A restful night’s sleep can feel impossible when you have back pain, but what if your sleep position is part of the problem? Many people unknowingly sleep in ways that put unnecessary strain on their spine, leading to stiffness and discomfort in the morning. The good news? A few simple adjustments can make all the difference.
In this blog, I’ll highlight the worst sleeping positions for back pain and show you how to fix them for a more comfortable, pain-free night’s rest.
HOWEVER – I often see people who do not follow the usual rules. Use this as a guide and a starting point but ultimately listen to your back! It will tell you very clearly if it is happy!
1. Sleeping on Your Stomach
If you’re a stomach sleeper, I hate to break it to you, but this is one of the worst positions for back pain. Lying face down forces your lower back into an unnatural arch, putting pressure on the spine. Plus, turning your head to the side for hours can strain your neck and upper back.
The Fix:
- If you can, try to transition to a side or back sleeping position.
- If you must sleep on your stomach, place a small pillow under your hips to reduce the arch in your lower back.
- Use a thin pillow (or no pillow) under your head to avoid extra neck strain.
2. The Twisted Side Sleeper
Side sleeping is generally better for back pain, but if your top leg twists forward and rests on the bed, it can rotate your spine and cause strain. This can lead to back stiffness and even hip pain in the morning.
The Fix:
- Keep your knees and feet in line with your hips.
- Place a pillow between your knees to maintain spinal alignment.
- Try sleeping with a small pillow under your waist for added support.
3. Sleeping in the Fetal Position (Too Curled Up)
Curling up in a tight fetal position can restrict movement and round your spine too much, leading to increased stiffness. This is especially problematic if you already have lower back pain.
The Fix:
- Try to straighten out your legs slightly to keep your spine more neutral.
- Use a supportive pillow to keep your head in line with your spine.
- A pillow between your knees can help maintain good alignment.
4. Sleeping Flat on Your Back with No Support
While back sleeping can be good for spinal alignment, lying completely flat with your legs straight may cause tension in the lower back, especially if your spine’s natural curve isn’t supported.
The Fix:
- Place a pillow under your knees to slightly bend them and relieve lower back pressure.
- If you have a naturally curved lower back, try placing a small rolled towel under your lower back for extra support.
- Ensure your pillow supports your head and neck without tilting your head too high or too low.
5. Sleeping on an Old, Unsupportive Mattress
Okay, this isn’t exactly a sleeping position, but it’s one of the biggest contributors to poor sleep and back pain. If your mattress is too soft, too firm, or sagging, it won’t provide the support your spine needs.
The Fix:
- Test different beds in your house to see if a firmer or softer surface feels better for your back.
- Consider adding a mattress topper for extra comfort and support.
- If your mattress is over 7-10 years old and causing discomfort, it might be time for a replacement.
Listen to Your Back
At the end of the day, the best sleeping position is one that feels comfortable and allows you to wake up with less pain. Small adjustments, such as using pillows for support and ensuring your mattress works for you, can make a big difference. If your back is comfortable then it is well supported. Don’t over think it too much.
Need More Help?
If back pain is keeping you up at night, I’d love to help. Join my FREE Back Pain Masterclass, where I’ll share expert tips to help you sleep better and move pain-free. Click here to sign up! I also offer a full back pain exercises and management program, if you are interested you can learn more about the Pain Free Back Program here.
Sweet dreams and pain-free mornings await!
Take care, Helen
Helen Manders BSc (Hons) MCSP HCPC
Chartered Physiotherapist Treating Back Pain Since 2001
