Chronic pain often reduces the quality of sleep and the ability to relax. Sleep is very important to the body and the wrong sleeping position can increase the pain and discomfort. Therefore, it is important to find a comfortable sleeping position. Theoretically, the most comfortable sleeping position is likely to offer a good quality of sleep. It is generally thought that the increase in muscular pain or pain from a certain position indicates the unsuitability of such a position. During sleep, the objective is to maintain the neutral position of the spine. The best way to achieve this is to lie on the back with the back of the head resting on a pillow and the knees slightly bent, or to sleep on the side with the knees slightly drawn up towards the chest (a fetal position). These are the most comfortable positions with the least amount of stress to the spinal discs. In the case where pain has been increased, it may be helpful to use a recliner or adjustable bed, as this will be easier to find a comfortable position. It is, however, still possible to have a good quality of sleep with most acute or chronic pain conditions.
Importance of a Comfortable Sleeping Position
People often fail to consider the importance of their sleep posture and its effect on the structural components of their body. Ligaments have a consistent stress level that they will adapt to over a prolonged period. If a person has a habit of sleeping with excessive pillow prop, for example, this can elevate the shoulder on the side of sleep and increase tension on that side’s shoulder and upper trapezius muscles. Over time, this can lead to shoulder pathology.
It is not uncommon for patients to state that a certain position that they slept in “caused” their neck pain. Although this may seem like an obvious conclusion to some, most patients do not understand why this is the case. A study in the Spine Journal (2008) evaluated the effects of different positions on MRI-verified injuries in the cervical spine. The authors found that the position of the neck has a substantial bearing on the amount of stress on the joints and internal discs of the cervical spine. They found that a neutral position with small pillow support was the best way to avoid increasing intradiscal pressure, which is a consistent cause of arm pain from a cervical disc herniation. This is particularly important during sleep as the repair cycle of the body is most efficient when a person is asleep. Poor sleep quality or sleep deprivation is well known to retard the reparative process.
Common Causes of Neck Pain and Burning Pain in Upper Right Arm
The characteristics of the pain, including its exact location, the way it feels, and whether pain is felt more in the neck or in the arm can provide information about the cause of the pain. Symptoms that add to the complexity and differing diagnoses of neck and arm pain include if the pain came on suddenly or was the result of some type of trauma, and if you experience pain, tingling or numbness in the shoulder or fingers. The predominant symptom (neck pain, arm pain, burning, pain, tingling, numbness) and problems that can be associated such as weakness or functional limitations are an important factor in diagnosing the cause of neck and arm pain. An accurate diagnosis is crucial in understanding the cause of the pain and formulating an effective treatment plan.
Pain is often displayed in different forms, making it a complex process to understand. Neck and arm pain, whether it occurs simultaneously or independently, can be debilitating, impacting your ability to go about your daily life. By understanding the causes and taking steps to address the problem, most people are able to find relief for neck and arm pain. In some cases, neck and arm pain can even be indicative of a more serious underlying problem.
Overview of Singapore’s Climate and Sleeping Conditions
This section explores the main features of Singapore’s climate and assesses how it impacts on the population’s sleeping conditions. It begins by focusing on the active and busy lifestyle in Singapore, which seems to serve the fundamentals of a 24-hour economy. This essentially means that a large proportion of the workforce operates in shift patterns including night shifts. This has an obvious effect on sleep and rest patterns as employees working shifts may attempt to ‘re-schedule’ their body clocks so that they can still partake in both work and social activities. This is confirmed by a local study, which shows that 33% of shift work and 23% of daytime workers obtained less than 6 hours of sleep a night. Although it is widely believed that lack of sleep is compensated with more time spent in bed, there were no significant differences in the bedtimes and sleep durations of shift work and daytime workers. Poor sleep was most evident in the older shift workers, which is not surprising given that the prevalence of neck pain increases with age. Shift workers also complained of sleep disturbances and difficulty in falling asleep. Neena et al (2000) showed that the likelihood of sleep disturbances was 1.7 times higher in shift workers compared to daytime workers. These disturbances were highly correlated with irregular work schedules and rotating shifts. As for the cause of the disturbances, a study on offshore workers shows that those who work throughout the night have lower levels of 6-sulphatoxymelatonin, a metabolite of the hormone melatonin which is secreted during the darkness phase of the light-dark cycle, compared to those working day or afternoon shifts. Low levels of 6-sulphatoxymelatonin were also found in those who had less than 4 hours of sleep a day and this would impair the ability to fall asleep. This then suggests a biologically plausible explanation for the sleep disturbances of shift workers. The exact cause of burning pain in the upper right arm between elbow and shoulder is unknown.
