How to Sleep to Improve Alignment and Help Alleviate Back Pain

Sleep positioning, rather than medical ailments, may be the cause of most back pain, according to balance expert Jean Couch, founder of the Palo Alto-based Balance Center.

“Misaligned bones create chronic tension,” Couch explains. “We can alleviate tension and pain by sitting, standing, bending and sleeping differently. Practicing proper alignment in bed takes stress off the joints and allows the muscles to relax for a more restful sleep.”

Couch offers these tips on optimal spine alignment during sleep:

Sleep in an elongated position, not curled in a ball. This lengthens the spine and increases moisture and nutrition to spinal discs, promoting a healthy back.

When sleeping on your side, place the upper arm on hip or side. If the arm drops forward, place a pillow under the armpit. This widens the shoulder girdle and aligns the entire shoulder area.

Position your pillow properly. If you are lying on your side, your pillow should be positioned as high as your shoulder is wide. Improper alignment, too high or too low,  can cause pain in the neck and spine.

Back sleepers should create a wedge shape with their pillow, with more height and dimension toward the top of the head. This forces the chin down and lengthens the neck, decreasing snoring and possibly helping with sleep apnea. The wedge shape also helps to relax the lower back.

Couch keeps these tips in mind in her own life as well, knowing that the right support is important to a good night sleep. Couch sleeps with two down pillow from McRoskey every night. “I can shape the down pillows depending on my comfort needs at the moment,” she says. “No foam or pre-shaped pillows for me.”

Learn more about the Balance Center and Jean Couch’s work at

About McRoskey Mattress Company: McRoskey Mattress Company has been handcrafting mattresses and box springs in San Francisco, California since 1899. Mattresses are available in standard and custom sizes. McRoskey has showrooms in Palo Alto and San Francisco.