“Doc, I know that you can help me get better, but what can I do on my own to keep this problem from coming back again?”
Almost everyone who comes to my office want to know what they can do to protect their neck from shifting into a bad position again, and one of the most important things someone can do to protect their neck is to create an optimal position for sleep.
Why is sleep important? Aside from the obvious benefits it has on mood, energy, healing, and overall longevity, the way we sleep also impacts the structural integrity of the spine. Just think about it, most of us spend almost 1/3 of our lives sleeping, and that time is often spent in one of a few postures.
In fact, I’ve seen numerous patients tell me that their problem began upon waking, or that they think that their problem began because they slept funny. The fact is that a prolonged period in a structurally poor position can affect the neck and affect the neurovascular tissues that travel through the neck. This can lead to Secondary Conditions like torticollis, neck pain, headaches, and back problems.
So how do we protect our neck and the nerves that pass through it? These tips should get you off on the right foot.
Positioning Matters
There are 3 primary positions, and sub variations around that.
Stomach Sleeping – Avoid it:
If you haven’t been told already, stomach sleeping without a specialized pillow can put your neck in too much twist in your neck.
Just try this. Turn your head to your right. Now keep it there for an hour.
I bet that sounds pretty terrible. Now think about how that must feel to have your neck sitting like that for 6-8 hours by the time you wake up.
Stomach sleeping also puts the spine in a hyper-extended position which can also lead to back pain on rising.
Side Sleeping
Side sleeping is a position where almost anyone can get their spine into a neutral position. It allows the
lumbar, thoracic, and cervical spine to line up in one plane when the correct pillows are used.
lumbar, thoracic, and cervical spine to line up in one plane when the correct pillows are used.
A pillow between bent knees helps keep the pelvis neutral, while a head pillow should be high enough to support the neck, but not be so high that it pushes the neck upwards like you see on the right.
Side sleeping can cause shoulder pain on the side of the low shoulder. This can be corrected by laying on the shoulder blade rather than the arm itself.
Back Sleeping
Sleeping on your back is probably the easiest way to protect your neck. However, it is associated with higher incidences of snoring and sleep apnea. Back sleeping can also be excruciating for someone suffering from acute low back pain. If this is the case for you, then a side sleeper may be your best resort.
What Pillow Do I use?
EVERYONE wants to know about pillows. It’s almost like they’re looking to justify buying $100 pillow as long as it’s approved by their doctor.
What’s the best brand? Does it need to have contours? What should it be made of? Water? Foam? Feathers?
While I do make specific recommendations for my patients in the office, the truth is that the brand and material matter far less than what the pillow is looking to accomplish.
Pillows should comfortably support the structure of your spine. If your head feels jammed or you feel too extended, then you are not getting the necessary support.
Any conversation about investing in a pillow should involve measurements of your head and neck so that your pillow fits your specific anatomy (it keeps your spine inline when lying down). The material should be hypoallergenic and supportive for long term use. That will usually leave feather based pillows out of the conversation, which they are shown to increase discomfort in pain patients.
Side sleepers – Side sleeping puts your shoulder distance between the head and the bed. Alarger pillow with firmer material is best to support the head and reduce cervical strain.
Back sleepers – Sleeping on your back puts a small distance between the head and the bed. A thinner pillow is usually helpful here. However, if you have severe Anterior Head Syndrome, than a flat pillow may be very uncomfortable and force too much hyperextension. Measurement is key to address your pillow concerns here, but correcting the anterior head syndrome will require a chiropractic approach.
While this may not solve all of your sleep dilemmas. It’s a fast and easy way to start getting better sleep today.
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