Is your back getting on your nerves?
Your spine provides structural support, enables mobility and flexibility and protects your spinal cord, which facilitates communication between your brain and the rest of your body.
It’s easy to screw up your spine with everyday activities, especially if you have bad posture, a sedentary lifestyle and poor technique when lifting stuff.
The good news is that I’ve got your back.
These are the best sleep positions for the spine and tips for good spine health to get you back on track, as well as the worst thing you can do for your neck and back.
How to keep your spine healthy
Eating a balanced diet, doing regular cardiovascular workouts and strengthening your core and flexibility are key to supporting your spine.
When patients come to me with neck or back pain, I’ll ask them, “What are you doing in terms of exercise?”
They stretch and work with weights, but they often neglect to mention cardiovascular exercise, which is a crucial part of maintaining good spine health.
Aerobic activities not only improve the heart and lungs, but also memory, mood and all the muscles in the body, including those in the neck and back.
Don’t forget about good posture
Exercise is important — and so is posture.
You should bring your shoulders back and lift your neck into a neutral position a couple of times throughout the day to reinforce the idea that you’re standing with good alignment.
It may help to go through some gentle stretches to move the neck muscles left and right and up and down.
If you’re at work and find yourself often looking down at your computer or phone, remind yourself to optimize the ergonomics of your spine.
Consider using a sit-to-stand desk or elevating your screen so you’re not always looking down.
The best positions for sleep
The spine, including the neck and lower back, needs to be in a naturally aligned, S-shaped position with balanced curves.
That’s why the best sleep positions for the spine are flat on your back or side.
Side sleeping, in particular, can take pressure off the back of the throat.
People who struggle with sleep apnea, which disrupts breathing, may find that position to be the most effective, along with a mouth guard that opens the airway and a doctor-prescribed CPAP machine to improve oxygenation throughout the night.
Belly sleepers are probably the most susceptible to neck and back problems.
That’s because their neck is more likely to be in a turned position, where the muscles on one side are more engaged than the other. That can lead to muscle spasms and tension, resulting in a stiff neck in the morning.
Someone who experiences neck pain when they wake up should consider a new sleep position.
It can be difficult to change a long-standing sleeping habit, but it can be worth repositioning yourself when you wake up in the middle of the night.
Sometimes that can take a few weeks to get used to, so you have to budget for that.
The best pillows for your sleep position
I recommend a medium-firm mattress and a pillow that doesn’t flex or extend the neck too much and keeps it in neutral alignment.
These tools become especially important with age. Our spine tends to degenerate as we grow older. The discs collapse, bone spurs form and arthritis sets in.
In general, pillows made of memory foam or latex will give support while also conforming to the contours of the spine.
Others may gravitate to pillows that are orthopedic with distinct shapes. All of these are fine, as long as they don’t elevate the neck too much to put tension on the alignment of the spine.
Back sleepers should have a pillow that gives just the right amount of height to their neck. That would be a pillow that’s about 3 to 5 inches tall.
Side sleepers need to have a taller pillow with a bit more height, something like a 4- to 6-inch pillow, to accommodate the shoulders and neck position and keep the spine neutral.
Side sleepers may also benefit from a pillow or comforter between their legs to prevent them from knocking together.
Also, keep an eye on your mattress. If you notice that parts of it are sagging, consider shopping for a new one. Some people recommend changing your mattress every seven to 10 years.
A terrible move for your neck and back
The worst thing you can do is fall asleep in a bad position.
It’s critical not to snooze on a couch or a recliner because your neck and back tend to be in a position that’s not going to help spinal alignment.
In fact, it’s more likely to put your joints and the discs of your spine in a rotated or crooked position. That’s going to lead to a stiff neck or back that may be painful or uncomfortable.
If you wake up with neck or back pain, consider taking a warm shower and massaging the hurting muscles. Topical over-the-counter anti-inflammatories and/or ice can be applied with the massage.
Basic over-the-counter medications, such as a nonsteroidal anti-inflammatory or acetaminophen, may help as well.
If you have pain that doesn’t improve with these treatments, you should consider seeing one of our specialists at NYU Langone Health and the Spine Center.
Themistocles Protopsaltis is the chief of the Division of Spine Surgery at NYU Langone Orthopedics. His clinical expertise includes major cervical and thoracolumbar spinal deformity in adults and children, degenerative spine conditions and minimally invasive and robotic spine surgery.
