Best Position to Sleep with Lower Back Pain


Aching muscles, stabbing pain, or burning sensations, if lower back pain haunts your nights, you're not alone.
These symptoms can turn restful sleep into a nightly struggle, robbing you of energy, focus, and quality of life.
Ignoring it only fuels fatigue and chronic discomfort. But relief may be closer than you think, discover the best sleep position to ease your pain and reclaim your rest.
Key Takeaways
Sleep on your back with a pillow under your knees to reduce lower back pressure and support spinal alignment.
Sleeping on your side with a pillow between your knees helps keep your hips and spine aligned, easing back pain.
The fetal position can relieve lower back pain by decompressing the spine and reducing pressure on discs.
Reclining at a 30–45 degree angle supports natural spine curves and lowers strain on your lower back.
Adjusting your sleep position can significantly ease back pain and sometimes reduce the need for medication.

Best Position to Sleep with Lower Back Pain
On Your Back with a Pillow Under Your Knees
- Sleeping on your back with a pillow under your knees eases pressure: Sleeping this way reduces spine pressure by slightly bending your legs, which relaxes lower back muscles and helps relieve pain.
- Doing gentle stretches before bed helps your back relax: Spending 5–10 minutes doing simple stretches like cat-cow or child’s pose loosens tight muscles and eases tension before sleep.
- A firm mattress supports your lower back better: Using a pocket sprung or orthopaedic mattress helps keep your spine aligned. If your mattress is too soft, placing plywood underneath makes it firmer and better for your back.
- A medium-firm pillow under your knees keeps your spine aligned: Choose a pillow that’s firm enough to stay in place but not too thick. Place it right under your knees to keep your back balanced and comfortable.
On Your Side with a Pillow Between Your Knees
- Keep Your Legs Slightly Bent for Neutral Spine Alignment: To maintain comfort and support, keep your legs slightly bent and place a pillow between your knees to help keep your hips aligned. Arrange your lower arm forward to rest more comfortably on your shoulder blade, easing any undue pressure and promoting a restful night’s sleep," says Dr. Mike Basten, owner and CEO at Foothills Sports Medicine Physical Therapy.
- Hugging a Long Pillow Stabilizes Your Body and Eases Tension: Wrapping a long pillow from your chest down to your knees helps stabilize your arms, legs, and torso, reducing tension throughout your hips and lower back.
- Position Your Lower Arm Forward for Comfortable Shoulder Support: Arrange your lower arm forward to rest comfortably on your shoulder blade, easing pressure and promoting a restful night’s sleep.
- Alternate Your Side to Prevent Muscle Imbalances and Promote Spine Health: To avoid muscle imbalances and future discomfort, alternate the side you sleep on each night. This promotes healthier spine alignment and balanced muscle use.

In the Fetal Position
- Sleeping curled up eases pressure on your lower back: The fetal position helps ease lower back pain by gently opening the space between your vertebrae. Curling up with your knees drawn toward your chest reduces pressure on your lower back and hips.
- Curling up helps if you have herniated discs or back pain: This position is especially recommended for those with herniated discs or general lumbar discomfort because it lessens stress on the spine.
- Sleeping this way too long can strain your back and neck: While it can provide immediate relief, consistently sleeping in this position may cause long-term strain on your back and neck due to the pressure it places on these areas, leading to misalignment and discomfort over time.
- Avoid curling too tightly if you have spinal stenosis: If you have spinal stenosis, avoid curling your body too tightly, as this can worsen the condition by putting too much pressure on your spine.
- Keep your knees bent and add a pillow between them for support: Keep your knees bent and hips slightly turned, and consider placing a pillow between your knees for added support.
- Curling up helps your lower back relax and feel better: Curling up in this way encourages the lumbar spine to relax and decompress, which can bring significant relief.
Reclined Back Sleeping (Inclined Position)
- Reclining back helps ease lower back pain: Reclined back sleeping means lying back with your upper body raised at an angle, like sitting in a comfy chair. This reduces pressure on spinal discs and keeps your spine naturally curved.
- Raising your upper body between 30 to 45 degrees works best: Experts say an incline of about 30 to 45 degrees supports your back better by spreading your weight evenly and lowering strain on lower back muscles.
- Long reclined sitting can cause stiffness without proper support: Staying reclined too long may lead to stiffness or poor posture, especially if your chair or bed doesn’t fully support your spine.
- Use adjustable beds or pillows under back and knees for comfort: At home, you can set this up by using adjustable beds or wedge pillows to keep your back and knees supported in a comfortable reclined position.