Recommended Sleeping Positions
The best way to find comfortable sleeping positions for neck pain is to experiment. If you have neck pain, you should look at getting a pillow that is the right height. The pillow should be contoured to fit the curve in your neck and your head. A feather pillow will also contour and provide support. If it is too high, your neck will be placed into a position that can cause it to bend, and if it is too low, your neck muscles will be strained as they try to tense up to bring the head into a straight position. Special therapeutic pillows are useful, especially for people with chronic pain. A semi-roll-shaped pillow is used to support the neck, correct the spinal alignment, and reduce muscle tension. You then need to look at positioning your head. Your head and neck should be in a straight and neutral position. Avoid sleeping with more than one pillow as this can put your head into a flexed position, increasing the strain on your neck muscles. If sleeping on your back is your favorite and you are finding it difficult to change positions, then you need to place a small towel roll under your neck for support. Then place a pillow under your knees and keep your spine as straight as possible. This will relieve the pressure on your lower back. If your pain is still bad when you wake up, then you can experiment by elevating the top of your bed by 4 inches. This can be done by placing a foam wedge between the bed and the box spring or by using an adjustable bed. This has been shown to reduce pain and disability, as well as the time taken to get up in the morning.
Sleeping on Your Back with Proper Support
Lie on your back on the floor or your bed. Place a large, flat pillow under your knees. Try rolling a towel and placing it under the small of your back for added support. The towel should roll up to about 5 inches in diameter. This should take the strain off your lower back. Be sure to use a pillow that supports the natural curve of your neck – this is not the same as a neck roll. A cervical pillow that juts out in the center is not supportive enough. You should feel your head being cradled, with your neck fully supported, and your head should not be able to reach back to touch the bed/floor. You can make a towel roll and place it in the bottom pillowcase of your regular pillow to save from buying a new pillow. Sleep with your arms by your sides – not up on pillows, nor down reaching towards your feet. This can sometimes help people if they have shoulder pain. Although this was written for back pain relief, the above mentioned position has been known to relieve upper back pain as well, and is recommended in cases of arm pain as the arm pain can be referred from the neck. However, it is not recommended to sleep on your back if you have sleep apnea, a condition where you stop breathing sporadically during sleep.
Sleeping on Your Side with a Pillow Between Your Knees
This position is also useful in late pregnancy. If you are unable to lie on your side, it may be more comfortable to place the pillows at your back and front to prevent you from rolling onto your back or in between the pillows.
This advice can be uncomfortable initially, especially if you are not used to sleeping on your side. However, it is usually the most comfortable once you get used to it. It is important to keep the pillow between your knees and not your ankles. Placing it between your ankles will cause too much rotation of your back. Do not try this if you have varicose veins. This position may be more comfortable if you bend the knees slightly, rather than leaving the legs straight. This is because having the legs bent will reduce the tension in the muscles and the hamstring. But never bring the knees up to a position higher than your hips.
This is a position that you can try if you like to sleep on your side. Place a firm pillow between your knees. This will keep your hips, pelvis, and spine in better alignment. A small pillow or roll of a towel should be placed under your waist to support the spine. The side to which you are going to place the pillow is the opposite of the side where the pain is (if the pain is on the left side, you will sleep on your right side).
Sleeping in a Semi-Reclined Position
If you have been diagnosed with a specific sleep disorder or are still not sleeping well throughout the night, it may be beneficial to find out from your sleep specialist what your optimum sleeping posture is. However, the sleep positions and pillow techniques described here are simple yet effective for helping anyone have a comfortable night’s sleep. The best way to ensure a good night’s sleep is to make an investment in a pillow that suits your particular sleeping posture and support needs. Take into account that it may take several days to several weeks to get accustomed to a new sleep position or pillow, so it is best to be patient and consistent with the use of your new pillow. Come back to this article when you figure you are ready to move onto the next sleep position and remember to listen to your body. And don’t forget to enjoy the fresh feeling of waking up and saying, “Ah, I slept just like a baby!”
