Best Sleeping Position for Lower Back Pain

Finding the best sleep positions for low back pain may do more than help you get a better night's rest, it may also help relieve your pain.

Why sleep position matters for people with lower back pain

Back pain is a thief—it can rob you of your all-important zzz’s. The pain/no-sleep cycle is a vicious one and all too common for the 31 million Americans who experience low back pain, according to the American Chiropractic Association.

Low back pain can be short-lived (lasting four to 12 weeks) or chronic (lasting 12 weeks or more), according to the Centers for Disease Control and Prevention. There are many possible causes, from fractures and muscle spasms to underlying diseases. And the pain may also travel with numbness or weakness if there is pressure on your nerves. (Here are the signs your back pain is an emergency.)

Whatever the cause, low back pain can make it hard to get comfy at night. And there are times when your pain will wake you—especially if you don’t snooze in the best sleeping position for lower back pain.

This lack of sleep makes the pain worse, says sleep medicine expert Raj Dasgupta, MD, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California in Los Angeles and a spokesperson for the American Academy of Sleep Medicine.

“Your sleep is less restorative,” he says. “If you get poor sleep, the pain will feel worse.” Sleep loss may impair healing or affect your mood, heightening pain sensitivity, or disrupting chemicals in the brain that are known to be involved in pain.

Woman sleeping in her bed at homeLuis Alvarez/Getty Images

The best sleeping position for lower back pain

Finding the best sleep position for lower back pain may help you get a better night’s rest and relieve your pain, Dr. Dasgupta says.

This takes some trial and error. In general, “it is best to try to keep the normal curvature of your back when you sleep,” says Yili Huang DO, director of the Pain Management Center at Northwell Health’s Phelps Hospital in  Sleepy Hollow, New York. (Here’s the best sleeping position for other health problems.)

That said, there is no one-size-fits-all sleeping position for lower back pain, adds physical therapist Jake Magel, PhD, a research assistant professor at the University of Utah in Salt Lake City. “The best sleeping position is one that feels most comfortable for you,” he says.

Here are the best sleeping positions for lower back pain.

Back sleeping and low back pain

When sleeping on your back, try placing a pillow under your knees or a small pillow under your lower back, Dr. Huang suggests. This will support the natural curve of your spine and reduce pressure on your lower back.

Side sleeping and low back pain

When sleeping on your side, try putting a pillow between your legs, Huang suggests. Keeping your knees bent will reduce pressure on your lower spine, too.

Stomach sleeping and low back pain

When sleeping on your stomach, try placing a pillow under your lower abdomen to keep your spine more aligned and reduce pressure, Huang says. Dr. Dasgupta cautions it may be the worst possible sleep position if you have low back pain. “You have gravity pushing down, and this is not the way the spine should be aligned,” he says.

Sleeping on the best mattress for you counts, too, Dr. Dasgupta adds, noting that this is also a personal choice. “Firm and soft are relative terms,” he says. Remember to replace your mattress regularly. “Don’t wait until the springs start showing.” (Here are 10 signs that it’s time for a new mattress.)

Treating your low back pain will also improve sleep. These are some low back pain relief treatments that really work.

Good sleep hygiene and low back pain

Good sleep hygiene also plays a role, Dr. Dasgupta says. Keeping your bedroom cool and dark will promote sleep, he says.

This means limiting caffeine after 2 p.m. as it can keep you awake. Drinking alcohol may help you fall asleep, but you won’t stay that way for long, he says. Avoid engaging in stressful activities before bed, such as paying bills or scrolling through the news headlines. Instead, adopt a relaxing pre-bedtime ritual, Dr. Dasgupta says. (Check out our essential guide to deeper sleep.)

Sleep apnea, which is marked by pauses in breathing while sleeping, can sometimes travel with low back pain, he notes. The two conditions do share some risk factors, namely obesity. Some of the pain medications that treat low back pain also slow down breathing, which can worsen sleep apnea symptoms, he adds.

Getting a diagnosis and treating sleep apnea or any underlying sleep disorder will have spillover benefits for low back pain, he says.

Back sleeping may be best for pain, but it can make sleep apnea worse, he cautions. “Gravity causes your jaw, tongue, and soft palate to drop back toward your throat, narrowing the airways and leading to blocked airflow and trouble breathing,” Dr. Dasgupta explains.

The last word

Finding the best sleeping position for low back pain can help you get a better night’s sleep, resulting in spillover effects on your pain. Experiment with different positions and pillow placements to find one that works for you. And talk to your doctor to make sure you are doing everything possible to address the cause of your back pain. Now that you know the best sleeping position for lower back pain, check out the best sleep routines.

Medically reviewed by Jill Silverman, MD, on February 26, 2021

Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.