Pain Relief | Physical Therapy

How Can I Sleep Pain Free?

Published May 27, 2019
By Health Loft

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Do you have trouble falling asleep at night because you are in pain? Does your pain wake you up in the middle of the night? Do you feel achy and sore in the morning?

A good night’s sleep can be one of the best forms of treatment when it comes to relieving pain. Conversely, a lack of sleep or poor sleep habits can lead to an increase in pain intensity. Pain can also trigger poor sleep quality. One night of a painful, disruptive sleep often leads to more pain along with less sleep in subsequent nights. If you experience pain before, during, or after sleeping, then you are probably familiar with this vicious cycle. Fortunately, there are strategies that help relieve pain with sleeping. Here, common causes of night pain and useful techniques to alleviate pain while sleeping will be discussed.

Common causes of sleep-related pain

Headaches: Oftentimes headaches may not follow a clear daytime or nighttime pattern.Symptoms may last late into the night, or they may not occur until mid-day. Improper neck support or altered head positioning while sleeping may act as driving factors toward nighttime headaches. Inadequate support at the head and neck at night can place increased stress on the joints at the neck, which may aggravate headache symptoms.

Low back pain: If you have low back pain it may feel like no sleeping position is safe. Various sleeping positions can be aggravating towards low back pain. At night, the muscles that usually support the low back become inactive, this may be one contributing factor towards increased pain when you are trying to sleep. Without the muscular support at your low back your spine must support the weight of your lower body.

Sleeping posture: You may not realize it, but your posture while you are sleeping is just as important as your posture throughout the day. There may be some truth to the saying “I slept on it funny”. Different sleeping positions can place excessive stress on the various joints throughout your body. Over the course of a regular sleep cycle, this pressure can develop into pain and aches which may wake you up, or leave you feeling sore in the morning.

Chronic pain: This type of pain can be categorized as pain that persists after normal healing has occurred. Pain is typically considered chronic when it lasts greater than three months after the initial injury. Sleeping time and sleep quality are usually diminished in people with chronic pain. Pain and sleeplessness are often closely related, as one affects the other.

Stress: Emotional stress is not necessarily a cause of pain, however increased stress levels can act to aggravate symptoms of an already painful condition. Heightened stress levels can increase your body’s sensitivity to pain, which can have a large effect on your sleeping habits.

What can I do?

If you have difficulty falling asleep at night due to pain, fortunately there are strategies to help reduce your nighttime pain and get you back on track towards a more restful sleep. All of these techniques can be implemented with nothing more than a few extra pillows. Proper pillow support in bed is crucial towards improving comfort and minimizing pain. Here are a few tips on how to use your pillows to your advantage:

For side-lying sleepers:

Head position: Place one pillow underneath your head so that it makes contact with the top of the shoulders. The pillow height should be adjusted so that the head and neck remain neutral, you shouldn’t feel like your head is tilted up or down. This position will allow the pillow to absorb all the weight of your head as you sleep.

Leg position: Place one pillow between your knees and one pillow between your ankles. Pillow height should be adjusted so that the normal gap between your legs in maintained (as if you were standing with feet shoulder width apart). Proper leg support will minimize the stress on your spine at night.

For back sleepers:

Head position: Place one pillow underneath the head so that it makes contact with the top of the shoulders, but is not underneath the shoulders. Pillow height should be adjusted so that the head and neck remain neutral.

Leg position: Place one pillow underneath the upper thighs, and one pillow underneath the knees so that the upper calves are also supported. Pillow height should be adjusted so that the hips and knees are resting in a slightly bent position. With the legs supported in this position, your spine is allowed to rest in a neutral position.

For stomach sleepers:

Sleeping face down or on your stomach should be avoided when possible. This position can place increased load through your spine as you sleep. Sleeping on your stomach also facilitates increased twisting and bending at the neck, which may aggravate pain in certain conditions. If you are one of those people that absolutely cannot fall asleep in any other position pillow support can still be beneficial here. Place one pillow underneath your hips and one pillow underneath your ankles. Adjust the pillow heights so that there is just a slight bend at the hips and knees.If you don’t see an improvement in your nighttime pain after trying these sleeping positions come see one of our physical therapists for an in-depth evaluation and further information on pain relief strategies.



Yamada K, Kubota Y, Shimizu Y, Shibata M, Morotomi N. Association of sleep sufficiency and duration with chronic pain prevalence: A population-based cross- sectional study. J Psychosom Res. 2019;120:74-80. Sweetman B. Various types of sleep disturbance due to different sorts of low back pain: A literature review: 4: Mechanisms and theories as to how back pathology might cause sleep disturbance. International Musculoskeletal Medicine. 2015;37(4): 146-152. Desouzart G, Matos R, Melo F, Filgueiras E. Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.Work.2016;53(2): 235-240

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