How to Sleep With Lower Back Pain: The 5 Best Positions to Try

A man standing beside his bed, touching his lower back due to back pain.

If lower back pain disrupts your daily life, you're not alone. In 2020, it affected over 600 million people and is the leading cause of disability worldwide, according to the World Health Organization.(1)


Yet knowing you're in good company doesn’t make it less of a struggle. You hope for sleep to offer refuge, but finding a comfortable sleeping position, falling asleep and staying asleep can be as challenging as pain management during the day.


This article explores the kinds of lumbar pain, effective sleeping positions and practical tips for sleeping with less pain.

Key Takeaways

  • There are 2 types of lower back pain: Acute, lasting up to 6 weeks from injury and chronic, persisting beyond 12 weeks due to sensitized pain pathways.

  • No single sleep position works for everyone; specific postures keep the spine neutral to reduce pressure on discs, joints, and muscles for more restful sleep.

  • Use a medium-firm mattress and supportive pillows to help with pressure distribution and maintain spinal alignment.

Table of Contents

Types of Lower Back Pain and How They Affect Sleep

The key differences between acute and lower back pain are duration, symptoms, causes and treatment.

Acute Lower Back Pain

Acute lumbar pain lasts up to 6 weeks, usually caused by muscle strain, herniated discs and ligament sprains. These result from an injury to the lumbar spine from lifting heavy objects, for example.


The pain is stabbing or sharp and worsens with sudden movements. However, acute pain improves with rest, therapy and non-steroidal anti-inflammatory drugs (NSAIDs).

Chronic Lower Back Pain

Chronic lumbar pain persists for more than 12 weeks due to changes in the nervous system, even after the tissue heals.


Initially, the pain stems from nerves at the injury site becoming more reactive, known as peripheral sensitization. Over time, your spinal cord and brain may amplify the pain signals, known as central sensitization.


The pain may result from an untreated injury, or conditions like fibromyalgia, osteoarthritis, spinal stenosis or degenerative disc disease. Symptoms include a dull or burning ache, fatigue, sleep disruption, stiffness and reduced mobility.


Treatment targets your mind and body through exercise, cognitive behavioral therapy and sleep optimization to reduce pain amplification.


Stress management, targeted mobility programs and improving sleep quality help calm nerve activity. Your doctor might also prescribe NSAIDs, medical procedures or manual therapy.


Quality sleep is essential for treating lumbar pain. Poor sleep heightens pain sensitivity, so finding a sleep position that eases pain is necessary.

The Best Sleeping Positions for Lower Back Pain

There's no one-size-fits-all sleeping position, but specific postures help.

On Your Side With a Pillow Between Your Knees

Sleeping in this position is ideal for lower back pain caused by pregnancy, sciatica or lumbar muscle pain.


Here’s how to sleep on your side for lower back pain:

A man sleeping on his side with a pillow between his legs to relieve lower back pain.

  • Lie on your right or left side with your shoulder on the mattress.

  • Place a pillow between your knees. Use a small pillow to fill any space between the mattress and your waist. The pillows ensure your body weight is distributed evenly.

  • Switch sides. Sleeping too long in the same position strains the shoulders and hips and worsens lower back pain.

According to Healthline, this sleep posture helps maintain proper alignment of your spine, hips and pelvis.(2) This side sleeping position also improves blood circulation.

On Your Side in a Fetal Position

Sleeping on your side with your knees tucked to your chest helps with a herniated disc or facet joint irritation (inflammation of the joints that link your vertebrae).


If you’re wondering what the best side to sleep on is in this position, either works.

A man sleeping in a fetal position for lower back pain relief.

  • Lie flat on your back and roll to your preferred side with your knees drawn to your chest.

  • Gently curl your torso towards your knees.

  • Your arms and chest should be round and curve near the knees.

Medical News Today says that the fetal position helps ease lower back pain by minimizing the bend of the spine and opening up your joints.(3)

On Your Back With a Pillow Under Your Knees

The supine sleeping position is excellent if you’re recovering from surgery or have spinal stenosis, wherein open spaces along the spine narrow, pinching the spinal cord or its nerves.

A man sleeping in the supine position with one pillow under his head and another under his knees to ease symptoms of lower back pain.

  • Lie down flat on your back.

  • Put a pillow under your knees to keep your spine neutral.

  • For additional support, roll a small rolled-up towel and place it under the small of your back.

This pillow helps maintain the lower back's natural curve.

On Your Back in a Reclined Position

This back sleeping position is ideal if you have isthmic spondylolisthesis, where a stress fracture causes one of your lower vertebrae to slip on top of the bone beneath it.

A man demonstrating the sleep position for lower back pain wherein he is sleeping on his back in a reclined position on an adjustable bed.

  • Use an adjustable bed or recliner.

  • Sleep in a reclined position.

