How To Sleep With Lower Back Pain

Medically reviewed by
 Dr. Jordan Burns DC, MS

Dr. Jordan Burns DC, MS

Meet Dr. Burns, a devoted chiropractor with an extensive seven-year professional career dedicated to optimizing patient health. With an academic background in Kinesiology, Life Sciences, and Sports Science and Rehabilitation,…

Last Updated On January 22nd, 2024
How To Sleep With Lower Back Pain

Key Takeaways

  • Optimal Sleeping Positions: Adjusting your sleeping position is a fundamental step in reducing lower back pain while sleeping. The recommended positions, such as lying flat on your back with adequate neck support or sleeping on your side with a pillow between your knees, can help maintain spinal alignment and alleviate pressure points. Avoiding stomach sleeping is advised to prevent additional strain on the lower back.
  • Importance of Pillows and Mattresses: Using pillows strategically, such as placing them beneath the knees, between the legs, or under the hips, can help alleviate pressure points and promote a more comfortable sleep position. Choosing a medium-firm mattress that supports the natural curvature of the spine is recommended, as both excessively soft and firm mattresses may exacerbate lower back pain.
  • Pre-Sleep Routine and Core Strengthening: Engaging in activities that promote stress reduction, such as relaxation techniques and gentle stretches before bedtime, can help alleviate muscle tension and prepare the body for sleep. Additionally, strengthening the core muscles through exercises like planks can provide better support for the spine and reduce the likelihood of relying on other weaker muscles for stability.

Lower back pain is an incredibly common ailment. According to the CDC, Verified Source Centers for Disease Control and Prevention (CDC) The United States’ health protection agency that defends against dangers to health and safety. View source  it’s the most commonly reported type of pain, and one in four Americans have complained of low back pain in the last three months.

Because of its prevalence, it makes sense that low back pain interferes with the quality and quantity of sleep for many people. A peer-reviewed paper Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source published by the National Institute of Health even says, “insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic lower back pain.”

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This article aims to explore the different options to establish a sleeping routine when you have lower back pain. Simple adjustments to your health, like gentle stretching, altering your sleeping position, and making sure you’re using the right type of pillow can greatly improve your quality of sleep when you’re dealing with lower back pain.

“Adopting the right sleeping posture is crucial for lower back pain relief,” advises Dr. Devon Hoffman. “A supportive mattress and strategically placed pillows can aid in aligning and supporting your spine.”

Tips For Managing Lower Back Pain From Bed

Try a different sleeping position

The easiest adjustment to make to alleviate your low back pain while you’re sleeping is to try changing your sleeping position. This change can be implemented immediately, so it’s a great place to start when looking to get better sleep. The medical experts at the Mayo Clinic Verified Source Mayo Clinic Ranked #1 hospital by U.S. News & World Report and one of the most trusted medical institutions in the world. The staff is committed to integrated patient care, education, and research. View source  suggest the following for the best sleeping positions.

The best sleep position is lying flat on your back, with your neck supported by a single pillow. This position enables your spine to be in total alignment, which helps reduce pressure points from forming at night.

The second recommendation is to sleep on your side. In this position, you’ll put the weight of your body on one of your sides, and it’s recommended you sleep with your knees slightly bent, like a relaxed version of the fetal position. Sleeping with a knee pillow can increase your comfort by supporting your upper leg.

This position can help your lower back pain by preventing pressure from forming in any one area of your back. Just make sure you have a soft enough mattress for side sleeping, or you can worsen your morning aches and stiffness.

“I recommend to my patients that the best sleeping position is on your non-dominant side in the fetal position with a pillow between your legs,” says Dr. Jordan Burns. “The pillow helps keep your low back and pelvis in a neutral position while sleeping on your non-dominant side allows you to neurologically feel safer having your dominant hand protect your heart and other organs.”

The least recommended position is lying on your stomach. This position can be hard on your back, causing tension in the lower back because of the lack of support to your hips and lower abdomen. If you’re already experiencing low back pain, it is not recommended that you sleep on your stomach.

Use pillows to support your spine

In addition to recommending your sleeping positions, the Mayo Clinic also has Verified Source Mayo Clinic Ranked #1 hospital by U.S. News & World Report and one of the most trusted medical institutions in the world. The staff is committed to integrated patient care, education, and research. View source  has recommendations on where to tuck a pillow or two to stay comfortable during the night. The support added by pillows helps prevent pressure points from forming and assures that every part of your body has adequate cushioning.

If you’re sleeping on your back, it’s recommended you tuck a pillow flat under your knees. They even recommend putting a soft, small pillow under the small of your back to help prevent lower back pain. Doing so helps maintain the natural curve of your lower spine. Of course, a pillow to cradle your neck is also required in this sleeping position.

