Side Sleep Positions and Pain

Side sleepIt has always been frustrating for me to wake in the middle of the night with back or neck irritation and pain . It doesn’t happen often, thank goodness, but many of my patients tell me they have this problem. Not only is it my task to help them with their daily pain, improve their function etc but to help them reduce some of these same symptoms when they sleep.


Many times I’ll suggest a medium hard bed and sleeping on your side since studies have shown most people prefer a medium hard surface and the side position is better for back support. Medium hard surfaces appear to help people get to a deeper sleep and help them stay asleep longer. Side sleeping reduces snoring and helps many side step sleep apnea.


Sleep positions, our tossing and turning on this medium hard surface and in a side lying position can either reduce our symptoms or increase pain. See the images below. So what has happened to us that we have lost positions of comfortable sleep. Look to the bed you sleep on as well as the pillow you use. Being conscious of your own sleep postures is very important as well.


The surface you sleep on is all important but just as important are the positions you lie in. Both the firmness of the bed as well as the shape and position of the pillow you use can make a very big difference for overall comfort and deep sleep.

New Design/Use Posture Bed Pillow



There are many bed pillows that claim a  “new design”  but there is only one bed pillow manufacturer claiming a  “new way to use”  bed/ pillow design! Z Comfort Plus LLC is a small company with a uniquely designed pillow. Designed to be used differently then any pillow on the market today.


Bed pillows are just something under the head. Bed pillows lie flat on the bed and our head rests  on it. Humanoids sleep on there sides, back or stomach. When we are young animals most anything can be used.  Rolled up Levis worked for me in a pinch, till they didn’t anymore.


Pillow supports and our need for an adequate rest for the head and neck changes with age and injury. Muscles complain in the morning or in the night unless our support is juuuuust right! How many wake up and tell you, “I must have slept wrong.” I know I get a lot of this, but then again I’m a non-force chiropractor.


Over the years I wondered if there could be a “special design” that could help most people despite age and injury issues and in most positions find better more comfortable sleep. I only found out later that this special design had to be combined with special use and posture considerations.


The pillow is a “rest” for the head first. At its core a bed pillow holds the head up, keeping it from falling to the side, falling back or front. Normally this pillow rest keeps us from tilting up or down, side to side or rotating left or right. The theory is that if the the loft and support is just right our head will rest in a neutral position. The problem arises. When we sleep and choose to lie in different postures  how do we maintain this neutral position?


This neutral position doesn’t matter to a bony hard head but makes a world of difference for our very flexible neck and shoulders.


According to this  site……………..there are 81 muscles. Yes 81 muscles for the head and neck.


There are 7 neck vetebra and 3 joints on the bottom of each of the 7 vertebra and 3 on the top of each 7 vertebra. Lets see now 7×3=21 and 7×3=21…Thats 42 joints!!! Oh My!


These 42 joints need comfort just like the muscles do but how about all these other structures in the neck. Structures like the cervical discs, or tendons; attaching muscle to bone or ligaments; attaching bone to bone.


Good gracious no wonder there is so much need for comfortable support and the incredible variety of bed pillows promising this support and comfort and I haven’t even started talking about the shoulders.


As I theorized and finally concluded that pillows, to be adequate for most users, for most positions we sleep in, had to be designed differently than what is seen now. The pillow had to move with the sleeper and be a “changling” as seen in the old Star Trek movies. This new design pillow had to conform/change to support various sleep positions and all these anatomical structures.


Memory foam does some of this it is true but my ideal bed pillow had to do so much more. Let me explain. As I sleep on my side, each segment and other structures in my neck  must compensate for the downward pressure of  gravity.  Gravity is a downward force causing the compensatory stretching of some and the contraction of other muscles.  Joints and other structures also must compensate for this force of gravity.


Unless an exacting upward support exists to counter act this downward force of gravity, structures and their ability to compensate will be taxed to their limits and irritation occurs. Irritation builds in time and forces us to change or sleep position. What irritation continues to grow we toss and turn constantly, consistently loosing needed sleep.


Each and every segment, and there supporting anatomical components has to be supported very well.  My second vertebra may need more upward pressure than my 6th vertebra Memory foam gives a consistent force through out the neck vertebra but what I need is a variable force that can only be determined by me for my needs.


My ideal pillow couldn’t just lie on the bed. It had to be micro adjustable by design and by me. It had to adjust to my individual needs for support. All my vertebra and muscles and joints and all those other tissues had to be supported in my way by me so I can sleep with my neck in comfort.


I designed my ideal pillow and this pillow is adjustable and micro-adjustable. It is interactive for my needs and for my past injury and my age related aches and pains. My ideal bed pillow helped is all of this in any posture I choose as long as  I kept ergonomics in mind.



