Here’s the Sleeping Position That’s Right for You, Based on Your Aches and Pains

When it comes to the best sleeping positions for various aches and pain, it’s most important to find one that promotes a neutral spine alignment and removes pressure from the associated nerves and joints, says rheumatologist and internist Jonathan M. Greer, MD.

That means someone with back pain will have a different ideal sleep posture for pain relief than someone with neck pain or hip pain, for example. And where one person might have their best night of sleep in the fetal position, someone else might swear by sleeping on their back, perhaps using a pillow beneath the knees to keep their spine aligned.

Below, orthopedic specialists break down the best sleeping positions for people with different kinds of pain (as well as the positions you should not sleep in), and how to adjust your sleep posture for maximum joint pain relief.

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What is the best sleeping position?

The best sleeping position for you will depend on a variety of factors, including existing areas of discomfort, your anatomy, and environmental factors, such as the pillows and mattress you use. Whether you share a bed with someone else matters, too, as some cuddling positions can be less comfortable than others. (If you wind up fighting over a shared comforter with a partner, allow us to introduce you to the brilliant Scandinavian sleep method.)

The individualistic nature of sleep means you might have to experiment with several different positions until you find the one that works best. “If you are having pain while sleeping, I would consider what position you are spending the majority of your time in,” says Mallory Behenna, DPT, orthopedic physical therapist at Brooks Rehabilitation. Listening to your body, says Dr. Behenna, is key when picking out the best sleeping position for you.

Best sleeping positions for back pain

Do: modified fetal position

If you have back pain, Dr. Greer and physical-medicine and rehabilitation doctor Jaspal R. Singh, MD suggest lying on your side with your legs bent (toward your stomach, in the direction of a fetal position) with a pillow sandwiched between your knees. The pillow helps to keep your hips aligned, and bending the legs takes pressure off of your spine, making this modified fetal position one of the best sleep positions for back pain.

The fetal position tends to get a bad rap, but people with neck and lower back pain might actually find relief in a mid-range fetal position, says Dr. Behenna. “As long as you're not getting any symptoms from it—especially numbness going down the legs or in the arms and hands—then it's a relatively safe position,” says Dr. Behenna.

This modified fetal sleep position is a great sciatica-friendly sleep posture, too, because it involves taking away pressure from one side of the body (and sciatica tends to affect just one side at once). If you struggle with sciatica, sleep on the unaffected side, with the side where you tend to get pain on top.

As a precautionary note, if your back pain is regularly keeping you awake or persists longer than three weeks, it’s worth getting it evaluated by a medical professional, says Dr. Greer. And the same goes if you’re experiencing recurring numbness or tingling radiating down a leg, which could be a sign of a pinched nerve.

Don't: sleep on your back or stomach

While sleeping on your stomach can cause compression of the spinal nerves (more on this below), lying flat on your back with your legs outstretched can cause over-extension of the spine, says Dr. Greer, worsening back pain. It can also “pull the pelvis forward if you have tight hip flexors,” says Dr. Behenna, “which can increase the arching of the back.”

However, if you strongly prefer to sleep on your back despite your back pain, you can adjust your position to be more spine-supportive by propping a pillow beneath your lower legs.

Another option: Consider an adjustable bed that bends upward a bit at the top, so you’re not lying fully flat, but instead, a bit more upright. “Elevating the head above the feet, similar to how you would in a recliner, can remove some pressure from the lower part of the back,” says Dr. Singh.

Best sleeping positions for hip pain

Do: sleep on your back

One of the best sleeping positions for hip pain involves lying on your back with your legs slightly propped up by way of a pillow placed under the knees or legs. Sleeping on your back removes some of the direct pressure on the hip that comes with sleeping on your side, and placing a pillow underneath your legs can help your hips maintain a neutral position.

Don't: sleep on your side or in a fetal position

Sleeping on your side could worsen existing hip pain, says Dr. Greer. “The bony prominence that sticks out of the hip called the greater trochanter has a sack of fluid on top called a bursa,” he explains, “which can often get aggravated when you lie on one side all night, especially if you’re on a hard mattress—and that can cause inflammation called bursitis.”

And while a mid-range fetal position can provide relief for some neck and back pain symptoms, the fetal position can worsen existing hip pain by applying direct stress to the hips and limiting hip flexion in the process.

Best sleeping positions for neck pain

Do: Sleep on your side or back

Lying on your side or back is your best bet if you’re looking for a sleeping position for neck pain, says Dr. Behenna, since both positions can allow for a neutral spine.

