Best Sleeping Position for Lower Back Pain

What’s the best sleeping position for lower back pain?

Well first, as I say to most of these questions: Everyone’s unique, but these guidelines work for most people.

So this is a great place to start.

1. Firstly, do whatever’s comfortable for you

I know that sounds obvious, but some people become too obsessed with doing the ‘right’ or ‘best’ thing, and ignore what their body is telling them.

This advice (do whatever is comfortable right now) applies mostly when your back is playing up, like after a recent injury or aggravation.

When that happens, it’s time to just follow your body’s lead and do whatever gives you the most relief.

After that however, if you want to know which sleeping positions relieve back pain, read on.

2. Don’t sleep on your front (if you can help it)

Sleeping on your front twists your neck (cats don’t seem to care).

Why?

Because your neck has to twist to one side (usually the same side), which pulls on your spine, all the way down to your low back.

And your back doesn’t like that.

For a lot of people, it’s a hard habit to break. And you can hardly help what position you wake up in.

But here’s the thing to remember:

The position you go to sleep in, is the one you’ll spend the most time in.

So if you’re used to sleeping on your front, just try to train yourself to fall asleep in a different position.

And the trick with that is to make it’s as comfy as humanly possible (as follows)

3. Sleep on your side or your back (but get your pillow right)

Correct pillow height is key. You want to keep your neck aligned with your body. Also known as the neutral position.

Your pillow height should match your frame, and the position you mostly sleep in.

So if you have broad shoulders, and sleep on your side, then your pillow is likely too small.

But if you sleep on your back with two or more pillows, it’s probably too much.

If you sleep on your back

You need a relatively flat pillow, as flat as is comfortable.

Some people need to have their head propped up more, like if they have a rounded upper back or a forward head carriage. But you want to prop your head up as little as necessary.

If you can scrunch the pillow under your neck a bit, then even better.

If you sleep on your side

Your head wants to be in line with your body.

Then it’s about having enough pillow to keep your head in line with your shoulders (the neutral position).

Not too low so your head is angled down toward the mattress.

Not too high so it’s propped up at an angle.

You can waste a lot of money on an expensive pillow, if it’s not the right size (But here’s how to FIX it).

It doesn’t matter if your pillow is curved, is made from bamboo fibre, or has ‘orthopaedic’ on the label.

If it’s not the right height, it’s not right.

And usually, that means it’s too low.

The simple fix for a low pillow, is just to put a folded towel underneath it.

Try putting a folded towel under your pillow, to raise it slightly.

Even raising it a few millimetres can make a huge difference. Just try it for yourself.

* If you have a pillow you like, but it’s a little too low, just get a towel and fold it a few times, then put it underneath your pillow.

It might take a bit of trial and error, folding the towel in different ways.

You’ll know when its right when your eyes close, as soon as your head hits the pillow.

That’s your body’s way of saying Yes, I’m ready to go to sleep now!”.

4. Try a pillow between your knees

A pillow between the knees can take pressure off the back.

A lot of people find relief from putting a pillow between their knees, especially if they sleep on their side.

If you lie on your back you can put it underneath your knees.

It takes the pressure off your sacroiliac joints (the two big joints at the back of your pelvis) and can make a big difference.

5. Also, go for a firm ‘sprung’ mattress (with a memory foam topper, if you like them)

Although this article is about sleeping positions and not mattresses, it’s still a point worth making.

If you’re thinking of getting a new mattress anyway, or if you just can’t find a comfortable position to sleep in, or if your back is always sore in the morning, then this information could be what you need.

The problem with recommending mattresses and pillows, etc., it’s that it’s so much about personal preference. You don’t know until you’ve tried it for a couple of weeks. Certainly not in the 30 seconds you lay on it in the bed store.

However, the feedback I’ve had from my patients over the past 15 or so years, is that most people prefer a sprung mattress (not fully memory foam), but with a 1-2 inch memory foam ‘topper’.

Some people love memory foam mattresses, but not everyone. Many guys, especially, find full memory foam too hot, as they retain the body heat more. So if you or your partner is a furnace at night time, they may not be the best choice.

You pay for the number of springs.

So buy the most ‘highly sprung’ mattress you can get at the time.

The more springs, the closer they are together, and the more supportive it feels.

Firmer isn’t always better.

Yes, a firm mattress is generally better. But again it’s down to personal preference. You may not want to sleep on a slab of concrete. So don’t necessarily go for the firmest mattress you can find.

The ‘nearly firmest’ is often the best choice.

6. A sacroiliac belt can give relief

It’s just a short-term fix, but if your back is currently playing you up at night* then a lot of my patients have found relief from wearing a sacroiliac belt overnight, for 3-4 nights.

*Back pain that’s worse at night is always a good reason to go and get checked over by a health professional (doctor, chiropractor, osteopath or physio), and that’s what we advise.

Sacroiliac belts wrap around the pelvis, compressing and supporting the joints. They can be very helpful when the problem is related to the sacroiliac joints.

You can also use them to hold an ice pack in place. Here are the ones we sell and recommend.

And as with everything, if it makes it worse, stop doing it.

Key points to take home

  • Lie on your side or your back (not your front)
  • Make sure your pillow is the right height
  • Try a pillow between the knees
  • Get a highly sprung mattress with a memory foam topper
  • And a sacroiliac belt can help if turning over at night wakes you up

Happy sleeping!

Want to book a consulation with Mike?

Written By Mike Cassidy-Hogg

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