Best Sleeping Position For Lower Back Pain (2024)

Grace Struth

Sleep Content Lead

Dr. James Keung, DC, RMT

Chiropractor | Registered Massage Therapist | Acupuncture & Orthotics

When you live with lower back pain, it makes getting a good night’s sleep difficult. There’s substantial evidence to suggest that chronic lower back pain is associated with poor sleep quality (Kelly et al. 2011, 178). But with the right sleeping position, it’s possible to find the relief that you and your back need.

In this article, we’ll show you the best position to sleep in for lower back pain, depending on whether you’re a side, back, or stomach sleeper. Each position uses a pillow to keep your spine aligned while you sleep.

We’ll also explore habits that can help you sleep better, what kind of mattress is best for back pain, and when to consult your doctor about your pain. Keep reading to discover the best sleep positions for lower back pain.

We co-authored this article with Dr. James Keung, a dedicated healthcare provider with expertise in chiropractic care and massage therapy. The following tips, including those from Dr. Keung, are general recommendations and aren’t meant to replace your doctor’s professional diagnosis. Always consult your physician before trying these sleep positions at home.

 

1. Sleeping On Your Side

best sleeping positions for lower back pain: illustration of a woman laying on a bed on her side, with a pillow under her bed and one in between her knees

If you’re a side sleeper, avoid lower back pain by keeping your hips and shoulders “stacked.” That means the shoulder and hip on the bed are directly positioned beneath the shoulder and hip facing up. Putting a pillow between your legs can help you stay in this position while you sleep. It can also maintain a more neutral position for your spine.

This position provides both support and pressure-point relief to the joints on either side of your body. Misaligned shoulders and hips can cause stress on the joints, which in turn put stress on the spine and lower back.

You can also sleep on your side with your legs folded and tucked close to your torso. Known as the fetal position, this position uses your upper legs to take the strain off your lower body. It can also be helpful for pregnant women in earlier trimesters, since this position reduces strain on the body’s midsection.

Sleeping with a pillow isn’t necessary when lying on a bed in the fetal position, but it can help reduce potential strain on your knees.

READ MORE: Get our list of the best mattresses for side sleepers

 

Dr. Keung’s Tip:

Check to see if the pillow used to support your head/neck is high enough to keep your head/neck aligned with your spine.

 

2. Sleeping On Your Back

best sleeping positions for lower back pain: illustration of a woman laying down on a bed on her back with a pillow under her head and one under her kneesSleeping on your back is a simple way to evenly relieve pressure in your shoulders, hips, and pelvis. This helps to take away strain on your lower back.

If you notice even more pain when you sleep on your back, this could be because your body’s natural curvature is arching your spine. You may be able to relieve this pressure and keep your back aligned by sleeping with a pillow underneath your knees.

Make sure the pillow beneath your head keeps your neck aligned with your chest and back. This helps to avoid any strain caused by uneven pressure along your body’s vertical length. You can also use an adjustable bed to change the angles of your body and find a comfortable elevation.

READ MORE: Check out our ranked list of the best mattresses for back sleepers

 

Dr. Keung’s Tip:

You might benefit from placing a small rolled-up towel beneath the low back area. This may help maintain the natural curve of your lower back.

 

3. Sleeping On Your Stomach

best sleeping positions for lower back pain: illustration of a woman sleeping on her stomach with one pillow under her head and one under her pelvis

If sleeping on your stomach is most comfortable for you, place a pillow underneath your pelvis. Most of your weight is located toward the middle of your body, and the pillow will reduce the amount of strain on your lower back.

However, it’s important to note that sleeping on your stomach isn’t healthy for your back or good for reducing back pain. This position may cause your stomach to sink into the bed and your lower back to overarch, causing more strain on your lower back. You’ll also need to turn your head to one side, which can strain your upper back and neck.

READ MORE: See our list of the best mattresses for stomach sleepers

 

Dr. Keung’s Tip:

Using a body pillow might help you stay in a side-lying position during sleep.

 

Types of Lower Back Pain

There are three common types of lower back pain:

  • Referred pain is often described as dull and achy by comparison. It’s more likely to move around from the original location.
  • Axial pain usually stays in one spot. It’s most often caused by muscle issues or problems with the facet joints that connect your vertebrae (the bones in your spine).
  • Radicular pain follows nerve pathways and often moves down the hips and legs. This kind of pain is often accompanied by numbness and/or a tingling sensation. It can also be referred to as “sciatica symptoms.”

It may be difficult to tell what kind of lower back pain you’re living with. Stress and injuries, whether new or old, are the most common contributing factors to lower back pain. However, pain may have no physical cause at all.

If your lower back pain is consistently keeping you from getting a good night’s sleep, check in with your doctor to discuss your symptoms and find out the best way to treat them.

