The Best Sleeping Position for Lower Back Pain

Waking up with an achy back? You're not alone. Lower back pain and neck pain are two of the most common sleep-related complaints, and often, your sleeping position is the culprit. How you sleep can ease pressure on your spine or worsen the discomfort, affecting your spine alignment .

Finding the best sleeping position for lower back pain can significantly improve comfort and promote better sleep quality, helping you wake up feeling refreshed instead of stiff and sore.

Below, we'll break down the top sleeping positions that support spinal alignment and reduce strain on your lower back. Whether you're a back sleeper, side sleeper, or somewhere in between, a few adjustments could be the key to better rest and a healthier spine.

Sleeping on Your Side

Side sleeping is one of the most helpful positions for easing lower back pain, as long as your spine stays aligned, according to a 2024 study [1]. A simple way to provide lumbar support and keep things in line is to place a pillow between your knees. This keeps your hips, pelvis, and spine neutral, taking pressure off your lower back and reducing that morning stiffness. Statistics indicate that up to 74% of people prefer side sleeping positions for back pain.

If you notice a gap under your waist, add a small pillow or rolled towel for extra support. The goal is even support from shoulders to hips so your spine stays stacked and your back stays calm through the night, minimizing pressure points.

Curious what your sleep position says about you? Discover your identity with our blog, which discusses the most popular names for sleeping positions. Find out which one you are!

Fetal Position for Lower Back Relief

Approximately 41% to 47% of individuals choose the fetal position when sleeping, according to multiple surveys, including Keck Medicine of USC — and for good reason. [2] The fetal position often feels secure and can ease lower back pain. For those with herniated discs, gently curling the body helps open the space between the vertebrae, reducing pressure on irritated nerves.

To do it right, lie on your side and pull your knees gently toward your chest. You want a comfortable curl, not a tight ball. This light stretch along your lower back helps your muscles relax and can facilitate natural alignment, making drifting off much easier.

One Pro Tip: Alternate sides regularly. Sticking to one side night after night can create imbalances in your muscles and hips. So switch it up. Your spine (and your posture) will thank you.

Back Sleeping with a Pillow Under Your Knees

Back sleeping can ease lower back pain if your spine stays in its natural curve. A simple fix is placing a pillow under your knees. This stops your lower back from arching and gives your spine steady support.

Without that support, your back can feel like it’s sinking or straining against the mattress. With a pillow under your knees — and good neck support — your weight spreads more evenly, reducing pressure on your lower spine and surrounding muscles.

Physical therapists often recommend this setup because it keeps your spine neutral and helps calm that deep ache that builds up overnight. It’s also helpful for tight hip flexors or sciatic irritation, making it one of the strongest positions for managing back pain and staying pain free.

Sleeping Tip: You may not have an extra pillow, so you can try a rolled-up towel.

Stomach Sleeping with Caution

Only about 7% of adults sleep on their stomachs, making it the least common sleeping position. While this posture can place added strain on the spine and neck and is not ideal for lower back pain, if it is the only position in which you can fall asleep, small adjustments can help improve comfort.

Use a thin pillow — or no pillow — under your head to keep your neck from arching. Then place a small pillow or rolled towel under your hips. This reduces pressure on your lower back by stopping your spine from overextending into the mattress.

These tweaks won’t turn stomach sleeping into the perfect position, but they can make it far less stressful on your back so you can sleep comfortably, even face down.

Sleeping in a Reclined Position

If lying flat increases your lower back pain, a reclined position may feel much better. Sleeping slightly upright shifts weight away from your spine and opens the angle between your torso and legs, which can ease pressure for people with spinal stenosis or similar conditions.

This position can also help if your spinal alignment is compromised, as it supports a more natural curve and reduces stress on the lower back. Think of it as a gentle V-shape: less compression, less tension on your lumbar region , and more room for your muscles to relax.

You don’t need an adjustable bed to try it — using pillows behind your back and under your knees can create the same supportive recline.

Did You Know: You can achieve peak spinal alignment and customized comfort for truly restorative sleep by exploring the benefits of an adjustable bed.

Additional Tips for Better Sleep

• Mattress and Pillow Choice Matters: If you wake up sore, your mattress or pillow might be part of the problem. Many people with lower back pain find that a medium-firm mattress gives the right mix of comfort and support. Pair it with a pillow that keeps your head and neck in line, and your back won’t have to work overtime all night.
• Stick with a Position That Helps Your Back: If you’re constantly flipping around to get comfortable, your back never gets a chance to relax. Try settling into the position that feels most supportive and train your body to stay there. Small changes like this can make mornings feel a lot less stiff.
• Use Heat to Unwind Before Bed: Tight muscles make back pain worse, especially at night. A warm bath, a heating pad, or even the warming feature on your Chilipad can help loosen things up so you can settle into bed without that stubborn tension.
• Talk with a Healthcare Professional When Pain Persists: If your back pain keeps sticking around, it can be frustrating. Getting expert guidance can be a huge relief. A healthcare provider can help you understand what’s going on and offer tips tailored to your specific needs.

Want more smart sleep strategies? Take a look at our blog highlighting 13 tips on how to sleep better.

Prioritize Spinal Alignment

Maintaining proper spinal alignment is crucial for minimizing discomfort and promoting restful sleep, regardless of your chosen sleeping position. Pay attention to the alignment of your head, shoulders, and hips to ensure your spine remains neutral.

If you notice any gaps between your body and the mattress, these can lead to unnecessary strain on your muscles and spine. Using pillows strategically can help fill these gaps, providing additional support and reducing pressure points.

When shifting positions during the night, be mindful of how you move. Twisting and turning can disrupt your alignment, so aim to move your entire body as a unit. Engaging your core and drawing your knees toward your chest while rolling over can help maintain proper alignment and prevent discomfort.

Final Thought

Keeping your spine neutral is one of the simplest ways to cut down on lower back pain at night. Make sure your head, shoulders, and hips line up in a straight line , and use pillows to fill any gaps that cause strain or pressure.

When you shift positions, move your whole body together instead of twisting. Rolling with your knees tucked slightly toward your chest can help you stay aligned and avoid extra tension.

Finding the right sleep position — like side sleeping with a pillow between your knees or back sleeping with a pillow under them — can make a noticeable difference and lead to a more restful sleep . Pair that with a supportive mattress and the right pillow, and your back gets the break it’s been asking for.

If your pain keeps getting in the way, reaching out to a healthcare professional can help you get personalized guidance. Good alignment supports comfort, protects your spine, and sets you up for a night of less pain and more restful night.