What Are the Best Sleeping Positions for Lower Back Pain?

June 13, 2023

You should ideally be spending nearly a third of your time in bed sleeping, so it should come as no surprise that the position in which you sleep at night can have a dramatic impact on your overall spine health.

If you regularly wake up with low back pain, especially if it’s happening with greater frequency than when you were younger, it may be time for a new mattress or change your sleep positioning habits.

Finding the right sleeping position can help alleviate low back pain, improve sleep quality and help ensure you wake up feeling refreshed.

Everyone’s body is unique, and it often requires some trial and error to find the best sleep position for your physiology.

Back Sleeping (Supine Position)

  1. Place a pillow under your knees. This helps maintain the natural curvature of the spine and reduces stress on the lower back.
  2. Choose a medium-firm mattress. A supportive mattress can provide better spinal alignment and reduce pressure on your back.

Side Sleeping (Fetal Position)

  1. Draw your knees toward your chest. By curling up slightly, you can relieve pressure on your lower back and open up the joints.
  2. Use a pillow between your knees. This helps keep your hips, pelvis and spine properly aligned, reducing strain on the lower back.

Note: Sleeping on the same side night after night can lead to imbalances and discomfort. Switch up your sleeping side to promote better spinal alignment and overall well-being.

Stomach Sleeping (Prone Position)

  1. Do your best to avoid this position. Sleeping on your stomach can strain the lower back by overextending the spine and putting pressure on the neck. If you can’t break the habit, try using a thin pillow for your head or no pillow at all to minimize strain.
  2. To alleviate pressure from your back, position a pillow under your pelvis and lower abdomen.

Combination Sleeping

  1. Experiment with pillow placement. Use a combination of pillows to support different areas of your body, such as placing a small pillow under your waist while sleeping on your side to maintain proper spinal alignment.
  2. Avoid sudden movements. Minimize tossing and turning during the night as it can strain your back. Gradually transition from one position to another, allowing your body to adjust.

Alignment is Key to a Healthy Spine

When it comes to finding the best sleeping position, maintaining proper alignment of your spine is key. Regardless of the position you prefer, ensuring that your ears, shoulders and hips are in alignment is crucial for minimizing strain and promoting spinal health.


  • Ears – Your ears should be in line with your shoulders, indicating that your neck is in a neutral position. Avoid tucking your chin or letting your head fall backward, as these positions can strain the muscles and lead to discomfort.
  • Shoulders – Keep your shoulders parallel to the mattress. Avoid hunching or rolling them forward. Proper alignment of the shoulders promotes a balanced distribution of weight and reduces stress on the upper back.
  • Hips – Align your hips with your shoulders, ensuring they are level and not tilted to one side. This alignment helps maintain the natural curve of your lower back, preventing excessive pressure and potential pain.


  • Pillow support – If you notice gaps between your body and the mattress that strain your muscles and spine, strategically place pillows to provide additional support. Side sleepers may benefit from keeping a pillow between their knees, as it will help align hips and reduce strain on the low bow. Back sleepers can try placing a pillow under their knees to maintain the spine’s natural curvature in sleep.
  • Experimentation – All bodies are different, so finding the right pillow placement may require some experimentation. Adjust the number and positioning of pillows until you find the configuration that fills in the gaps and supports your spine in a comfortable and aligned position.

Remember, proper alignment and pillow support are crucial elements for reducing stress on your spine and ensuring a restful night’s sleep. Take the time to assess your body’s alignment in your preferred sleeping position and make necessary adjustments (using pillows as needed).


By prioritizing spinal health during sleep, you can wake up feeling refreshed, rejuvenated and free from unnecessary muscle tension or discomfort. However, the key to a healthy spine goes much further than just sleeping in a proper position.

At Non-Surgical Orthopaedics, P.C, we offer comprehensive treatment plans that are designed to support your overall spinal health. From back pain management therapies to spinal injection techniques, our spine specialists develop customized treatments for each patient.

To explore the services we provide, visit our website or contact us at 770-421-1420 with any questions.

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