 

Worst Sleeping Position for Lower Back Pain

If possible, avoid sleeping on your stomach if you’re living with lower back pain. Most of your body’s weight is located between your ribs and upper thighs. Sleeping on your back may cause your stomach to sink into the bed and your lower back to overarch, resulting in more strain on your lower back.

You should also avoid twisted side sleeping. This occurs when you’re lying flat on your back with your legs twisted to one side, or on your side with your lower half lying flat.

Sleeping in this position applies extra pressure to your lower back and torque to your spine. This may lead to issues with your vertebrae and spinal discs, and could aggravate lower back pain.

 

Tips for Sleeping Better with Lower Back Pain

If you’re living with back pain, the best way to get a better night’s sleep is to address the underlying cause of your pain. Maybe you spend hours sitting at a desk every day, or perhaps an injury is keeping you awake at night. Whatever the reason, it’s a good idea to speak with your doctor about your symptoms.

You can also try these tips for preventing or relieving lower back pain to get a good night’s rest:

illustrations of a pillow, a coffee cup, a clock, and a mattress listing tips to sleep better with lower back pain

Find your best sleep position for lower back pain

Try the sleep positions described earlier in this article and see what’s most comfortable for you. You might even find that switching to a completely new position helps you get a better night’s sleep.

 

Avoid alcohol and caffeine before bed

If you’re having trouble sleeping at night, back pain might not be the only cause. Limit your daily caffeine intake, and try not to have any at all after 5pm. You’ll fall asleep more easily without a stimulant keeping you up.

Keep your alcohol consumption to a minimum, too. While alcohol might help you fall asleep, it disrupts REM cycles, resulting in an overall shorter sleep period and lower-quality rest.

 

Follow a nighttime routine and avoid sleep disruptions

Doing the same tasks before bed every night will help you sleep better. This could include drinking herbal tea, reading a book, or taking a hot bath to relax sore muscles.

Keep screens and other distractions out of this routine, and turn them off at least 30–60 minutes before bed. Resist the urge to browse your phone or read on your tablet as you’re preparing to fall asleep. In fact, it’s best to keep screens out of your bedroom altogether.

Finally, make sure to cover or remove any other items that could disrupt your sleep, like ticking clocks and blinking lights.

 

Choose a supportive, good-quality mattress

The best type of mattress for lower back pain can vary from person to person. However, foam and hybrid mattresses are go-to choices, thanks to their body-contouring layers of foam and/or metal coils.

Choosing either type of mattress with a medium-firm feel can help relieve lower back pain. Studies have demonstrated that medium-firm feel mattresses help improve sleep quality and reduce risks of developing low back pain (Caggiari et al. 2021, 23).

If you’re struggling with lower back pain, we recommend trying Douglas Original. This foam mattress provides balanced support and pressure-point relief. It also has a medium-firm feel that’s ideal for all sleep positions.

 

 

When to See a Doctor About Lower Back Pain

While lower back pain isn’t necessarily a sign that you need urgent treatment, you should still know when to talk to your doctor about it. Back pain can be a sign of a deeper issue with your personal health. See your physician right away if your pain:

  • Has persisted for some time and doesn’t seem to be getting better
  • Is constant and intense
  • Is followed by numbness, a tingling sensation, or involuntary movements
  • Comes on suddenly rather than gradually
  • Begins at the same time as, or shortly after, a traumatic injury
  • Extends down one or both of your legs
  • Is accompanied by sudden body changes like swelling or weight gain

READ MORE: Best sleeping position for peripheral artery disease

We can’t always distinguish one type of pain from another, so a back injury may feel similar to an injury in a nearby part of the body. Your doctor will ask you to describe your pain in detail. This lets them assess and diagnose what kind of pain you’re experiencing and how best to treat it.

Lower back pain afflicts many of us throughout our lives, and it can be a long-lasting burden. But with the right sleeping position, the right habits, and the right mattress, it’s possible to overcome lower back pain and find the sleep you deserve.

References:

  1. Kelly, Gráinne A., Catherine Blake, Camillus K. Power, Declan O’Keeffe, and Brona M. Fullen. “The Association between Chronic Low Back Pain and Sleep.” The Clinical Journal of Pain 27, no. 2 (February 2011): 169–81. https://doi.org/10.1097/ajp.0b013e3181f3bdd5.
  2. Johnson Pang Chun-Yiu, Sharon Tsang Man-Ha, and Allan Chak Lun Fu, “The Effects of Pillow Designs on Neck Pain, Waking Symptoms, Neck Disability, Sleep Quality and Spinal Alignment in Adults: A Systematic Review and Meta-analysis,” Clinical Biomechanics 85 (May 1, 2021): 105353, https://doi.org/10.1016/j.clinbiomech.2021.105353.
  3. Gianfilippo Caggiari et al., “What Type of Mattress Should Be Chosen to Avoid Back Pain and Improve Sleep Quality? Review of the Literature,” Journal of Orthopaedics and Traumatology 22, no. 1 (December 1, 2021), https://doi.org/10.1186/s10195-021-00616-5.