For side sleepers, the number one recommendation is to put a pillow between your knees. Paired with the recommendation to raise your knees slightly towards your chest, this sleeping position helps prevent pain from developing overnight.

You may find it more comfortable to sleep with a body pillow between your knees, which serves the same purpose as a smaller pillow. A thicker pillow is recommended beneath your head when you’re sleeping on your side.

If you do sleep on your stomach, you’re going to want to need at least one pillow, but not where you think. The pillow, which should be firm, goes under your hips and pelvis. This pillow will reduce the tension that sleeping on your stomach causes on your low back.

You will need to see whether using a pillow under your head increases tension on your back. If it does, then it’s recommended that you try sleeping without a pillow.

Make sure you’re using the right pillow for your sleeping position

While adjusting your sleeping positions for lower back pain, you’re going to want to make sure you’re using the correct type of pillow to support the muscles in your neck at night. They can be made out of tons of materials, like feathers, memory foam, down alternative, and more.

Pillows can be thin and malleable, hard, or in-between. But making sure you sleep on the right kind can improve the sleeping posture of your back and keep you more comfortable during the night. Some sleepers need a soft pillow, others a firm pillow.

If you’re sleeping on your back, you want one or two thin pillows beneath your head. If this is not a comfortable situation for you, consider a neck roll or cervical pillows for optimal alignment. Some back sleepers may use a wedge pillow for acid reflux or sleep apnea.

If you’re a side sleeper, your head and shoulders need more support. You will want to use firmer, medium-height pillows under your head and shoulders. Materials like latex or memory foam will do the trick when it comes to pillows for side sleepers.

For stomach sleepers, it’s advised to try to sleep without pillows. The angle they support your head at can cause tension in your neck and shoulders, which can radiate into low back pain low back pain. Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source . Try resting your head on the mattress instead.

You also want to make sure you’re covering your pillows in a pillowcase and that you’re washing the pillow and its case as regularly as you need to. Regular laundering keeps oils and allergens from building up, disturbing your rest. Pillowcases should be washed at least once a week, while machine-washable pillows should be cleaned every few months.

See our guide to laundry care and washing symbols if you need help deciphering your pillow’s care label.

Make sure you’re sleeping on the best type of mattress for your back pain

There is no one right mattress for everyone’s lower back pain. The rumor that firm mattresses were best for back pain has been proven false. Mattresses that are too soft or too hard don’t do a sufficient job of supporting your spine so you can rest properly. Having one of the best mattresses is key to good spine health because when you’re sleeping, your back fully relaxes and can heal from the strain of the day.

It’s recommended that you try something in the “medium-firm” category. However, the best mattress for back pain will be different for everyone. If your body is wider, you may want a mattress that’s a bit softer. You need the mattress to have the capability to give a little to support your spine while you sleep. If you have a narrower body, you will probably be more drawn to a firmer mattress.

Go visit a mattress store, one of the best places to buy a mattress, where you can try out different models to get an idea of what mattress supports your back best.

Move your body slowly and carefully when getting in and out of bed

It may sound silly to be warned to get in and out of your mattress carefully, but it’s advice that some people need to hear. With it being the ultimate place of comfort, you may have a tendency to get in and out too quickly or with poor posture that causes strain on your lower back.

Thankfully, this natural instinct can be modified! To help reduce muscle pain, try getting into your place on the mattress at a slow, gentle pace while keeping your spine in as neutral a position as possible. Even when it comes to assuming your chosen sleeping position, it’s recommended to move calmly and intentionally into place.

“For example, if I have a patient with right-sided low back pain, I will recommend rolling to their left side and using the right hand to slowly push up allowing the right side to not be compressed as they get up to a seated position,” says Dr. Burns.

If you can afford one, you may want to look into purchasing an adjustable bed. Sleepers can raise their mattress in the morning for an easier time sliding out of bed. Other adjustable bed features, like massagers and a zero-gravity preset, can also improve life with back pain.

Tips For Managing Lower Back Pain Outside Of Bed

Strengthen your core by exercising

Research suggests that Verified Source Cleveland Clinic Ranked #2 hospital by U.S. News & World Report and one of the largest academic medical centers in America. The Cleveland Clinic serves patients from all over the world. View source strengthening your core can reduce lower back pain. Your core is made up of the muscles in the front and sides of your abdomen as well as the muscles that run up along your spinal disc.

If the muscle in your core is weak, you’re more likely to rely on alternate sources of strength to stay upright. This includes the ligaments in your abdomen, which are too weak to hold you up on your legs without causing major pain.