If you continuously wake up with a stiff neck, try sleeping on your side with a pillow filling the space between your neck and the bed. “When you're lying on your side, you should be able to draw a straight line from the back of your head all the way down your spine,” says Dr. Behenna of a side sleeping position that can help relieve and prevent neck pain.

“When you're lying on your side, you should be able to draw a straight line from the back of your head all the way down your spine.” —Mallory Behenna, DPT, orthopedic physical therapist

And the same goes for an ideal back sleeping position for neck pain: The head should form a straight line with the spine (and shouldn’t be curved forward or tipped backward).

For that reason, it’s also important to choose your pillow carefully. The best pillows for neck pain are relatively soft and conform to the curvature of the upper spine and neck. “You don’t want to go with multiple pillows under the neck or no pillow at all, as either option can cause unnatural extension,” says Dr. Singh.

Don't: sleep on your stomach

As noted above, sleeping on your stomach forces your spine to be in an unnatural arched position, and it also requires you to “keep your head rotated in an end range for a long period of time, which puts strain on the muscles and vertebral joints,” says Dr. Behenna.

Whereas, choosing a side or back sleeping position allows you to keep the spine and neck in a neutral position and minimizes strain on the joints and nerves, says Dr. Behenna.

What is the worst position to sleep in?

While there are different ideal sleeping positions for different people, doctors agree that the worst sleeping position (particularly if you deal with joint pain) is sleeping on your stomach. (But fear not, stomach sleepers: It’s possible to train yourself not to sleep on your stomach.)

That’s, again, because stomach sleeping places the spine in an unnatural position. “We have a natural slight forward curve in the lower lumbar spine,” explains Dr. Behenna, “but when we lie on our stomach, that curve increases.” Throughout the night, the lumbar spine becomes more and more extended, adding more pressure to the vertebrae, “which can cause irritation, inflammation, and increased pain [in the neck and back],” she says.

The nerve compression triggered by stomach sleeping can also “cause numbness or tingling in the arms,” says Dr. Singh.

As is true for any sleeping position, though, small adjustments can make a major difference. If you’re a diehard stomach sleeper and don’t want to turn right side up, try placing a pillow underneath your stomach before you snooze, suggests Dr. Behenna. “This will give you a little bit more support to keep the spine neutral instead of letting it arch,” she explains.

How many pillows should you sleep with?

The perfect number of pillows to sleep with is wholly dependent on your preferences and needs. For people who sleep on their back, a singular medium-density pillow might be enough to keep the head in line with the neck. In other scenarios, however, someone might want an extra pillow to slide beneath or in between the legs for additional hip or lower-back support.

If you’re trying to figure out how many pillows you should rest your head on, Dr. Behenna recommends considering the height of your pillows. If you have thin (aka low loft) pillows, you might need two to fill the space between the head and the shoulder(s) depending on your anatomy and whether you’re sleeping on your side or back.

If you’re in the market for a new pillow, however, going for a happy medium that feels right for your ideal sleeping position—not too thick or too thin—can keep your head, neck, and spine well-aligned. Looking for a place to start? Consider the best pillows for side sleepers or the best pillows for combination sleepers.

Regardless of your sleep posture, however, Dr. Behenna recommends opting for a pillow made of shredded memory foam, which combines the contouring benefits of memory foam and the flexibility of down filling.

In any case, it’s important to let comfort be your guide, says Dr. Greer. “I always say, if you’re doing any kind of exercise or activity that creates or worsens some kind of pain, it’s a signal that you need to adjust,” he says, “and that applies to your pillow and sleeping position, too.”

Is there a better side to sleep on?

Unless you’re dealing with a particular health condition, neither side is better to sleep on than the other. If you have aches or pains that are concentrated on one side (such as sciatica pain running down one leg), it’s better to sleep on the unaffected side to relieve pressure from the muscles and joints of the side that hurts.

The question of which side you should sleep on when it comes to prior health conditions is only really relevant if you have a gastrointestinal condition like acid reflux or indigestion, or a heart condition. In the case of the former, you may do best to sleep on your left side¹ (which keeps the stomach from pressing on the bottom portion of the esophagus), and in the case of the latter, it may be better to sleep on your right side, which can keep the heart from moving or turning within the chest cavity².

Also of note: It’s often advised for pregnant people to sleep on their left side, particularly in the third trimester, as this can better facilitate blood flow for both the baby and the pregnant person.