When I woke up in the morning with debilitating back pain, and couldn’t move, the first thing that I thought about was that I must’ve slept wrong. If sleeping wrong could cause so much pain, then what are the best sleeping positions for back pain? I wanted the pain gone, and the first thing that I could try was adjusting how I dozed.

I talked with my doctor about it during that first appointment, and he gave me suggestions for mattresses, pillows, and the best sleep positions to avoid back pain. I will go over all of these in this article. Aside from my doctor, I have to credit Healthline
as a source of information for this article.

By the way, you are not alone. Back pain is the number one disability worldwide (Driscoll T, Jacklyn G, Orchard J, et al., 2010)!

The Best Way to Sleep for Back Pain

It turns out that the best position to sleep in to help alleviate and avoid back pain is on your back, with a pillow under your knees. The pillow under the knees helps to keep the spine neutral and maintains the natural curve of the lower back. For an added bonus, add a small, rolled up towel under the curve in your lower back for support.

Sleeping on your back distributes your weight across your entire body. This gives your joints and discs the best opportunity to rest and repair after a day of continued use. Healthline reports that this sleep position helps align the spine and internal organs as well.
Sleeping on back with back pain

But I Can’t Sleep on my Back

I hear you. I can lay down and rest on my back comfortably, but I cannot fall asleep. I don’t know why that is. Perhaps, I need to lay there every night until my body and mind give in, allowing me to sleep. But, I need my sleep, and I don’t want to torture myself! No worries, if you can’t snooze on your back, there are four other sleep positions to try for alleviating back pain.

1) Side Sleepers Rejoice (this is me)! The trick to making this work for your back is to place a pillow between your knees to align the hips, pelvis, and spine properly. You can also put something small under your waist for support if it is not making contact with the mattress. Try not to sleep on the same side every night as you will develop sore spots from pressure points. Switch it up, and you should be fine. I move a lot throughout the night, so I wind up sleeping on both sides.

Sleeping on side with back pain2) If you have a herniated disc, try the fetal position. Similar to sleeping on your side, you would bring your knees up closer to your chest and position your torso towards your knees. This will open up the disc space between your vertebrae, allowing the herniation to move back relieving pressure on the nerves. Again, avoid sleeping on the same side to prevent pressure points and imbalance.

3) Sleeping on your stomach is generally not recommended for back pain. It can actually make it worse (I used to be a stomach sleeper) due to the pressure that it adds to your spine. The way to sleep this way and relieve that pressure is to put a pillow under your stomach/pelvis area. Also, if you can, try not to use a pillow for your head. This sleep position is helpful to those with degenerative disc disease, like me, as it relieves the pressure between the discs.

4) Are you able to sleep in a recliner? This position is especially helpful for those with isthmic spondylolisthesis, which is when a vertebrae slips and is misaligned. If sleeping in a recliner is comfy, consider getting an adjustable bed or base. I have an adjustable base, and I love it. I sleep flat, but when I am laying in bed reading, or writing (like right now), I can adjust the head and foot of the bed so that I am more comfortable and have the least amount of pressure on my spine. The recline position creates an angle that relieves stress on your spine.

Alignment Matters Most

The sleeping position you choose is vital in that your body is aligned to provide the best relief for your back. Healthline recommends keeping your ears, shoulders, and hips aligned while you sleep. If you notice any gaps between your body and the mattress, fill them with pillows or a rolled towel. If you turn as you sleep, make sure to keep things aligned. Do this by moving the entire body at once to avoid twisting the spine. You can engage the core muscles or bring your knees up as you turn.

Pillows for Spine Health

The critical factor with your pillow(s) is that your neck is supported. This helps the cervical (neck) area of the spine rest and repair. The space between your neck and the mattress should be filled according to the Cleveland Clinic. Your shoulders should be on the bed, not on a pillow.

If you’re going to sleep on your back or in the reclined position, you’ll want a thin pillow but one that has enough padding to support your neck.

If you have to sleep on your stomach, remember to put a pillow under your lower abdomen and try not to use a pillow for your head.

Side sleepers should be using a firm pillow under the head and one between the knees for optimal spine alignment.

Mattress Factors for Good Sleep and Less Back Pain

When my back pain became severe enough to disable me, I was sleeping on an expensive “hybrid” mattress that was super soft and comfortable. Y’all, it was like sleeping on a cloud. Literally. I had some of the best sleep of my life on that mattress, but I’d always wake up with a sore shoulder and back. I spent so much money on the mattress that I was in denial for a while that the bed could be a problem.

After looking online, I decided to try one of the trending ‘bed in a box’ options. The beds that you order online and it comes shrink wrapped in a box. Open it up, and it magically turns into a mattress. There are hundreds of online mattress companies out there now, and they usually offer a lengthy trial period and hassle-free returns if it doesn’t work for you. I tried three of those before I found one that helped me wake up to less pain. Here’s the mattress:

Here’s what to look for. Think of Goldilocks, not too firm, not too soft, but just right. People who sleep on firm mattresses have the poorest sleep according to some studies. And a bed that’s too soft will leave you in pain when you wake up. A good medium-firm mattress will offer the best support. When shopping, look for companies that provide a decent trial period, and that won’t hassle you about returns. If you can’t afford a new mattress right now, my doctor recommends putting a piece of plywood under the mattress or putting the bed directly on the floor to get better support.

That’s it for now; I hope to have helped you learn the best way to sleep for back pain relief.

Please tell me about your experiences below. I’d love to hear from you. Use the sharing buttons (bottom of page) to help your friends too.

Also, note – I am not a doctor, and anything written here should not replace the medical advice of a professional.

Be well and in good spirits today!



Driscoll T, Jacklyn G, Orchard J, et al. The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases 2014;73:975-981.