This position reduces pressure on your spine by creating an angle between your torso and thighs, reducing the overlapping of your vertebrae.

On Your Front With a Pillow Under the Pelvis and Stomach

The prone sleeping position is considered the worst posture for neck pain. However, if you’re used to sleeping on your stomach, it’s easier to maintain your position.

A man sleeping in the prone position for lower back pain with one pillow under his head and another under his pelvis.

  • Lie down on your stomach.

  • Put a thin pillow under your lower abdomen and pelvis.

  • If a pillow under your head causes discomfort, do without it.

This stomach sleeping position helps with spinal overextension. It also eases stress on the spaces between your discs if you have degenerative disc disease.


We recommend testing the different postures to determine what works for you.

How to Choose the Best Pillow for Lower Back Pain

In general, using the best pillow for each sleeping position is recommended. This section discusses explicitly which pillows are effective at reducing lower back pain.


  • Wedge pillow for knee support: This pillow reduces strain on your joints, discs and paraspinal muscles by flattening the lumbar curve. Choose one 8 to 12 inches tall to elevate your knees at a 20- to 30-degree angle.

  • Pregnancy pillow: This C or U-shaped body pillow simultaneously supports your head, neck, back and knees. Great for side sleepers and pregnant women, its primary benefit is stabilizing the spine to prevent lumbar twisting.

  • Adjustable foam pillow: You can adjust the loft and firmness of this pillow by removing or adding shredded memory foam. It’s suitable for stomach sleepers, reducing tension on the lumbar joints. Go for a loft of 2 to 4 inches to prevent neck pain.

  • Wedge back-rest pillow: This pillow is ideal for the reclining sleep position. It elevates your upper body at an angle that opens your spinal canal and eases the load on vertebral discs.

  • Contoured lumbar roll: This pillow fits under the small of your back to help distribute pressure evenly. Choose one with a 4- to 6-inch diameter and an adjustable strap to prevent it from slipping.

How to Choose the Best Mattress for Lower Back Pain

Apart from the best sleeping positions and bedding for lumbar pain, here are tips to help you get a good night's sleep:


Establish good sleep hygiene habits, including keeping your room dark, quiet and cool at the ideal sleep temperature of 60 to 67 degrees Fahrenheit. Use a 100% blackout sleep mask for total darkness and drown out disruptive sounds with a white noise machine.


Unwind for bed with calming activities. Gentle stretching (like knee-to-chest holds for up to 30 seconds per side) and guided meditation can ease the pain and relax the mind and body. Consult your physical therapist beforehand to ensure the stretches won't harm your condition.


Exercise your core by strengthening your abdominal, pelvis, hip and back muscles. A strong core stabilizes the spine, lowering your risk of muscle spasms at night and easing back ache.


Prioritize stress management. According to WebMD, stress is associated with back pain.(4)


Seek early medical advice from a spine specialist when your lower back aches to identify the cause, prescribe proper treatment, and prevent acute pain from turning chronic.

Tips for Sleeping With Lower Back Pain

The right mattress can help with sleep and offer relief, especially if you have chronic lumbar pain.


Here are a few guidelines to follow:


Choose a mattress that helps you maintain spinal alignment as you sleep.


Generally, a medium-firm mattress is ideal. Too soft, your shoulders and hips sink, throwing your spine out of a neutral position. Too firm and it compresses the pressure points on your hips, shoulders and back.


Consider a mattress with targeted support provided by coiled or foam layers that are firmer under the lumbar area and softer under the hips and shoulders. This mattress elevates your midsection and offers contouring where needed.


Consider investing in a mattress topper if your mattress is too firm. Choose one made from memory foam, high-density foam or latex.


Test a mattress by lying down on your side, back and tummy to ensure it’s comfortable and offers optimal support.

Conclusion

Lower back pain can seriously affect your sleep quality, but it doesn’t have to be that way.


There are ways to get the quality sleep needed for recovery and pain management, including the correct sleeping position, pillows and mattress. Good sleep hygiene, exercising your core, and stretching also help. Always consult a doctor when lower back discomfort is severe or persists.


Did this article help you sleep better despite lower back pain? Let us know by commenting below.

Sources:  

(1) "Low back pain.” World Health Organization, www.who.int/news-room/fact-sheets/detail/low-back-pain. Accessed 15 May 2025.

(2) “The Best Sleeping Positions for Lower Back Pain, Alignment Tips, and More.” Healthline, www.healthline.com/health/healthy-sleep/best-sleeping-position-for-lower-back-pain. Accessed 15 May 2025.

(3) “How should you sleep if you have lower back pain?” Medical News Today, www.medicalnewstoday.com/articles/320870. Accessed 15 May 2025.

(4) “9 Sleep Tips for Back Pain.” WebMD, www.webmd.com/back-pain/sleep-tips-for-back-pain. Accessed 15 May 2025.


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