Best Sleep Positions to Prevent Neck & Back Pain

1. Back Sleeping (Supine Position) — Highly Recommended

Why it works: Sleeping on your back promotes spinal alignment and evenly distributes body weight, reducing strain on spinal muscles and joints.

Tweaks for comfort: Place a small pillow at the base of your neck and a pillow under your knees to maintain the natural curve of your spine.

Hands placement: Resting your hands by your sides or on your chest can minimize unwanted muscle activation and spinal rotation.

Caveats: Back sleeping may aggravate snoring or sleep apnea and worsen breathing issues for some.

2. Side Sleeping — A Strong Alternative

Why it’s good: This common position supports spine alignment and is particularly beneficial for people with back pain, snoring issues, or reflux (especially on the left side).

How to optimize it:

• Use a thick, supportive pillow that fills the gap between your ear and shoulder while keeping your head level with your spine.
• Place a pillow between your knees to align your hips and spine, reducing stress on your lower back.
• If you curl up in the fetal position, avoid excessive curling—keep your chin untucked and legs relaxed to reduce spinal strain.
• Hug a body pillow to support your upper body, ease shoulder tension, and discourage rolling onto your stomach.

3. Stomach Sleeping (Prone Position) — Least Recommended

The risks: This posture flattens the lumbar spine and forces your neck to turn to one side, which can cause neck pain, stiffness, and lower back strain.

If unavoidable:

• Use a very thin or no pillow under your head to minimize neck rotation.
• Place a thin pillow under your hips or abdomen to help restore spinal curve and ease pressure.

Strengthening the Foundation: Mattresses & Pillows Matter

Mattress firmness: A medium-firm mattress strikes a balance—too soft can misalign your spine; too hard can create pressure points.

Pillow tips:

• Choose pillows that support natural neck curvature—memory foam or feather pillows often conform best to your shape.
• Avoid pillows that are too thick or stiff, as they may immobilize your neck in a flexed position overnight.

What Research Tells Us

A 2025 systematic review found that supine (back) sleeping is associated with a lower prevalence of low back pain, while prone sleeping significantly increases risk due to lumbar strain. Supportive side-lying positions also reduce pain, but poor alignment can make it worse.