The Best Sleeping Positions for Every Joint with Arthritis (UK)

Name: Best Sleep Positions for Joint Pain: Every Joint (UK)
Creator: Louis Maxwell

Written by Louis Maxwell — First Contact Practitioner, HCPC PH128483.

Clinical review status: not yet recorded

Quick answer: The best sleep position depends on which joint hurts. Generally, keep joints in a comfortable, supported middle position: a pillow between the knees for hip, knee or back pain when lying on your side, a pillow under the knees on your back, and lying on the opposite side, hugging a pillow, for a painful shoulder.

When a joint hurts, finding a comfortable way to lie can make the difference between a broken night and a decent sleep. There is no single "best" position for everyone with arthritis. The right one depends on which joints are painful, your body shape and what feels comfortable. The general principle is simple: support the painful joint in a relaxed, middle position so it is not twisted, squashed or hanging. This guide goes joint by joint, with simple pillow set-ups you can try tonight. For the bigger picture on sleep, see our full guide on how to sleep with arthritis.

Five principles for sleeping with painful joints

Neutral is best. Aim to keep your spine and painful joints in a middle position, not fully bent or twisted.
Support, do not squash. Avoid lying directly on a very painful joint, and use pillows to fill gaps.
Pillows are tools. Ordinary pillows, a rolled towel or a long body pillow can do most of the work. Specialist pillows help some people but are not essential.
Change position. Lying still for hours stiffens joints. It is normal to turn several times a night.
Comfort wins. If a "recommended" position feels worse, do not force it.

Quick guide: positions by joint

Painful area	Often most comfortable	Pillow set-up	Often worth avoiding
Neck	Back or side	Pillow height that keeps neck level with your spine	Front-lying with head turned
Shoulder	Back, or lying on the other side	Hug a pillow to support the painful arm	Lying on the painful shoulder; arm above head
Lower back	Side with knees bent, or back	Pillow between knees on side; under knees on back	Front-lying on a soft mattress
Hip	Back, or lying on the other side	Pillow between knees and ankles	Lying on the painful hip; top leg crossing over
Knee	Back or side	Pillow between knees on side; small pillow under thigh/knee on back, briefly	Long periods with knee bent tightly or propped bent all night
Hands and wrists	Any	Rest hands on a pillow; wrist in neutral; night splint if advised	Sleeping with wrists bent under the head or pillow
Feet and ankles	Back or side	Keep bedding off toes; pillow under calves if swollen	Heavy, tight bedding pressing toes down

Neck arthritis

The aim is to keep your neck in line with the rest of your spine.

On your back: one medium pillow, or a pillow that supports the curve of your neck, so your chin is not pushed down to your chest or tipped back.
On your side: a slightly firmer or higher pillow that fills the gap between your shoulder and ear, keeping your head level.
Avoid: sleeping on your front, which forces your head to turn to one side for hours, and stacking several soft pillows.
Tip: a rolled small towel tucked inside the pillowcase along the lower edge can add neck support.

Shoulder arthritis and shoulder pain

Shoulder pain is one of the most common reasons for disturbed sleep, and many people find it worse when lying on the affected side.

On your back: place a small pillow under the elbow and forearm of the painful arm, so the arm rests slightly away from your body and the shoulder is supported.
On the other side: hug a pillow in front of your chest and rest the painful arm on it, so it does not fall forward across your body.
Reclined: during a bad spell, some people find sleeping propped up on several pillows or in a reclining position easier for a short time.
Avoid: lying on the painful shoulder, and sleeping with the arm stretched above your head.

Lower back arthritis

On your side: bend your knees slightly and place a pillow between them. This stops the top leg pulling your pelvis and lower back into a twist.
On your back: place a pillow under your knees to take tension off the lower back. A small rolled towel in the small of your back can help some people.
On your front: if this is the only way you can sleep, put a thin pillow under your hips and lower tummy to reduce arching, and use a flat pillow or none under your head.
Getting up: roll onto your side, drop your legs over the edge of the bed and push up with your arms, rather than sitting straight up.

Hip arthritis

On your back: often the most comfortable for a painful hip. A pillow under the knees can help.
On the opposite side: place a pillow, or two, between your knees and ankles to keep the top leg level with the hip, so it does not drop forward and twist the painful hip. A long body pillow does this well.
On the painful side: some people with osteoarthritis are comfortable lying on the affected hip on a softer mattress or topper. Pain on the outside of the hip when lying on it is often from tendon or bursa irritation rather than the joint itself.
After a hip replacement: follow the specific advice from your surgical team about positions and how long to keep using a pillow between your legs.

Knee arthritis

On your side: a pillow between your knees stops bony knees pressing together and keeps hips and knees aligned.
On your back: a small pillow under the knees can feel comfortable for a while. Try not to keep the knee propped in a bent position all night every night, as this can make it harder to straighten the knee fully. A small pillow under the thigh or calf, rather than directly behind the knee, can be a good compromise.
Swollen knee: raising the leg on a pillow under the calf can help swelling.
Morning stiffness: gentle knee bends and heel slides in bed before getting up can help. See our morning stiffness routine.

