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Sleeping Positions for Lower Back Pain: How to Sleep More Comfortably
Lower back pain can make it difficult to find a comfortable sleeping position. When pain is present, the position you normally sleep in may no longer feel comfortable, and you may wake up with increased stiffness or discomfort.
There is no single sleeping position that is suitable for everyone with lower back pain. However, changing your position and using pillows for support may make sleeping more comfortable for some people.
The three common sleeping positions are sleeping on your back, sleeping on your side and sleeping on your stomach. Each position affects the body differently, and individual comfort is important when choosing how to sleep.
This guide explains sleeping positions for lower back pain, how to use pillows for support, what to consider when choosing a mattress and when nighttime back pain should be evaluated by a doctor.
What Is the Best Sleeping Position for Lower Back Pain?
The best sleeping position for lower back pain is not necessarily the same for everyone. A position that feels comfortable for one person may increase discomfort for another.
In general, the aim is to find a position that feels comfortable and allows you to maintain a reasonably supported and relaxed posture while sleeping.
Two positions commonly used for people with lower back discomfort are:
Sleeping on your back with support under the knees
Sleeping on your side with a pillow between the knees
Some people also prefer sleeping on their stomach, although this position may be less comfortable for some people with back or neck symptoms.
If changing positions increases your pain, there is no need to force yourself into a particular position.
Sleeping on Your Side
Side sleeping is another common position. If you sleep on your side and have lower back discomfort, placing a pillow between your knees may provide additional support.
How to Sleep on Your Side With Lower Back Pain
Lie on your side in a comfortable position.
Keep your head and neck supported by a suitable pillow.
Bend your knees slightly if that feels comfortable.
Place a pillow between your knees.
Try to keep your hips and shoulders in a comfortable position rather than twisting your body.
Change sides if remaining on one side becomes uncomfortable.
The pillow between the knees can help provide support between the legs and may make side sleeping more comfortable.
The height of your head pillow also matters. A pillow that is too high or too low may leave your neck in an uncomfortable position.
Sleeping on Your Stomach
Some people naturally prefer sleeping on their stomach. However, this position can be uncomfortable for some people with lower back or neck symptoms.
When sleeping on your stomach, your head usually needs to be turned to one side to breathe. This can place the neck in a rotated position for an extended period.
If stomach sleeping is the only position in which you feel comfortable, you can experiment with your pillow arrangement and sleeping surface to find a position that causes less discomfort.
If sleeping on your stomach consistently increases your lower back or neck pain, consider trying side or back sleeping instead.
How to Use Pillows for Lower Back Pain
Pillows can be used to provide additional support while sleeping.
The appropriate arrangement depends on your sleeping position.
If You Sleep on Your Back
Try placing a pillow under your knees. You can adjust its height until the position feels comfortable.
If You Sleep on Your Side
Place a pillow between your knees. This can provide support between the legs while you sleep.
If You Sleep on Your Stomach
If you prefer stomach sleeping, you may need to experiment with pillow height and positioning to find a comfortable arrangement.
Choose a Comfortable Head Pillow
Your head pillow should provide comfortable support for your head and neck without forcing your neck into an awkward position.
There is no universally correct pillow height for everyone because body shape, sleeping position and personal comfort differ.
Can Your Mattress Affect Lower Back Pain?
Your mattress is another factor to consider when you have lower back pain.
However, there is no single mattress type or firmness that is appropriate for everyone. Personal comfort, sleeping position and individual needs can all influence which mattress feels suitable.
If your mattress is old, uncomfortable or no longer provides adequate support, you may notice discomfort while sleeping or when getting out of bed.
When considering a new mattress, focus on whether it allows you to sleep comfortably and provides appropriate support for your body.
A new mattress should not be viewed as a treatment for an underlying spine condition.
How to Change Your Sleeping Position
If your usual sleeping position is uncomfortable, you can gradually try another position rather than forcing yourself to change immediately.
For example:
- If you normally sleep on your stomach, try lying on your side with a pillow between your knees.
- If you sleep on your side, experiment with different pillow heights.
- If you sleep on your back, try placing a pillow under your knees.
