The best sleeping position for lower back pain is the one that reduces your symptoms, supports your hips and spine, and lets you relax. Start on your least painful side with a pillow between your knees. If that does not help, lie on your back with one or two pillows under your knees. No single position works for everyone.
Best sleeping positions for lower back pain
| Sleeping position | How to set it up | When to try it |
|---|---|---|
| On your side | Bend your knees slightly and place a pillow between them. Support your head without bending your neck sideways. | A good first option, particularly if lying on your back hurts. |
| On your back | Place one or two pillows under your knees. Keep your heels supported by the mattress. | Try it if bending your knees reduces pressure in your lower back. |
| On your stomach | Place a thin pillow under your lower abdomen or hips. | Use this only if stomach sleeping is already comfortable for you. |
1. Sleep on your side with a pillow between your knees
Lie on your least painful side with your hips and knees slightly bent. Place a pillow between your knees to help keep your pelvis and lower back from twisting. If your waist does not touch the mattress, a small pillow under your waist may provide extra support.
Do not pull your knees tightly toward your chest if that increases your pain. A relaxed, slightly curled position may feel better than holding your spine in one fixed posture.
2. Sleep on your back with pillows under your knees
Lie on your back and place one or two pillows beneath your knees. This can reduce the arch in your lower back and help your back muscles relax. Keep your head supported, but avoid using enough pillows to push your neck forward.
3. If you sleep on your stomach, support your hips
Stomach sleeping can make back pain worse for some people. However, you do not have to force yourself into another position if stomach sleeping is the only way you can fall asleep. Try placing a thin pillow under your lower stomach or hips to reduce the strain from arching your lower back.
How to get into and out of bed with less pain
Avoid sitting straight up or twisting quickly. Instead:
- Bend your knees.
- Roll onto your side as one unit.
- Move your legs over the edge of the bed.
- Push yourself upright with your arms.
- Stand up slowly.
Use the same steps in reverse when lying down. This reduces sudden twisting through your lower back.
What to do before bed
- Use gentle heat if it helps. Superficial heat is a non-drug option for many cases of acute or subacute low back pain. Follow the heating pad instructions, and do not fall asleep with an unmonitored heating device.
- Take a short, easy walk. Gentle activity is generally better than prolonged bed rest, which can make recovery harder for some people.
- Avoid heavy lifting and forceful twisting. These movements can aggravate an acute back problem.
- Do not replace your mattress only because it is labelled "firm." A mattress that supports you, does not sag, and feels comfortable is a more practical choice than one firmness level for everyone.
- Ask a pharmacist or clinician before taking pain medicine if you have kidney disease, stomach ulcers, heart disease, take blood thinners, are pregnant, or use other medicines. Do not exceed the dose on the label.
When lower back pain needs urgent medical attention
Seek emergency care if back pain occurs with:
- New loss of bladder or bowel control
- Inability to urinate
- Numbness around the genitals, buttocks, or inner thighs
- New or worsening weakness, particularly in both legs
- Severe pain shooting down both legs
- Back pain after a major fall or accident
These symptoms can indicate serious nerve compression or another condition that needs prompt assessment.
Contact a healthcare professional promptly if your back pain comes with fever, unexplained weight loss, a history of cancer, significant trauma, or night pain that is getting worse.