Hands, wrists and fingers

Rest your hands on a pillow beside you or on your tummy, rather than tucked under your head or pillow.
Keep your wrists straight. Bent wrists for long periods can increase hand pain and tingling.
If you wake with numbness or tingling in your thumb, index and middle fingers, this may be carpal tunnel syndrome. The NHS suggests wrist splints worn at night can help; a GP, physiotherapist or hand therapist can advise.
Resting splints for inflamed joints can be provided by a hand therapist or occupational therapist if your rheumatology team recommends them.
Warm your hands in warm water before bed if they stiffen at night.

Feet and ankles

Loosen tucked-in sheets, or use a bed cradle, so heavy bedding does not press on painful toes. This can be particularly helpful during gout attacks.
If your feet or ankles swell, raising them slightly on a pillow under the calves can help.
Gentle ankle circles in bed before getting up can ease morning stiffness.

Several painful joints

If you have arthritis in many joints, a long body pillow or a U-shaped pregnancy-style pillow can support several areas at once: between the knees, under the top arm and along the back. Lying on your back with a pillow under the knees and small pillows under each forearm is another option. Change positions through the night, and do a few gentle movements before settling.

Turning over and getting comfortable

Turn as one unit: bend your knees, then roll your shoulders and hips together.
Smooth or satin sheets, or satin pyjamas, can make turning easier.
A bed rail or bed lever can help you turn and get up. An occupational therapist can advise; ask your GP or local council about an assessment.
Bed height: a bed at a height where your feet are flat on the floor and your knees are roughly level with your hips makes getting in and out easier.

Mattresses and pillows

There is no single mattress that is best for arthritis. Many people with painful hips and shoulders find a medium-firm mattress, or a softer topper on a firmer base, comfortable because it supports the spine while letting shoulders and hips sink slightly. A very soft mattress can make turning harder. Before buying, try mattresses in store if you can, and check the return policy. Replace pillows that have gone flat, as they no longer support your neck. If money is tight, adding a topper and the right pillows is a cheaper first step.

Beyond positions: other things that help

A regular sleep routine and a calm wind-down, as the NHS recommends.
Gentle movement during the day; NICE's osteoarthritis guideline (NG226) recommends exercise as a core treatment, and activity often helps sleep. See our exercise hub.
Warmth on stiff joints before bed, and cold on hot, swollen ones.
Pain relief timed as your GP or pharmacist advises. See our pain relief guide.
If you wake in pain, have a plan. Our night-time joint pain guide explains what to do at 3am.
Avoid sleeping tablets unless prescribed; they can increase the risk of falls at night. See sleeping tablets and falls.
During a flare, use extra pillows and follow your plan. See our flare-up guide.

When to get medical help

See your GP if joint pain regularly stops you sleeping despite trying these steps, if night pain is new or getting worse, or if you have had trouble sleeping for several weeks. The NHS recommends cognitive behavioural therapy for insomnia (CBT-I) as a main treatment for long-term sleep problems.
See your GP soon if you have night pain that does not ease with any change of position, or night pain with fever, night sweats or unexplained weight loss.
See your GP if you snore loudly, stop breathing or gasp during sleep, or feel very sleepy in the day, as this can be sleep apnoea. See our sleep apnoea guide.
Call NHS 111 or go to A&E for a suddenly hot, red, swollen, very painful joint with fever, or back pain with numbness around the bottom or genitals or bladder or bowel problems.
Call 999 for chest pain, severe breathlessness or signs of a stroke.

What is the best sleeping position for hip arthritis?

Many people find lying on their back, or on the opposite side with a pillow between the knees and ankles, most comfortable. The pillow keeps the top leg level and stops the painful hip twisting. If you have had a hip replacement, follow your surgical team's advice.

How should I sleep with a painful shoulder?

Try lying on your back with a small pillow under the elbow of the painful arm, or on the other side hugging a pillow to rest the painful arm on. Avoid lying on the painful shoulder or sleeping with your arm above your head.

Is it good to sleep with a pillow between your knees?

For many people with hip, knee or lower back pain, yes. A pillow between the knees when lying on your side keeps the hips, knees and spine aligned and stops bony knees pressing together. A long body pillow can make this easier.

Should I put a pillow under my knee if it is arthritic?

A small pillow under the knees can feel comfortable when lying on your back. Try not to keep the knee propped bent all night every night, as it may become harder to straighten. A pillow under the calf or thigh is a good alternative.

What type of mattress is best for arthritis?

There is no single best mattress. Many people find a medium-firm mattress, or a softer topper on a firm base, supports the spine while cushioning hips and shoulders. Very soft mattresses can make turning harder. Try before you buy if possible and check the return policy.

Is sleeping on your front bad for arthritis?

Front-lying can strain the neck, because your head is turned to one side, and can arch the lower back. If it is the only way you can sleep, use a thin pillow or none under your head and a thin pillow under your hips.

Sources and further reading

Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.

Continue with related help

How to sleep with arthritis — the full sleep guide
Night-time joint pain — a 3am survival plan
Sleep apnoea — snoring and daytime sleepiness
Sleeping tablets and falls — safer choices
Pain relief — options to discuss
Exercise hub — daytime moves for better nights
Flare-up guide — sleeping during a flare

Last updated 2026-10-10. This is general information, not a substitute for personalised medical advice.