Sleeping on Your Stomach:
Sleeping on your stomach, known as the fully prone position, is the sleep position I rarely recommend (and discourage) to almost all of my patients. I say this because it is specifically strenuous on the joints of your low back because it causes your spine to be pushed into slight extension while you’re laying face down. This prolonged extension can lead to dysfunction and irritation of the low-back facet joints, which is a common low-back conditions I see every day in practice. In this position, your neck also needs to be fully rotated to one side or the other, which puts a lot of stress on these joints, muscles and ligaments of the neck and upper back. This torquing of the neck often leads to one-sided facet joint problems in the neck and upper back and muscular and ligament problems on the opposite side, creating pain, stiffness and sometimes spasm in the morning. But as with all sleep positions, I recognize that for some people this is the only way they can get a restful, uninterrupted sleep through the night. If this is true for you, you can reduce the amount of extension strain on your low back by placing a thin to medium sized pillow under your pelvis and lower abdomen. This helps bring your lower spine out of extension and back into a more neutral position. Using a pillow in this position can also increase the stress on the joints of your neck and upper back, as it forces your neck into extension. As such, stomach sleepers would often benefit from sleeping with no pillow under their head at all. Try slowly transitioning to not using a pillow at all by gradually using thinner pillow thicknesses over the course of 3-4 weeks so that the change isn’t too drastic for you.