Best sleeping positions for back pain (and what to avoid)
Best sleeping positions for back pain (and what to avoid)
If you’re searching for the best sleeping position for back pain, you’re not alone. Sleep should be the time your body recovers, but the wrong position (or the wrong pillow set-up) can leave you stiff, sore, or waking up with a “caught” lower back.
The goal is not to find one perfect posture forever. It’s to reduce strain on your spine and surrounding muscles, support natural alignment, and keep you comfortable enough to actually stay asleep.
Below are the positions that often help, what to avoid, and simple pillow tips you can try tonight.
What makes a sleeping position “good” for back pain?
A supportive sleeping position generally:
Keeps your spine in a neutral, comfortable alignment (not twisted or overly arched)
Reduces pressure on sensitive joints and tissues
Helps muscles switch off rather than stay guarded overnight
Doesn’t force your neck into a sharp angle
If you wake with pain that eases after moving around, it can be a sign your overnight position, pillow, or mattress set-up is not suiting you.
The best sleeping positions for back pain
1) Side sleeping (often the most comfortable option)
For many people with lower back pain, side sleeping is a strong starting point because it can reduce extension (over-arching) through the lower spine.
Try this set-up:
Place a pillow between your knees so the top leg doesn’t drop forward and twist the pelvis
Keep your head pillow high enough to fill the gap between your shoulder and neck, so your neck stays neutral
Who may like this most:
People who feel worse lying flat on their back
People who get achy hips or lower back stiffness overnight
People who tend to snore (side sleeping may also help breathing for some)
Extra tip: If your shoulder gets sore, try hugging a pillow in front of you. It can stop your top shoulder rolling forward and reduce upper back strain.
2) Back sleeping (great if you can tolerate it)
Back sleeping can work well because it distributes weight more evenly, but some people find it increases lower back discomfort if the lumbar curve is unsupported.
Try this set-up:
Place a pillow under your knees (or a rolled towel) to soften the arch in your lower back
Use a neck pillow that supports the natural curve of your neck without pushing your head forward
Keep your arms in a relaxed position rather than overhead if that aggravates upper back or shoulder tightness
Who may like this most:
People who feel “twisted” or sore from side sleeping
People with pain that flares with spinal rotation
People who wake with neck or shoulder discomfort (with the right pillow height)
Sleeping positions to avoid (or modify)
Stomach sleeping (often the biggest culprit)
Stomach sleeping tends to:
Force your neck to turn to one side for long periods
Increase arching through the lower back
Create a “twist” through the spine and pelvis
That said, some people simply can’t fall asleep any other way. If you’re a dedicated stomach sleeper, it can help to modify the position rather than forcing a big change overnight.
If you must sleep on your stomach, try:
A very thin pillow or no pillow under your head (to reduce neck strain)
A small pillow under your lower abdomen/hips to reduce the lower back arch
One knee slightly bent out to the side (only if it feels better, not worse)
If stomach sleeping consistently leaves you worse in the morning, it’s worth transitioning gradually to side sleeping using pillows as “barriers” behind your back and in front of your chest.
Pillow tips that can make a big difference
Use pillows to stop twisting
Twisting is a common reason people wake sore. Two easy options:
Between the knees (side sleeping)
Under the knees (back sleeping)
Match pillow height to your shoulder width
A pillow that’s too high can tilt your head up, and too low can drop it down. Both can irritate neck and upper back tissues. Ideally, your nose should be roughly in line with the centre of your chest when you’re on your side.
Consider a body pillow if you move a lot
If you change positions during the night, a body pillow can:
Support your top arm and leg
Reduce rolling into a painful position
Make side sleeping feel more stable
What about your mattress?
Even the best sleeping position can be undermined by a mattress that doesn’t suit you.
As a general guide:
Too soft: your hips may sink, creating a twist or arch in the lower back
Too firm: pressure points can build at shoulders and hips, making you toss and turn
A supportive mattress usually allows your shoulders and hips to settle slightly while keeping your spine relatively aligned. If you routinely wake with back pain that improves after leaving bed, your mattress may be contributing.
When back pain at night should be checked
Most sleep-related back pain is mechanical, meaning it relates to joints, muscles, posture, load, and recovery. But you should seek timely assessment if you have:
Pain that is worsening over time, especially at night
Pain with unexplained weight loss, fever, or feeling unwell
Significant pain after a fall or injury
Numbness, tingling, weakness, or pain spreading down the leg
Changes to bowel or bladder function
Severe, persistent morning pain that does not ease with movement
If you’re unsure, it’s worth getting checked by a qualified health professional. A tailored assessment can help identify what’s driving your symptoms and what positions and supports are most suitable for you.
Quick takeaway
For many people, the best sleeping position for back pain is side sleeping with a pillow between the knees, or back sleeping with a pillow under the knees. Stomach sleeping often aggravates pain, but can sometimes be modified with the right support. The “best” option depends on your body, your symptoms, and what you can maintain comfortably through the night.
FAQ
What is the best sleeping position for lower back pain?
Often, side sleeping with a pillow between the knees, or back sleeping with a pillow under the knees. Both can reduce strain through the lower back by supporting a more neutral position.
Is it bad to sleep on your stomach if you have back pain?
It can be for many people because it increases lower back arching and forces the neck to rotate. If it’s the only way you can sleep, try a thin pillow under your head and a small pillow under your hips/lower abdomen.
Should I put a pillow under my back?
Usually it’s more helpful to support the knees (under the knees for back sleepers, between the knees for side sleepers). A pillow directly under the lower back can sometimes increase arching, depending on your shape and symptoms.
Why is my back pain worse in the morning?
Common reasons include staying in one position too long, a pillow or mattress that doesn’t suit you, or stiffness from reduced movement overnight. If morning pain is severe or persistent, consider an assessment.
Can a chiropractor help with sleep-related back pain?
Chiropractic care may help some people by assessing joint and muscle function, identifying contributing factors (like stiffness, mobility limits, or load sensitivity), and providing individualised care and advice. Results vary and depend on the underlying cause.
If you’re waking up sore most mornings, it may help to get a proper assessment. Wellbeing Chiropractic can check how your spine and surrounding muscles are functioning, discuss what positions are likely to suit you, and help you build a practical plan based on your symptoms and daily routine. Consider booking an appointment at a clinic near you.
