How should you sleep if you have lower back pain?

Below, learn about some appropriate sleeping positions for people with lower back pain. Then, find advice about choosing the right pillows and mattresses.

We also explore what having good sleep hygiene entails and when to see a doctor.

The best sleeping positions

Certain positions can place unnecessary strain on the neck, hips, and back, worsening, or even causing, back pain.

It is important to maintain the natural curve of the spine when lying in bed. To do this, make sure that the head, shoulders, and hips are aligned and that the back is properly supported. Sleeping on the back may help achieve this.

However, many people find that sleeping on their backs is uncomfortable or leads to snoring. Luckily, several other positions may also help improve the quality of sleep and reduce back pain.

Anyone with lower back pain might try the following sleeping positions:

On the back with knee support

Lying on the back evenly distributes the body’s weight, helping to minimize pressure and ensure a good alignment of the head, neck, and spine.

Placing a small pillow under the knees may provide additional support and help maintain the natural curve of the spine.

To get comfortable in this position:

1. Lie flat on the back facing the ceiling. Avoid tilting the head sideways.
2. Position a pillow to support the head and neck.
3. Place a small pillow under the knees.
4. For extra support, fill any other gaps between the body and mattress with additional pillows. Try placing one beneath the lower back.

On the side with a pillow between the knees

Lying on the side can be comfortable, but it can pull the spine out of alignment, straining the lower back.

It can be easy to correct this issue by placing a firm pillow between the knees. This raises the upper leg, restoring the natural alignment of the hips, pelvis, and spine.

To get comfortable in this position:

1. Get into bed and carefully roll to one side.
2. Use one pillow to support the head and neck.
3. Pull the knees up slightly, and place another pillow between them.
4. For extra support, fill any gaps between the body and mattress with more pillows, especially at the waist.

Anyone who usually moves from their side to their front may also want to try hugging a large pillow against their chest and stomach to help keep their back aligned.

In the fetal position

For anyone with a herniated disk, sleeping in the fetal position may help. This is because lying on the side with the knees tucked into the chest reduces bending of the spine and helps open up the joints.

To get comfortable in this position:

1. Get into bed and carefully roll to one side.
2. Position a pillow to support the head and neck.
3. Draw the knees up toward the chest until the back is relatively straight.

On the front with a pillow under the stomach

This is generally considered the least healthy sleeping position — but for people who struggle to sleep any other way, placing a slim pillow beneath the stomach and hips can help improve spinal alignment.

Also, sleeping on the front may actually benefit anyone with a herniated disk or degenerative disk disease.

To get comfortable in this position:

1. Get into bed and carefully roll onto the stomach.
2. Place a slim pillow beneath the abdomen and hips.
3. Use a flat pillow for the head, or consider sleeping without one.

On the front with the face down

Sleeping on the front is generally unhealthy when a person turns their head to the side, twisting the spine and placing additional stress on the neck, shoulders, and back.

To avoid this, try lying face down. To do so comfortably:

1. Get into bed and carefully roll onto the stomach.
2. Place a slim pillow beneath the abdomen and hips.
3. Position a pillow or a rolled-up towel under the forehead to create enough breathing space between the mouth and mattress.

On the back in a reclined chair or bed

This might help people with lower back pain, particularly those with isthmic spondylolisthesis, a condition in which one spinal vertebra slips over the vertebra right below.

If a person gets significant relief from resting in a reclined chair, it may be worth investing in an adjustable bed that can be positioned in the same way.

Choosing a pillow