Given that we spend abot a third of our lives asleep, it’s crucial to sleep in a position that supports our body’s physical recovery. A good sleep position can relieve stress on your spine, while an unhealthy position can increase pain or stiffness in your back, neck, arms, or shoulders, all while contributing to lower-quality sleep quality.

In this post, I’ll explore the four most popular sleeping positions for those struggling with low back pain, along with some additional tips for a more restful night’s sleep.

Side Sleeping:

Side sleeping can be beneficial for low back pain, especially when the spine is properly aligned.

Try lying on your side with your knees slightly bent and a pillow between your knees to keep the hips, pelvis, and spine in alignment.

Avoid curling into a tight foetal position if you tend to experience back pain when bending forward or sitting. However, if you have degenerative back pain that is worse when you stand and walk, the tightly curled foetal position may ease your pain.

If you have wide hips and a small waist, side-lying tends to be most comfortable if you have a softer mattress or use a thick mattress topper, allowing your hips to sink in and maintain a neutral spinal position.

If you have narrower hips, a firmer mattress may help you maintain a neutral spinal position.

Back Sleeping with Knee Support:

One of the most comfortable positions for low back pain is sleeping on your back with a pillow placed under your knees.

This position helps maintain the natural curve of the spine and reduces pressure on the lower back.

Experiment with the number of pillows that makes you feel most comfortable. Typically this will be more pillows for someone with degenerative back problems, and less pillows for someone with discal back pain.

Ensure the pillow is positioned comfortably under the knees to provide adequate support, without causing strain.

Stomach Sleeping (with Caution):

While stomach sleeping is generally not recommended due to the risk of straining the neck and upper back, some people find relief of their low back pain in this position.

If sleeping on your stomach is most comfortable for your back, try placing a pillow under your pelvis to help maintain the natural curve of the spine.

Be mindful of your neck position and consider using a thin pillow or no pillow at all for the head.

Reclined Position:

For some individuals, sleeping in a reclined position can offer relief by reducing pressure on the lower back.

Use an adjustable bed or supportive pillows to prop yourself up slightly while sleeping on your back or side.

Experiment with different angles to find the most comfortable position for your back.

Additional Considerations for Better Sleep and Back Health:


Pillow Selection:

Choose a pillow that complements your sleeping position and provides adequate support for the head, while maintaining a neutral neck and spine position.

Back sleepers: Opt for a pillow with medium thickness that cradles the head and neck while maintaining alignment with the rest of the spine.

Side sleepers: Choose a thicker pillow to fill the gap between the shoulder and ear, ensuring proper alignment and preventing neck strain.

Stomach sleepers: Consider using a thin pillow or no pillow at all to avoid excessive strain on the neck and lower back.

Mattress Choice:

An old, saggy mattress or one that is either too firm or too soft can exacerbate discomfort. Opting for a mattress that offers the right balance of support and comfort is crucial for achieving restorative sleep.

As mentioned above, consider adding a topper to a firm mattress if you have wide or bony hips and you sleep on your side.

On the flipside, consider investing in a new mattress, or simply placing wooden boards under your mattress if the combination of bed and mattress lack support.


Perform simple exercises to loosen your back muscles before bedtime. Applying heat therapy locally, such as using a hot water bottle, can also aid in relaxing and relieving soft tissues around the spine.

Relaxation techniques:

Incorporate relaxation techniques into your bedtime routine. Mindful meditation or relaxed breathing have been proven to reduce the perception of pain and may contribute to improved sleep. There are lots of free Apps and YouTube videos that offer guided meditations or relaxation advice.

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