Sleeping in a semi-reclined position: A semi-reclined position is one in which you are slightly sitting up. It is best to sleep in one of these positions rather than completely sitting up, as this can cause stiffness in your lower back and make your upper back and neck area sore. One common way to sleep in a semi-reclined position is to sleep in a recliner. An even better way to sleep in a semi-reclined position is to elevate the head of your bed about 30 degrees and put several pillows behind your back so that you are supported in this position. This can be done by placing a foam wedge between the mattress and box spring or using an adjustable bed. The medical reason for recommending a semi-reclined position is that this has been shown to decrease the rate of regurgitation of stomach acid into the esophagus and decrease the number of reflux events during the night. Since acid reflux can result in a burning sensation in the throat and chest, it can worsen neck pain and arm pain. Also, research in Japan has shown that sleeping in a semi-reclined position can help people with shoulder, arm, and neck pain. An added advantage of an elevated bed or foam wedge is that it can put you in a relatively stable position and may decrease the number of times your sleep is disrupted compared to when you try to use several pillows to prop yourself up.
Avoiding Sleeping on Your Stomach
In general, sleeping on your stomach can place a lot of strain on the back and neck because the spine can be forced out of its natural position. If you only sleep on your stomach, using a single thin pillow or no pillow at all will be the closest to the natural position and cause the least amount of pain. Using a thick pillow is the worst, since your head and neck will be so far out of normal position. If you sleep on your stomach, a good pillow should be considered to help reduce the associated neck pain. It provides you with an option to have a more natural sleeping position and at least in the initial phase, use it to train yourself to sleep on your side using the recommendations in section 2.2 above. Also, for a trial period, you could tape a pocket TENS machine around the upper thigh/groin/buttock area on the worst side for one hour before bedtime and during sleep, then remove it after one hour of waking. This has been reported to reduce discomfort in trials with others having related pain or referred leg symptoms.
Additional Tips for Comfortable Sleep
Choose the right pillow and mattress. Select a pillow that will keep the neck aligned with the chest and lower back. Most people sleep on a pillow that is too soft. This will not support the neck properly and can result in pain in the arm, as well as tingling, numbness, and weakness in the arms. The most common position that people sleep in is on their side. It is recommended that you place a small pillow or a rolled-up towel into the pillowcase to give extra support to the neck. This will alleviate any pain that you will be experiencing from your neck into your arm. An ergonomic pillow that is contoured to the curve of the neck is also recommended. This also applies to choosing the right mattress. A mattress should provide good support. It should be possible to achieve support of the natural curve of the spine and maintain good alignment when lying on the side. Due to personal preferences and spinal condition, it is difficult for a mattress to be chosen. It is advisable to try several mattresses before buying. If possible, sleep on a mattress for a couple of weeks and purchase it if it will likely ensure a good night’s sleep and reduce symptoms of neck pain and burning/pain in the arm.
Choosing the Right Pillow and Mattress
If you have a good mattress and pillow, your neck will be in a neutral position and you will avoid any positions that put your neck into any extreme position. It is probably the most important factor in helping to avoid neck pain after sleep. The goal is to have your head in a position similar to when you are standing with good posture. Try to avoid using too high or stiff a pillow, a pillow that is too high will keep the neck muscles working all night to support your head. It may also put pressure on neck joints. A good pillow should conform to the shape of your head and allow it to sink in, whilst filling the space between the head and the mattress, taking the strain off the neck and giving support to the shoulder. A contoured pillow may be a good choice. A mattress should provide full support of the spine and keep the spine in the same shape as good standing posture. Most often, a medium firm mattress may be the best choice. If you are unsure whether your mattress or pillow are suitable, put some thought into trying out some different pillows and mattresses. In cases of severe pain, a physiotherapist or healthcare professional with expertise in the area of spinal health may be able to provide advice on suitable pillows and mattresses.
Incorporating Neck and Arm Stretches Before Bed
Neck Rotation: Slowly turn your head to the left while in a sitting or standing position. Hold the stretch for 15-30 seconds. Repeat the above stretch with the head turning to the right. You can increase the stretch slightly with this and the following stretch by applying some extra overpressure with your hand. Do not push with your hand, only enough to feel a comfortable stretch of your neck muscles. Repeat each side 2-4 times.
Neck Flexion: Slowly lower your chin down to your chest and let the weight of your head provide a gentle stretch. You can increase the stretch slightly with the hand on the same side of the pain by applying some extra overpressure. Hold for 15-30 seconds and repeat 2-4 times.
