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Johns Hopkins Health Alert

Don't Forget Your Pillow

Good sleeping posture allows the body to follow the natural S-shape curve of the spine. Here's advice on protecting your neck and back while you sleep.

Lying in certain positions while you sleep can throw the spine out of alignment; for example, sleeping on your stomach puts stress on your neck and exaggerates the curve of the lower back. A better choice that helps maintain the natural curves of your spine is to sleep on your side with your knees bent and a pillow placed between.

Another option is to sleep on your back, but keep your knees slightly raised by placing a pillow underneath them. This prevents your lower back from overarching by supporting the weight of your extended legs. If you can't break the habit of sleeping on your stomach, place a pillow underneath your abdomen to keep your spine aligned. If you have neck pain, consider using a neck support pillow.

A recent study in the Journal of Rheumatology found that individuals with chronic neck pain who slept with a neck support pillow and performed simple isometric neck exercises (see below) five to 10 minutes a day reported significant improvement in their symptoms. However, use of heat or cold packs with gentle massage, exercise alone, or the neck pillow alone was not as effective.

Another benefit from combination treatment: Those who used both the neck pillow and the exercises continued to feel better up to one year later. If you're interested in such a regimen, ask your doctor to refer you to a physical therapist who can teach you the exercises and the appropriate way to use a neck pillow during sleep.

Isometric Neck Exercise:
Here's an example of an isometric exercise for the neck: Tilt your head to the right while applying resistance with your right hand. Hold for 20 seconds. Repeat on the left side, then do the same exercise, tilting your head first forward and then backward.

Posted in Back Pain and Osteoporosis on July 10, 2009
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


1) If you are a side sleeper and have broad shoulders, you may need two, even three pillows (depending on the thickness) under the head, to sleep comfortably.A third pillow is also good to have as a "saftey" if another drops off the bed, or if you need support under an arm.

2) Before getting in bed, bend over from the waist and grab your toes to release tension you back and neck.

3) If you have morning neck pain and headaches, do a side-to-side isometric on the neck before sleeping. You can do this on your pillow, pushing your neck against your hand, 20 seconds each side. Pain relief and headache relief for the next day can be *miraculous*.

4)Always *seek* the most comfortable neck position with your pillows *before* falling asleep. If your neck feels tense before you go to sleep, it won't feel better in the morning!

5) An open nasal airway decreases facial and neck muscle tension. Take a hot shower before going to bed if stuffed-up; get an ENT evaluation if congestion is chronic-may be allergy or crooked septum.

6) Neck pain with forehead soreness in the temple, eye,and jaw joint region may be from a crooked bite. Get an evaluation from an orthodontist.

Good article. Common sense!

Posted by: No Headaches | July 11, 2009



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