Low Back Pain: 5 Sleeping Positions to Help

Medically Reviewed By Amy Elizabeth Wolkin, PT, DPT, MBA
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One effective way to ensure proper alignment as you sleep is to keep your ears, shoulders, and hips aligned to support your spine. With any sleeping position, this alignment can help ease lower back pain. Lower back pain continues to affect people of all ages. In 2018, the National Health Interview Survey found that 28% of males and 31.6% of females aged 18 years and older had experienced lower back pain in the past 3 months.

For many people, that pain can worsen from sleeping in positions that aggravate the lower back. Below are the five best sleeping positions for relieving lower back pain.

1. On your back

a woman is asleep on her back in a white bed
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Although not always easy, sleeping on your back equally distributes your weight across your spinal column, which can prevent undue pressure on a specific area of your back.

Placing one or more pillows under the back of your knees can further reduce the pressure on your spine. You should also put a small pillow or roll under your neck to properly support your head, your shoulders, and the natural curve of your spine.

2. On your side

Sleeping on your side can also help alleviate lower back pain, as long as you are in the right position.

Placing a firm pillow between your knees can help keep your upper leg from moving. In turn, this helps prevent your spine from moving out of alignment. Placing a pillow or a rolled towel under your waist and head can also provide additional support for your spine.

3. In the fetal position

Another sleeping position on your side, this one involves curling up into a fetal position, with your knees drawn toward your chest.

Sleeping in the fetal position can also be suitable for people with lower back pain due to a herniated disc. Try to switch sides every so often to prevent imbalances.

4. On your stomach

Many people are stomach sleepers, but this position does not allow much support for your spine.

If you do sleep on your stomach, place a flat pillow under your stomach and pelvis to help extend your spine and keep it straight. The pillow at your head should be flat. Alternatively, consider using no pillow at all.

5. At a slight recline

If you find it easier to sleep in a reclined position, be sure to support your spine with firm pillows.

However, if this temporary position becomes permanent because it is the only way to find relief from lower back pain, talk with your doctor to see if you need additional evaluation and treatment for a more serious back condition.

Changing positions as you sleep

It is not uncommon to change positions when you sleep, but remember to move your entire body as you move from one position to the next to avoid placing stress on any specific part of the body. Move with care, and avoid forcing your body into a new position too quickly.

Also, you should try to choose a new position that maintains your spinal alignment to reduce stress on it, thereby relieving lower back pain.

Pillows and mattresses

When choosing pillows, select one that works best for your preferred sleeping position. For example:

  • Sleeping on your back: Choose a pillow that supports the natural curve of your neck without sacrificing comfort. If the pillow is too thick or fluffy, it could push your neck into an unnaturally high position.
  • Sleeping on your side: You should have a pillow under your neck that keeps your spine straight. Also, putting a firm pillow between your knees can help prevent leg movement.
  • Sleeping on your stomach: Use a flat pillow or no pillow at all under your head. You also want a flat pillow to place under your stomach and pelvis.  

When it comes to mattresses, the goal is to find one that promotes spinal alignment while providing you with a good night’s sleep. You may need to try more than one type of mattress — such as soft, hard, foam, or pillow top — to find one that works for you.

A 2015 review of studies found that medium-firm mattresses were the most effective for optimal sleep quality and spinal alignment.

Sleep tips

Between lower back pain and a busy day, it can sometimes be hard to get a good night’s sleep.

The Centers for Disease Control and Prevention (CDC) offers the following tips:

  • Exercise regularly: This can also help you maintain a strong core and a healthy spine. Maintaining a moderate weight could also help reduce the stress on your spine.
  • Reduce dietary stimulants: Limit your alcohol, caffeine, and food intake before bedtime.
  • Avoid screens: Try not to check your email or use social media while in bed. It may be best to avoid all screens before sleeping.
  • Create a sleep ritual: Establishing habits can prepare your body for bed. For instance, take a shower, have a glass of water, then head to bed. This signals to your body that it is time to go to sleep.

Learn when to contact a doctor for sleep problems here.

Home remedies for lower back pain

If you want to reduce your lower back pain, there are some home remedies that you can try aside from just a good sleeping position.

For instance, the National Institute of Neurological Disorders and Stroke recommends:

  • Trying hot and cold therapies: If your lower back pain is due to an injury, applying a cold compress or an ice pack can help reduce swelling and numb the pain. If it has been at least 2 days since the injury, or if the back pain is due to something other than an injury, applying a heating pad can provide warmth to relax tight muscles.
  • Staying active: Staying physically active and gently stretching your back could help loosen and relax the muscles. Yoga and tai chi are great for stretching back muscles.
  • Taking pain relievers: Using an over-the-counter pain medication such as ibuprofen can help alleviate lower back pain. Be sure to take these medications as directed, and if you do not find relief, talk with your doctor.

When to contact a doctor

If your lower back pain continues for several weeks or gets more painful, contact your doctor.

Your doctor will likely take a medical history and complete a physical exam to evaluate your spinal alignment. If necessary, they may also take X-rays or perform other diagnostic tests to find the cause of your lower back pain.

There are several conditions that your doctor might look for that cause lower back pain. These include:

Learn more about contacting a doctor for back pain here.

Summary

Having lower back pain can make it very difficult to sleep. Finding the best sleeping position for lower back pain can help alleviate your discomfort and allow you to get a good night’s rest.

However, if your lower back pain lasts for longer than a few weeks or gets worse, you should contact your doctor for a full evaluation. They can also determine if additional treatment is necessary.

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Medical Reviewer: Amy Elizabeth Wolkin, PT, DPT, MBA
Last Review Date: 2022 Jan 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.