Sleeping Positions to Help Alleviate Lower Back Pain

Waking up with an achy back? You’re not alone. Lower back pain is one 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.

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 five 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.

Side Sleeping with a Pillow Between Knees

Sleeping on your side is one of the best sleeping positions to reduce lower back pain and when done right, it can work wonders. The key is alignment. When you lie on your side without support, your top leg tends to drift down, pulling your spine out of its natural curve. That’s where the knee pillow comes in.

Placing a pillow between your knees can help keep your hips, pelvis, and spine in a neutral position, which takes pressure off your lower back. You might notice that your muscles feel less tense in the morning or that familiar dull ache in your lower back starts to fade.

If you feel a gap between your waist and the mattress, try sliding a small, soft pillow or a rolled-up towel under your waist for added support. It’s all about maintaining even support from shoulders to hips. Think of it as stacking your spine in perfect alignment for pain-free sleep. We all know that less pain means better sleep.

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!

Curled Up in the Fetal Position

It’s no surprise that the fetal position is the most popular sleeping position; it’s instinctively comforting and offers real benefits for your spine. Especially helpful for people with herniated discs, this curled-up sleeping position gently opens the space between your vertebrae, easing pressure on the spine and helping to reduce nerve-related pain.

To get the most out of it, lie on your side with your knees drawn slightly toward your chest, enough to feel supported but not overly scrunched. The stretch along your lower back can feel like a gentle release, making it easier to relax into sleep.

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 Knees

If you’re a back sleeper, good news, this position can be excellent for lower back pain when done right. The trick? Slide a pillow under your knees. This minor adjustment helps maintain your spine’s natural S-curve by preventing your lower back from arching too much.

Lying flat without support may feel like your back is sinking or straining against the mattress, especially in the lower back area. But with a pillow under your knees, the tension eases. You'll feel a more even distribution of weight, which reduces pressure on your lower spine and surrounding muscles.

It’s a go-to position recommended by many physical therapists because it promotes neutral alignment and can help reduce that deep, dull ache that creeps in after hours of lying flat. Bonus: it’s also a great setup for anyone dealing with tight hip flexors or sciatic nerve irritation.

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

Stomach Sleeping with Caution

Sleeping on your stomach isn’t typically recommended for lower back pain, as it can be the worst position because it can strain both the spine and neck. But for some, it’s simply the most natural and comfortable way to fall asleep. If that’s you, there are a few adjustments you can make to reduce discomfort and protect your alignment.

Start by using a thin pillow, or no pillow at all, under your head. This helps prevent your neck from arching unnaturally and reduces strain through your upper spine. Next, place a small pillow or rolled-up towel under your hips or lower abdomen.

This added support can ease pressure on your lumbar region by preventing your back from overextending into the mattress.

With these simple tweaks, stomach sleeping becomes less about compromise and more about comfort, so you can have quality sleep, even face down.

Sleeping in a Reclined Position

For some people, lying flat just doesn’t cut it, especially if lower back pain is in the mix. Sleeping in a reclined position, like in a reclining chair, can ease discomfort by shifting weight away from the spine and opening up the angle between your torso and legs.

This setup can feel noticeably more supportive if you deal with conditions like isthmic spondylolisthesis, where spinal alignment is compromised. By elevating your upper body and/or legs, you reduce stress on the lower back and create a more naturally supported curve in your spine.

Think of it like creating a gentle V-shape with your body—your back feels less compressed, your hips aren’t bearing all the weight, and your muscles can finally relax. Even if you don’t have an adjustable bed, propping yourself up with pillows behind your back and under your knees can mimic the same relief.

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 Selection: Choosing the right mattress and pillow is crucial for supporting the spine and alleviating back pain. A medium-firm mattress is often recommended, along with a supportive pillow that keeps the head and neck aligned.
• Stick to a Consistent Position: Avoid tossing and turning by training your body to settle into the most supportive position for your back.
• Try Heat Therapy before Bed: Use a warm bath, heating pad, or the Chilipad’s warming feature to relax tight muscles and improve comfort before settling into your sleep position.
• Consultation with a Healthcare Professional: If you’re dealing with chronic back pain, it’s a good idea to check in with a healthcare provider to get personalized advice and rule out any underlying issues.

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

Finding the right sleeping position for back pain can play a significant role in improving your overall sleep quality, resulting in a good night's sleep. By adopting positions such as side sleeping with a pillow between the knees or back sleeping with a pillow under the knees, individuals can support their spine and reduce discomfort while sleeping.

It is also important to consider factors like mattress and pillow selection, as well as consulting with healthcare professionals for personalized advice. Prioritizing proper sleep posture not only enhances comfort but also contributes to long-term spinal health, allowing for a more restful and rejuvenating sleep experience.