Ergonomic head and neck position suggested by Dr Lee…..for use with the Totillow Pillow design.


“No matter the posture you choose to sleep in, maintain your ears and head, back and in line with your shoulders.”


“Your nose is centered over your sternum/chest bone.”


“Side sleepers as you turn in bed through out the night…. re-position this pillow so that the narrow side is tipped up off the bed and into the nape of the neck to suit your needs.”


“This pillow is used to help correct and maintain your relative  head, neck and shoulder positions throughout the night”


When you understood and use, better sleep postures, consciously and persistently, you may find, not only improved comfort, but a better, a deeper sleep then you have had in years.”


“Now (for those with shoulder complaints and can sleep on their side) try putting your  arm and shoulder under the pillow at different angles to meet your comfort needs. This will slightly stretch muscles that for some lead to pain and discomfort.”

Back Sleeping Postures

Back Sleep Posture Positions


by Dr. Lee Parimuha DC


Lying on one’s back is not recommended by most health care and sleep specialists due to the risk of developing sleep apnea. Gravity while sleeping on your back influences the soft palate and with normal breathing the soft palate can fall closing the airway enough to cause snoring. Snoring may increase over time causing more closure of the airways leading to less oxygen and increased likelihood of developing sleep apnea.


The Sleep apnea diagnosis are of three types, central, obstructive or mixed. Two of the best ways to decrease your chances of developing this disease is to loose weight and sleep on your side.


If you do sleep on your back use pillows under your knees and take most of the fill from the middle compartment of your Totillow Pillow. In this way the fill that is left can be gathered with the pillow fabric itself and placed under the cervical spine.


I recommend that the fill volume and pillow position be adjusted so that the back of the head will comfortable rest on the bed itself. The neck curvature is  supported by the pillow and the head is back, lying on the bed in an improved ergonomic position.


This better ergonomic position has the ears and head back and centered over the shoulders with the nose centered over the sternum. This might be the ideal ergonomic position when sleeping on your side, back or stomach and side combined position.


The side compartments on the pillow are not altered as is the center compartment fill is so the two side compartments encase the head like ear muffs. Many find this configuration rather comforting. The neck is supported and the head and ears snuggled between the two side compartments. This position also helps reduce ambient noises from the outside.


Not everyone can have their head back on the bed as I suggest since many of us already have their head in forward posture in relation to the shoulders. We have grown accustomed to this position and to force the head back to the bed might just cause more problems then it is worth.


If your normal head position is forward when standing and has been that way for awhile you may want to add fill so that in the lying on the back position of the head would be similar to the posture you have during the day.

Try this one. Have someone take a photo from the side of your head and neck while standing and another photo form the side while lying down on your back with the altered fill pillow. Compare the views and change the fill in the pillow so that both side views are similar. Always defer to your own need for comfort though as everyone’s need is different. Let your own comfort and ability to sleep all night be your guide.


The posture I recommend if you want to sleep on your back that may be kinder to you regarding sleep apnea development is the position called Back and Side Sleep Posture Position, Part 4. More in my next post.


Part 1: Side Sleep Posture Positions 

Part 2: Stomach Sleep Posture Positions 

Part 2 Pillows and Sleep Postures for Baby Boomers

By Dr. Lee Parimuha, DC

Part 2: Stomach Sleep Posture Positions

Simple do’s and don’ts may help you find a comfortable position while sleeping on your stomach. Do not sleep in this position if you have chronic pain syndromes or nerve pain. I originally used this stomach side lying position with good results for some of my patients that had low back pain or mild sciatic pain. If you have any of these symptoms please check with your doctor/therapist before trying these position suggestions. Continue reading

Better Sleep with Healthy Side Sleeping Postures

By Dr. Lee Parimuha, DC

Totillow Deep Sleep Side Sleeper Pillow Baby ImageThe joy of healthy sleep can’t be underestimated. In our fast paced stressful life a great sleep experience is becoming harder to find.

When was the last time you slept like a baby? I mean, really slept well, waking with new life and mentally, emotionally, physically ready for the day. That’s right. We all are a combination of parts. Like it or not. Believe it or not it’s all about the mental, emotional and physical parts that need to rest. How can we get the rest we need for all parts of ourselves on a consistent basis?

Pain and pain syndromes are the most common reasons for insomnia today. As we age, pain becomes a problem due to the natural aging process. Our hormone levels are only a shadow of what they once were. We experience more pain. We toss and turn trying to find that position where we find comfort. When if we find that position, for many of us, it doesn’t last long and we move again and the search continues. Continue reading

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