When your lower back hurts, blissful snoozing can seem so far away. You toss and turn, trying to find some kind of setup that won’t make the ache keep you awake. The good news is that you don’t have to change your sleeping position altogether to find some relief. In other words, if you’re a lifelong side sleeper, there are things you can do to stay on your side but also keep your back pain at bay (we’re assuming you’re doing everything you can to keep back pain away during the day, too, like those exercises your PT told you to do and having your computer (and yourself) set up in the most back-friendly way). Same if you sleep on your back or stomach.
For many people, tweaking their pillow placement to ensure they’re sleeping in an ideal position to minimize pain can make all the difference. (You don’t have to sleep on the floor. Find out why here.) According to MH advisor Daniel Giordano, D.P.T., C.S.C.S., co-founder of Bespoke Treatments, the following positions may help to bring relief if you’re experiencing low back pain:
How to soothe back pain if you sleep on your back
Put a pillow under your knees. Sleeping on your back without one there may contribute to an increase in low back pain, Giordano says. Lying on your back is okay—it evenly distributes your body pressure. “However, lying flat on your back may increase pressure on your spine and may even lead to hyperextension of the spine. So prop a pillow—maybe even two—under your knees in order to decrease pressure on your spine,” he says. This helps open up the space between your vertebrae, which should help take the pressure off the discs.
How to soothe back pain if you sleep on your side
Place a pillow between your knees. “Keeping the pillow between your knees should help with spine alignment,” Giordano says. “This position takes the pressure off most discs and is usually ideal for those with nerve pain from ‘herniated’ or ‘bulging discs’ or with pain from scoliosis.”
How to soothe back pain if you sleep on your stomach
Put a pillow under your abdomen and pelvis. Lying flat on your stomach without a pillow may cause hyperextension of the spine and lead to an increase in symptoms, Giordano says. Prop a pillow under your abdomen and pelvis in order to lift the pelvis slightly. “I usually see this as the biggest relief for those with degenerative disc disease,” he says.
Other rules for low back pain relief while you sleep
- Sleep with only one pillow under your head. “Sometimes we see an increase in pain symptoms with more than one due to the neck flexion that occurs, which can ultimately put a painful stretch on the paraspinal muscles,” he explains.
- Sleep on a middle-of-the-road mattress. Sleeping on an extremely soft mattress won’t help with alignment, while extremely hard mattresses may be so uncomfortable you don’t sleep well, Giordano says. Find a happy medium—maybe one that leans more toward the firmer side.
- Do everything you can to get better sleep. Better sleep can mean less back pain. “Ideally, we want the most undisturbed sleep in order to get into deep (REM) sleep to help with hormone release, anabolic state and muscle repair,” Giordano says. That means following the usual “sleep hygiene” rules about making sure your room is cool and dark, closing down screens 30 minutes before bedtime, and keeping pets out of the bed (sorry). When they move around, they disturb your sleep, leaving you less refreshed.
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