- Give yourself time to become comfortable with a new position.
- Stop using a position if it consistently increases your pain.
The purpose of changing positions is to find a comfortable way to sleep, not to force your spine into a particular posture.
Can Sleeping Position Cause Lower Back Pain?
Sleeping position can affect how comfortable your back feels during the night, but lower back pain can have many possible causes.
Back pain may be associated with muscles, joints, discs, nerves or other structures. In some cases, the cause may not be related to sleeping position at all.
If you regularly wake up with lower back pain, consider whether the discomfort also occurs during the day and whether other symptoms are present.
Persistent or recurring pain should be assessed rather than attributed only to your sleeping position.
Why Is Lower Back Pain at Night a Red Flag?
Lower back pain at night doesn’t automatically mean a serious underlying problem. However, persistent or unexplained nighttime back pain deserves attention, particularly when other symptoms accompany it.
Seek medical advice if back pain:
- Continues or becomes progressively worse
- Is severe or unexplained
- Regularly wakes you from sleep
- Occurs after a significant injury
- Is accompanied by fever or feeling unwell
- Is associated with unexplained weight loss
- Occurs with numbness or weakness
- Travels down the leg with neurological symptoms
The cause of nighttime back pain cannot be determined from the sleeping position alone. A healthcare professional can assess your symptoms and determine whether further evaluation is required.
When Should You See a Doctor for Lower Back Pain?
Many episodes of back discomfort improve with time and appropriate self-care. However, medical evaluation may be appropriate when pain persists, worsens or interferes significantly with daily activities or sleep.
You should seek prompt medical attention if lower back pain is accompanied by:
- New or worsening weakness in the legs
- Significant numbness
- Numbness around the inner thighs, buttocks or genital area
- Loss of bladder or bowel control
- Difficulty walking or maintaining balance
- Severe pain following an accident or significant injury
These symptoms can require urgent assessment.
If you have a known spine condition, previous spine surgery or persistent symptoms, speak with your doctor before making major changes to your exercise or self-care routine.
Frequently Asked Questions
How do I sleep to relieve lower back pain?
Try a sleeping position that feels comfortable and provides adequate support. Some people find back sleeping with a pillow under the knees comfortable, while others prefer side sleeping with a pillow between the knees. There is no single position that works for everyone.
What is the best sleeping position for lower back pain?
Back or side sleeping may be comfortable for some people with lower back pain. If you sleep on your back, a pillow under the knees may provide additional support. If you sleep on your side, a pillow between the knees may be useful.
What is the worst sleeping position for back pain?
There is no universally worst sleeping position. However, stomach sleeping can be uncomfortable for some people with back or neck symptoms because of the position of the spine and neck. If a particular position consistently increases your pain, consider trying another position.
What is the best sleeping position to decompress your lower back?
There is no single sleeping position that can be guaranteed to decompress the lower back. A comfortable, supported position may reduce discomfort for some people. If you have persistent pain or symptoms suggesting nerve involvement, medical assessment is more appropriate than relying on a sleeping position alone.
Should I sleep with a pillow under my knees?
If you sleep on your back, placing a pillow under your knees may make the position more comfortable for some people. The height and firmness of the pillow can be adjusted according to your comfort.
Should I sleep with a pillow between my knees?
If you sleep on your side, placing a pillow between your knees can provide additional support between your legs. Try different pillow thicknesses to find an arrangement that feels comfortable.
Can a mattress cause lower back pain?
An uncomfortable or poorly supportive mattress may contribute to discomfort during sleep for some people. However, lower back pain can have many causes, so persistent pain should not automatically be attributed to the mattress.
The Bottom Line
Finding a comfortable sleeping position can be an important part of managing everyday lower back discomfort. Sleeping on your back with a pillow under your knees or sleeping on your side with a pillow between your knees are options that some people find comfortable.
The most suitable position depends on your symptoms, body and personal comfort. Avoid forcing yourself into a sleeping position that increases pain.
If lower back pain persists, becomes worse, repeatedly disrupts your sleep or occurs with symptoms such as numbness, weakness or bladder or bowel changes, seek medical evaluation.