To begin the process of enhancing your core, the plank and side plank are really good exercises. To do a side plank, sit on the floor with your right hand below your right shoulder and legs stacked. While keeping your legs long, abdominals engaged and feet stacked, lift your body up and hold it.

To do a regular plank, get on all fours. Suck in your abdomen and step your feet behind you until your legs form a straight line. Keep your hands directly under your shoulders straight and hold. You can make these exercises harder for yourself by holding them for progressively longer amounts of time.

“Movement is medicine,” says Dr. Burns. “There is not a better way to start reducing low back pain than by developing exercise, mobility and flexibility routines to help stretch, strengthen and improve your core, back and overall musculoskeletal system.”

Relax before bed because stress causes inflammation which worsens back pain

According to Dr. William Deardorff, stress causes a cycle where stress causes inflammation, which causes additional stress, and so on. Going to sleep when you’re feeling stressed could lead to higher rates of inflammation which will worsen your lower back pain. To combat this, develop a routine before bed that helps you unwind.

A good way to start relaxing is by putting your phone away for the evening. In fact, research from the Cleveland Clinic Verified Source Cleveland Clinic Ranked #2 hospital by U.S. News & World Report and one of the largest academic medical centers in America. The Cleveland Clinic serves patients from all over the world. View source says that for your health, you should ditch all screens in the hour before you go to sleep, in order to get a good night’s rest.

Some ideas to incorporate into your pre-bedtime routine could be a bubble bath, some time spent reading a book, or drinking a cup of tea. Taking this time to care for yourself and relax is an important step in the quest for a good night of sleep when you’re dealing with lower back pain.

“I recommend putting your phone ‘to bed’ at least 90 minutes before you go to bed in a place that’s out of arm’s reach,” says Dr. Burns. “This allows less blue light exposure which can harm your natural circadian rhythm. This also allows you to not see any news or information on your phone that could cause stress right before bed.”

Do some gentle stretches before bed

Before you go to sleep, it is recommended that you do some gentle stretches to free up any tension in your spine. Experts recommend spending ten minutes of stretching before bed to help create a transitionary time for your body to realize it is time to sleep. Not only does establishing this stretching time help reduce lower back pain at night, it has a myriad of other positive benefits.

Stretching can help improve blood flow and free up muscle tension. Not only are these benefits associated with improved sleep quality, but they also help with muscular recovery. This means that if your lower back pain is due to a strain or other temporary issue, stretching before bed could help it resolve quicker.

It’s recommended that you start these stretches between 30 and 60 minutes before bed. This time buffer allows your mind to begin to transition into the end of the day before you are too tired to complete the stretches. Some recommended stretches to do to help the muscles in your lower back include child’s pose, cat-cow, and lying with a single knee to your chest. These simple stretches can help free up tension in your back and improve your lower back pain and the quality of your night’s sleep.

When To Consult A Doctor

There may come a point when it is time to seek out medical advice regarding sleeping and your back pain. If the suggestions in this article provide you with no relief, your back pain is chronic, or you’re really struggling to manage your back pain and sleep, seeing a doctor or hospital may help you get your condition under control.

In this situation, a doctor will probably evaluate the site of your pain in their office before sending you to get any imaging they feel is relevant. They’ll want to review the condition of your spinal column and search for the source of your discomfort. Depending on what they find and your overall health, they may prescribe you medicine, physical therapy, steroid injections, or other treatment related to improving the pain in your spine.


There are many factors that go into how to sleep with lower back pain. Since sleeping is so important to your overall health, it’s worth taking the time to troubleshoot your spine and see what can be done to alleviate your lower back pain. There may come a time when you need to seek medical advice to sort out the state of your sleep and pain, but there are many options to try to relieve low back pain at home before going for a medical solution.

Make sure you’re getting a good sleep foundation by using the optimal mattress, pillow type, and sleeping in a position that helps keep your spine in alignment. You’ll also want to examine your evening routines outside of bed. There are many resources on how you can strengthen your core muscles and stretch before sleep.

Create a soothing bedtime routine that helps you relax, which will help decrease related muscle inflammation. But lastly, don’t be afraid to consult with a spinal clinic or other modern medicine if these tips do not help. Don’t let lower back pain, whether chronic or acute, ruin your sleep.

About the author

Emily Courter is a freelance writer based in New England, specializing in health and wellness, with a particular focus on women's health. Her articles, published in smaller health and wellness publications, provide valuable insights and practical tips to readers. Emily's dedication to addressing women's health concerns makes her a trusted source for reliable and relevant information.

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