Why side sleepers can experience more neck & shoulder pain

Cat with good alignment!

You could be doing your pilates once or twice a week; be getting every massage, stretch, and desk setup perfect during the day, but if you’re spending 6–8 hours a night with your neck bent awkwardly, you’re undoing all of it while you sleep.

💡 Quick home check: Lie on your side with your head on your pillow, and have someone take a photo from behind at head height. Your nose should be in line with your sternum — if your head is angled up or down, change pillow thickness until it’s straight.

If you are a side sleeper with a very thin pillow, you’re probably letting your head drop toward the mattress, which means your neck is spending hours tilted sideways. That compresses one side of the cervical joints and overstretches the other, and it can also strain your shoulder muscles because they’re being squashed under your body.

My Advice:

1. Match the pillow height to your shoulder width. For side sleepers, your pillow should be thick enough to fill the gap between the mattress and the side of your head/neck, keeping your head level with your spine. If the pillow is too thin, your head tilts down; too thick and it tilts up.

2. Support the neck curve, not just the head. A good side-sleeping pillow should have enough loft to keep your neck in neutral alignment, and ideally a slightly firmer edge where your neck rests.

3. Check your shoulder comfort. If your mattress is very firm, your shoulder may be pushed up into your neck. In that case, you either need a pillow with a cutout or a softer mattress top layer so your shoulder can sink in.

4. 
   

Pillow Types I’d Suggest:

• Contoured Memory Foam Side-Sleeper Pillow – one with a higher edge for your neck and a dip for your head.

• Adjustable Loft Pillow – shredded memory foam or latex that you can add/remove filling from until it’s the perfect height for your body.

• Water or Air Chamber Pillow – allows precise height adjustment and can give gentle, even neck support.

• Side-sleeper shaped pi

  llow – some have a “cut-out” for your shoulder, so you don’t compress it all night.

It's an easy improvement to make to ease neck & shoulder pain, so give it a go! And if you'd like to practise some pilates on top to help with your posture and alignment, contact me and we can discuss whether some online or face to face sessions could benefit you.