Here are some simple and effective stretches for your neck and upper right arm that you can use:
Stretches are an essential part of any exercise or physical activity, and they can also greatly help the quality and ease of your sleep. Stretching your neck and arm muscles before bed can help relieve any ongoing tension and discomfort that you are experiencing with your neck pain and arm pain. It can also help reduce the chances of waking up with a stiff or sore neck after a night’s sleep. Make sure to stretch gently, and if anything increases your pain, then stop immediately. Overstretching and aggravating your pain will be counterproductive and could lead to a more disturbed night’s sleep.
Creating a Relaxing Sleep Environment in Singapore’s Climate
Step out from the bedroom, the rest of the ideas are using fans and a dehumidifier. Fans provide a cool and comfortable environment with ventilation and air circulation, although it does not lower room temperature. A dehumidifier is able to remove moisture from the air and it also provides indoor cooling.
To achieve a cool feeling without the use of air-conditioning, the textile industry’s research and development efforts present to you a fabric known as “cooling fabric”. Cooling fabric is made of natural mineral and botanic additives which give the fabric a cool and comfortable feel. The natural mineral provides the cool touch and the botanic additives provide a cottony soft feel to the fabric. The fabric controls micro-climate humidity so that it stays cool, dry, and comfortable, and it provides excellent moisture transport with wicking and fast-drying capabilities. Such a fabric would be a good choice to make bed sheets or in creative pillow making. Unfortunately, this fabric might not be found in the market yet. An alternative to cooling fabric, cotton fabric meets most of the criteria. Cotton bed sheets and pillowcases are cool and comfortable. Cotton absorbs heat from our body and transmits it to the surrounding air, thus giving us a cool and comfortable feeling, and it is breathable due to the fact that it does not trap perspiration between our skin and the fabric. A 250-340 thread count cotton pillowcase is suggested for a cushioned, soft feeling. This is the same for the mattress, but you would also look into mattress pads. Wool and synthetic mattress pads are usually warm and heat retentive. Opt for a cotton mattress pad because it is cool and comfortable and it is able to absorb body moisture.
How do you keep the body cool at night for a good night’s sleep? We want something that does not use electricity (because we are trying to save the Earth too, right?), feels cool, absorbs sweat, dries fast, and is comfortable. If you are the type that uses air-conditioning all night, you will be allowed to have thicker mattresses and use fewer blankets because the environment is already cool.
Tropical climate can be a hindrance to comfortable sleep. Singapore falls into this category. There would be nights when you wake up with a sweaty and sticky back. Sweating at night is the body’s way of cooling during too much heat or humidity. While it is very important to cool the body down, waking up soaking wet is not the best way to achieve this.
Seeking Professional Help for Persistent Neck Pain and Burning Arm Pain
Persistent neck pain or arm pain that indicates nerve damage is a serious problem. In a normal case of nerve root compression, the type that can cause pain or weakness that travels into the arm, it is wise to try to 2 weeks to get the pain to go away. Consult your Singapore medical doctor if the arm pain and or neck pain has not gone away after a month, but is not too severe. If it is severe, or has gotten consistently worse in a 2-6 week period, then seeing a spine specialist as soon as possible is advised. Well, how do you know if your pain is severe? One thing to consider is the way you hold yourself. If you are guarding your arm, and are hesitant to move or make certain movements because it causes the pain to intensify, then this is a good indicator that the condition is more serious than not. Numbness, tingling, or a burning feeling down into the arm or hand can be an indicator that this type of condition is present. Seek an orthopaedic or neurosurgeon and ask his or her opinion. In situations when the doctor says that the condition should be evaluated with tests but nonsurgical treatment is still the course of action. Such tests as MRI or EMG can confirm where the pain is coming from, and at what level a nerve may be getting pinched. This can direct what the best approach is for fixing the pain. A test or a visit to the specialist does not necessarily mean that surgery is imminent, so long as there is improvement in the condition with the nonsurgical treatments. Oftentimes, it is the case that the condition will improve and the pain will go away, and at a more rapid rate than for someone who lets the condition linger on for months or years before seeking the appropriate care. At any rate it is best to play it safe and seek the appropriate treatment for neck and arm pain of this nature.
These suggestions are applicable also for the comfort and prevention of neck and arm pain, although patients may have specific position preferences. The suggestions can safeguard that the comfort is not causing extra pain to the neck and arm and give an overall better night’s sleep.
– Use a cervical pillow to help maintain your neck’s normal curve. – Sleep on your side with your knees slightly bent. – If you sleep on your back, use a small pillow under your neck and a small rolled towel under your neck. – Do not sleep on your stomach. – Avoid any prolonged positions on your arm with overhead positions or reaching, as these will challenge the neck and upper back muscles.