Joint Pain and Sleep: Strategies for a Better Night's Rest

Key Takeaways

• Strategic sleep positioning can reduce joint pain and improve rest quality
• The right mattress firmness matters—medium-firm often works best for arthritis
• Timing your pain medication properly can help you fall asleep and stay asleep
• Simple bedroom adjustments and sleep hygiene habits make a real difference
• Persistent sleep problems deserve medical attention—don’t suffer in silence

If you’ve ever spent hours tossing and turning because your knees ache or your hips throb, you’re not alone. Nearly 80% of people with arthritis report sleep problems, according to the Arthritis Foundation. The connection is clear: pain disrupts sleep, and poor sleep makes pain worse. It’s a frustrating cycle.

The good news? You can break that cycle with the right strategies. Let’s explore practical, proven ways to get the rest your body needs to heal and feel better.

Why Joint Pain Gets Worse at Night

Ever notice that your joints seem to hurt more when you’re trying to fall asleep? There are real reasons for this.

During the day, you’re moving around. Movement helps pump fluid through your joints and keeps them lubricated. When you lie still at night, that natural joint “oiling” slows down. Stiffness sets in.

Your body also produces less cortisol (a natural anti-inflammatory hormone) at night. With less cortisol on board, inflammation can flare up. Add in the fact that you’re no longer distracted by daily activities, and you become more aware of every ache.

Understanding this helps you fight back with targeted strategies.

Sleep Positions That Reduce Joint Pain

The way you position your body can make or break your night. Here’s what works for different problem areas:

For Knee Pain

If your knees keep you awake, try sleeping on your side with a pillow between your knees. This keeps your hips aligned and takes pressure off your knee joints. The pillow prevents your knees from rubbing together, which can trigger pain.

Back sleepers should place a pillow under their knees. This takes stress off the lower back while keeping knees in a comfortable, slightly bent position.

For Hip Pain

Side sleepers with hip arthritis should use a thick, firm pillow between the knees to keep the hips stacked properly. If you sleep on the painful hip, try switching to the other side.

Back sleeping works well for hip pain. Place a pillow under your knees to maintain your spine’s natural curve and reduce hip strain.

For Shoulder Pain

Avoid sleeping on the painful shoulder. Sleep on your back or on the opposite side. If you’re a committed side sleeper, try hugging a body pillow. This keeps your painful shoulder from bearing your full weight.

Some people find relief with a small rolled towel placed under the curve of their neck for extra support.

For Lower Back and Spine Issues

Back sleepers should use a pillow under the knees and a small rolled towel under the lower back curve. Side sleepers benefit from a pillow between the knees and should make sure their pillow keeps the head aligned with the spine—not tilted up or down.

Choosing the Right Mattress and Pillows

Your mattress matters more than you might think. Research shows that medium-firm mattresses work best for most people with arthritis. Too soft, and your joints sink into awkward positions. Too firm, and pressure points develop.

If your mattress is more than 7-8 years old, it may be time for a replacement. A sagging mattress won’t support your joints properly.

For pillows, the goal is to keep your spine aligned. Side sleepers need a thicker pillow than back sleepers. Stomach sleeping (which we don’t recommend for joint pain) requires the thinnest pillow or none at all.

Memory foam toppers can add cushioning to an existing mattress without the cost of replacement. A 2-3 inch topper often provides enough extra comfort to make a difference.

Timing Your Pain Relief

When you take pain medication can be just as important as what you take.

If you’re using over-the-counter anti-inflammatory medications (like ibuprofen or naproxen), taking them 30-60 minutes before bed can help you fall asleep more comfortably. This gives the medication time to start working before you lie down.

For prescription medications, follow your doctor’s instructions carefully. Some pain medications work better when taken with food, while others should be taken on an empty stomach.

If you have moderate to severe knee osteoarthritis and are considering longer-lasting pain relief options, hyaluronic acid injections can provide several months of pain reduction that may help restore normal sleep patterns.

Never exceed recommended doses, and be aware that some pain relievers can cause stomach upset if taken on an empty stomach right before bed.

Sleep Hygiene Tips for Chronic Pain

Good sleep habits become even more important when you’re dealing with ongoing pain. Here’s what actually works:

Keep your bedroom cool. Aim for 65-68°F. A cooler room reduces inflammation and helps you fall asleep faster.

Stick to a schedule. Go to bed and wake up at the same time every day, even on weekends. This regulates your body’s internal clock.

Create a wind-down routine. Spend 30-60 minutes before bed doing relaxing activities. Read a book, listen to calm music, or try gentle stretches. Avoid screens—the blue light interferes with sleep hormones.

