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5 Effective Sleep Positions for Lower Back Pain Relief

close up shot of woman sitting up in bed feeling lower back pain

Lower back pain is a common concern, affecting a significant portion of the population at various times in their lives. As of 2020, around 619 million people worldwide were impacted by lower back pain. Forecasts suggest this number might increase to approximately 843 million by 2050, considering factors like population growth and aging.[1] Lower back pain can disrupt sleep, so you may find yourself seeking the right sleep position to enhance sleep and relieve pain. In this blog, we list the sleeping positions to avoid, and 5 sleep positions which can be beneficial for alleviating discomfort caused by back pain and quality sleep.

What causes lower back pain?

Lower back pain can arise from a variety of factors, often related to the structures and functions of the lower back:

  1. Physical strain and injury: Common causes of lower back pain include muscle strains and ligament sprains, often resulting from heavy lifting, sudden movements, or poor posture over time. These strains can lead to painful muscle spasms.


2. Degenerative changes: As we age, natural wear and tear can affect the spine. This includes degeneration of intervertebral discs, which can result in reduced cushioning between the vertebrae, and osteoarthritis, which can cause joint inflammation.


3. Disc issues: Herniated (slipped disc) or bulging discs can put pressure on the spinal nerves, leading to pain that may radiate to other parts of the body, such as the legs.


4. Nerve compression: Conditions like spinal stenosis, where the spinal canal narrows, can result in compression on nerve roots, and cause pain or numbness, particularly when walking or standing for prolonged periods.


5. Lifestyle factors: Lack of regular exercise, poor posture, and prolonged periods of sitting can exacerbate lower back pain. Additionally, being overweight can put extra stress on the back muscles and spinal structures.


6. Other medical conditions: Certain medical conditions, such as kidney stones or infections, can also manifest as lower back pain.

Understanding these common causes can help in identifying the best approaches to treat and prevent lower back pain. Lifestyle changes, physical therapy, and, in some cases, medical treatments can be effective in managing this condition.

How sleep positions impact lower back pain.

While poor sleep positions can exacerbate existing lower back pain, choosing the right sleeping positions can significantly alleviate this discomfort. It’s important to understand that not all sleep positions have the same effect on the lower back. Some positions can effectively relieve back stress and reduce pain, while others might increase strain and potentially worsen the pain. Recognizing and adopting sleep positions that provide optimal support for the lower back can help to effectively manage and ease discomfort and pain.

Sleep positions that can worsen lower back pain

Stomach sleeping without support: This position disrupts the spine’s natural alignment. This can lead to enormous strain on your back and spine.

Sleeping on an unsuitable mattress: A mattress that doesn’t suit your body can worsen back pain. If it’s too soft, the body will sink, misaligning the spine. If it’s too firm, it can increase pressure on certain areas, leading to discomfort.

5 sleep positions for lower back pain relief

Adopting the right sleep positions can be extremely helpful for relieving lower back pain. Here are 5 recommended positions, each specifically addressing different aspects of back health:

  1. Sleeping on your back with knee support: By lying on your back and placing a pillow under your knees, you can distribute your body weight more evenly and reduce stress on your spine. This position allows you to maintain better spine alignment.


2. Sleeping on your side with a pillow between knees: Placing a pillow between your knees can prevent your upper leg from pulling your spine out of alignment, thus reducing strain on your lower back. For side sleepers, aligning the hips, pelvis, and spine is crucial for good spine alignment – the pillow is the key for this. Try not to always sleep on the same side to prevent muscle imbalance.


3. Sleep in the foetal position: If you have a herniated disc, sleeping in a curled-up, foetal position may bring relief. This position expands the space between vertebrae and can reduce the pressure on a herniated disc. Again, try to avoid sleeping on the same side to prevent muscle imbalances.


4. Sleep in the reclined position: For those who find relief in a reclined chair or position, imitating this reclined position when sleeping can provide relief for those who have isthmic spondylolisthesis. * This position can help reduce the strain on your lower back. (Spondylolisthesis is when one vertebra (bone) in the spine slips forward over the one below it.)


5. Sleeping on your front with a pillow: Sleeping on your front (stomach sleeping) is of the least recommended sleeping positions, especially for back pain. Sleeping in this same position over time places strain on the spine, neck and back. Most of your weight sits in the middle of the body making it hard to keep a neutral spine position. If you prefer to sleep on your front, placing a pillow under your lower abdomen can help maintain the natural curve of your spine. This modification can help reduce the strain typically caused by this sleep position.


Most importantly, maintain proper spinal alignment.

If you find a specific sleep position that relieves your lower back pain, consider sticking with it. If there are gaps between your body and the bed, using pillows to fill these spaces can help reduce strain.

Whichever sleeping position you adopt, the most important factor is maintaining proper spinal alignment. To ensure proper alignment, focus on aligning your ears, shoulders, and hips while finding a comfortable sleep position. Alignment is key to maintaining good posture and reducing strain on your spine.


How we sleep can either worsen or improve lower back pain. If you find that you are experiencing poor quality of sleep due to lower back pain, consider changing your sleep position, and assess whether that helps to reduce the pain. Stomach sleeping or sleeping on an unsuitable mattress can worsen back pain, so consider avoiding sleeping on your stomach or finding a mattress more suited for your needs. Using extra pillows and placing these either between the knees or under your lower abdomen (depending on the sleep position), helps to distribute body weight more evenly, reduces stress on the spine and allows for better spine alignment.

Whichever sleep position you choose, remember that the most important factor in reducing spinal strain is maintaining proper alignment, especially aligning of your ears, shoulders, and hips.

In conclusion, finding the right sleep position tailored to your needs can improve both your sleep quality and lower back health. By being mindful of how you rest and making small adjustments for better alignment, you can take a proactive step towards alleviating lower back pain.


  1. GBD 2021 Low Back Pain Collaborators. ‘Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021.’ Lancet Rheumatol. 2023 May 22;5(6):e316-e329. doi: 10.1016/S2665-9913(23)00098-X
  2. Burton MR, Dowling TJ, Mesfin FB. Isthmic Spondylolisthesis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  3. Raja A, Hoang S, Patel P, et al. Spinal Stenosis. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

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