Can Proper Sleep Positions Replace Medication for Lower Back Pain?
- Proper sleep posture can ease lower back pain quickly: Proper sleep positions can play a powerful role in managing lower back pain and sometimes reduce the need for painkillers. While they may not completely replace medication for everyone, adjusting how you sleep can ease discomfort faster than you might expect often within days.
- Better sleep alignment may reduce the need for medication: Many people find that correcting their sleep posture helps relieve chronic pain without side effects. Simple changes like sleeping on your back or side with proper support can improve spinal alignment and reduce pain naturally often making medication less necessary.
- Sleeping on your stomach may worsen your back pain: On the other hand, sleeping on your stomach (prone) can increase strain on your lower back and worsen pain. Avoiding this position can help protect your spine while you sleep.
- Good sleep posture helps improve daytime back comfort: research shows that People who wake up with spinal symptoms often spend more time in harmful sleep positions and report lower sleep quality. Improving sleep posture isn't just about nighttime comfort it directly affects how your back feels during the day.
- Start with posture before turning to pills: Relying only on sleep positions isn’t always enough, but it’s a smart and natural first step. Listening to your body and giving it the chance to heal through better sleep posture can delay or reduce the need for medication.
When to Consult a Physical Therapist About Sleep Posture?
- Waking up stiff most mornings means your sleep posture might be wrong: If you often wake up with stiffness or persistent lower back pain, your sleep posture might be causing stress on your spine and muscles. It’s a common but important sign that something isn’t right.
- Trying new pillows or mattresses and still hurting? That’s a red flag: If changing your mattress or pillow doesn’t make the pain go away, it’s likely not just your bed it's your posture. This is when a physical therapist can step in to help.
- Pain right after sleeping usually means your posture is to blame: When your pain feels worse after getting out of bed, or sharp discomfort happens in certain positions, it's a strong clue that your sleep posture is part of the problem.
FAQs
Can Sleeping on the Stomach Relieve Lower Back Pain?
Sleeping on your stomach can worsen lower back pain by forcing your back to arch unnaturally. If you sleep on your stomach, placing a thin pillow under your pelvis can reduce pressure and improve alignment. However, experts recommend sleeping on your side or back to better protect your spine.
How Can Adjusting the Mattress Help with Lower Back Pain During Sleep?
If you have lower back pain at night, adjust your mattress by flipping or rotating it to even out wear and support your spine. If it still feels uneven, add a firm mattress topper or place a plywood board underneath for better support. Elevate your knees with a wedge or raise your upper body with an adjustable base to reduce pressure on your lower back. Use targeted lumbar support to maintain a natural spine position.
Are There Any Sleep Positions That Can Prevent Morning Stiffness in the Lower Back?
Maintaining proper spinal alignment during sleep prevents stiffness. Sleep on your back with a pillow under your knees or on your side with a pillow between your legs to support your spine. Keeping your spine straight and supported throughout the night is key.
How Does Sleep Duration Impact Lower Back Pain Relief or Aggravation?
Getting 7 to 9 hours of quality sleep helps relieve back pain by allowing your body to heal and reduce muscle tension. Oversleeping can cause stiffness and more pain, while too little sleep increases inflammation and stress on your back. Poor sleep is linked to more intense and chronic back pain.