Use your bedroom only for sleep. Don’t work, watch TV, or scroll your phone in bed. Your brain should associate your bedroom with rest, not activity.

Limit evening fluids. Drinking too much before bed means painful trips to the bathroom at night. Stop drinking 2-3 hours before sleep if frequent nighttime urination is a problem.

Bedroom Adjustments That Help

Small changes to your bedroom setup can reduce joint pain:

• Install night lights along the path to the bathroom so you don’t stumble in the dark
• Use a bed rail or grabber if getting in and out of bed is difficult
• Raise your bed height if standing from a low bed hurts your knees or hips (bed risers are inexpensive)
• Keep pain medication and water on your nightstand in case pain wakes you
• Use blackout curtains to keep your room dark and promote deeper sleep

When to Talk to Your Doctor

Sometimes self-help strategies aren’t enough. Schedule an appointment if:

• You haven’t had a full night’s sleep in weeks
• Morning stiffness lasts more than 30 minutes every day
• Over-the-counter pain relievers no longer help
• You feel exhausted during the day despite being in bed for 8+ hours
• Your pain is getting worse instead of better
• You’re experiencing new symptoms like numbness or tingling

Poor sleep takes a toll on your overall health. It raises inflammation levels, weakens your immune system, and makes pain harder to tolerate. Don’t dismiss sleep problems as “just part of getting older.”

Your doctor can evaluate whether you need stronger pain management, whether underlying sleep disorders (like sleep apnea) are contributing to the problem, or whether treatments like cortisone injections might provide temporary relief while you work on longer-term solutions.

The Mind-Body Connection

Stress and worry about pain can make sleep problems worse. If you find yourself lying awake dreading tomorrow’s activities because of pain, consider these approaches:

Progressive muscle relaxation: Starting at your toes and working up to your head, tense and then relax each muscle group. This releases physical tension and calms your mind.

Deep breathing: Breathe in slowly for four counts, hold for four counts, exhale for four counts. Repeat 10 times. This activates your body’s relaxation response.

Guided imagery: Picture yourself in a peaceful place—a beach, a forest, anywhere that feels calm. Focus on the sensory details. What do you see, hear, smell, and feel?

These techniques take practice, but they can help you fall asleep faster and cope with nighttime pain flares.

Creating Your Personal Sleep Plan

Everyone’s different. What works for your neighbor might not work for you. Here’s how to create a plan that fits your life:

1. Identify your biggest pain trigger. Is it your mattress? Your sleep position? Lack of pain relief?
2. Make one change at a time. Try a new sleep position for a week before adding a pillow upgrade or medication timing change.
3. Track your progress. Keep a simple sleep journal. Note when you went to bed, how long it took to fall asleep, how many times you woke up, and your pain level in the morning.
4. Adjust as needed. If something isn’t working after 2 weeks, try something else.

The Bottom Line

Joint pain doesn’t have to steal your sleep. Strategic positioning, the right mattress and pillows, properly timed pain relief, and good sleep habits can transform your nights—and your days.

Remember that sleep and pain relief work together. When you sleep better, your body has time to heal and reduce inflammation. When your pain is well-managed, sleep comes more easily.

If you’ve tried these strategies for a few weeks and you’re still struggling, it’s time to talk to a healthcare provider. Better sleep is possible, and you deserve it.

Frequently Asked Questions

Should I take pain medication every night before bed?

Talk to your doctor about daily pain medication use. For occasional bad nights, over-the-counter options may help. For chronic nighttime pain, your doctor may recommend a scheduled pain management plan that’s safer for long-term use.

Will a heating pad or ice pack help me sleep better?

Both can help, but use them before bed rather than leaving them on while you sleep. Try 15-20 minutes of heat or cold therapy as part of your wind-down routine. Never fall asleep with a heating pad on—it’s a burn risk.

How long should I try a new sleep strategy before giving up?

Give most changes at least one to two weeks. Your body needs time to adjust to new positions or routines. If something causes more pain after a few nights, stop and try a different approach.

Can exercise during the day help me sleep better at night?

Yes, but timing matters. Regular low-impact exercise like walking or swimming can reduce pain and improve sleep quality. Just avoid vigorous exercise within 3-4 hours of bedtime, as it can be too stimulating.

Is it normal to wake up stiff even after a good night’s sleep?

Some morning stiffness is common with arthritis. If it lasts less than 30 minutes and improves with movement, that’s typical. If it lasts longer or is getting worse, discuss it with your doctor—it may indicate your arthritis needs better management.

---

This article is for informational purposes only and does not replace medical advice. Always consult with a healthcare provider about your specific sleep and pain management needs.

Last medically reviewed: February 2025