The Best Sleeping Positions for Lower Back Pain, Alignment Tips, and More

What can I do?

Do you deal with lower back pain? You’re not alone.

The Global Burden of Disease study named lower back pain the leading cause of disability across the globe.

What’s even more interesting is that most back pain isn’t caused by serious medical conditions, like cancer or arthritis. Instead, it’s often brought on by stress or strain from bad posture, awkward sleeping positions, and other lifestyle habits.

Here are the best sleeping positions to try if you have lower back pain, as well as some other things you can do to get a better night’s rest.

1. Sleep on your side with a pillow between your knees

If lying flat on your back feels uncomfortable, try shifting over to your side:

Allow your right or left shoulder to make contact with the mattress, along with the rest of that side of your body.
Place a pillow between your knees.
If there’s a gap between your waist and the mattress, consider using a small pillow there for added support.

Whether you use one pillow or opt for two, you should resist the urge to always sleep on the same side. Doing so many cause issues like muscle imbalance and even scoliosis.

How does this position help? Sleeping on your side alone won’t make you feel better. It’s using the pillow between your knees that’s the trick. The pillow will keep your hips, pelvis, and spine in better alignment.

2. Sleep on your side in the fetal position

If you have a herniated disc, you may want to try sleeping on your side curled in a fetal position:

Lay on your back and then roll over gently onto your side.
Tuck your knees toward your chest and gently curl your torso toward your knees.
Remember to switch sides from time to time to prevent any imbalances.

How does this position help? Your discs are soft cushions between the vertebrae in your spine. Herniation happens when part of a disc pushes out of its normal space, causing nerve pain, weakness, and more. Curling your torso into a fetal position opens the space between vertebrae.

3. Sleep on your stomach with a pillow under your abdomen

You may have heard that sleeping on your stomach is actually bad for back pain. This is partly true because it may add stress to your neck.

But if you find yourself resting on your stomach, you don’t have to force another position. Instead:

Place a pillow under your pelvis and lower abdomen to relieve some of the pressure off your back.
Depending on how this position feels, you may or may not choose to use a pillow under your head.

How does this position help? People who have degenerative disc disease may benefit most from stomach sleeping with a pillow. It can relieve any stress that is placed on the space between your discs.

4. Sleep on your back with a pillow under your knees

For some people, sleeping on their back may be the best position to relieve back pain:

Lay flat on your back.
Place a pillow underneath your knees and keep your spine neutral. The pillow is important — it works to keep that curve in your lower back.
You may also place a small, rolled up towel under the small of your back for added support.

How does this position help? When you sleep on your back, your weight is evenly distributed and spread across the widest area of your body. As a result, you place less strain on your pressure points. You’re also able to get better alignment of your spine and your internal organs.

5. Sleep on your back in a reclined position

Do you feel most comfortable snoozing in a recliner? Although sleeping in a chair may not be the best choice for back pain, this position can be beneficial if you have isthmic spondylolisthesis.

Consider investing in an adjustable bed so you can sleep this way with the best alignment and support.

How does this position help? Isthmic spondylolisthesis is a condition where a vertebra slips over the one below it. Reclining may be beneficial for your back because it creates an angle between your thighs and trunk. This angle helps to reduce the pressure on your spine.

Remember: Alignment is key

No matter what position you choose, keeping proper alignment of your spine is the most important part of the equation. Focus specifically on aligning your ears, shoulders, and hips.

You may notice gaps between your body and the bed that strain your muscles and spine. You can reduce this stress by using pillows to fill the gaps.

Be careful while turning in bed. You can get out of alignment during twisting and turning motions as well. Always move your entire body together, keeping your core tight and pulled in. You may even find it helpful to bring your knees toward your chest as you roll over.