be great, however there are some things you can do to make it not as great.  A correctly sized pillow is essential.  One that is too big or too small, may lead to a strain or tightening of your neck musculature. If you wake up with neck pain in the morning, this is a good indication your pillow may be to blame. Placing a pillow between your knees can also help to lessen strain in your low back, especially if you have wider hips which can pull on your low back as it hangs to meet your other knee. Those with wider hips can also have problems in this position, depending on the firmness of the bed. The harder a surface the more pressure this exerts on your greater trochanter (the bone that sticks out of the side of your hip).  This may cause tightening and pain in your gluteus medius muscle or irritation of your bursa (tiny fluid filled sac that lies over this bone to help with friction). Sleeping in this position may also lead to problems with your bottom shoulder, as it forces the whole shoulder complex forward. This may lead to a dysfunctional shoulder, sick scapula, biceps tendon pain, and rotator cuff problems. If you sleep in the side position, it is best to switch sides throughout the night.

sleeping position

3. On your back: This is (in my opinion) one of the best positions you can sleep in. Once again, pillow size plays an important role. If you use a pillow that is too large it may lead to neck strain and musculature tightening and pain. It is also important to have a pillow that supports the curve in your neck. I recommend memory foam pillows that have 2 humps or a valley in the center, which helps to support your neck as your head lies in the valley. It is best to sleep with your arms by your side and not overhead. An arm above your head may lead to adaptive shortening of your rotator cuff muscles and possibly biceps tendon irritation and pain. Your legs should also be straight. Turning your leg out to the side, as in a figure four position, will cause adaptive shortening of the hip external rotator muscles and may lead to sciactic nerve pain, tight hip flexors, and low back pain. If you have low back problems, it is best to sleep with a pillow under your knees in this position.

sleeping position

If you are sleeping in a position you feel is detrimental to a problem you have, it can take some time to retrain yourself to sleep in another position. Constant correction of sleeping positions will help your subconscious eventually start to prefer a better position. Continuing sleeping in a poor position will cause problems, and eventually pain, possibly worsening of a condition you already have.

If you have any questions regarding sleeping positions, please contact me at

If you found this article useful, please sign up for my newsletter below for updates on new articles!

[wysija_form id=”1″]


My love,

Dr. Kristin