Best Sleeping Position for Back Pain

Sep 03, 2024
Fact Checked
Discover the best sleeping positions recommended by experts to relieve back pain and enhance sleep quality.
Written by: Lauren Sherman, MS
Medically reviewed by: Suzanne Gorovoy, PhD

Key Takeaways 

Chronic pain can significantly diminish our overall quality of life and is more common as we grow older. A 2022 survey found that 28% of U.S. adults reported having chronic lower back pain, with the highest percentage in the 50–59 age group. Survey respondents reported difficulty standing, exercising, and sleeping due to pain. 

As the leading cause of disability worldwide, back pain also has severe negative financial and social impacts. According to the Centers for Disease Control and Prevention (CDC), more than one in four (26%) working adults experience low back pain in the U.S. Treatment is costly, with an estimated more than $100 billion spent annually on addressing back pain.

Effective back pain management involves more than medication and physical therapy. Sleep quality is critical. A poor sleeping position can increase back pain, leading to restless nights and ongoing discomfort. Choosing the right position may help lessen pain and promote better sleep. In this article, we explore the best sleep positions for managing back pain and provide practical advice to help you achieve restful sleep and reduce discomfort.

Understanding back pain

Understanding the types and causes of back pain is crucial for effective management and prevention. It can also help people maintain a healthy spine and reduce discomfort.

Types of back pain

Back pain can be classified into two main types: acute and chronic. 

Acute back pain

Acute back pain usually comes on suddenly and lasts a short period, typically less than six weeks. It often results from an injury or strenuous activity. 

Chronic back pain

Chronic back pain typically persists for 12 weeks or more, even after treating the initial injury or underlying cause. It can greatly impact daily life and may require ongoing management and treatment​.

Causes of back pain

Several common causes can lead to back pain: 

Posture

Poor posture may contribute to back pain, especially for people who spend long hours sitting or standing in improper positions. This can strain the spine and surrounding muscles, leading to discomfort and pain. 

Medical conditions

Medical conditions, such as arthritis, osteoporosis, degenerative disc disease, and scoliosis, also contribute to back pain. Arthritis can cause inflammation and stiffness in the spine, while osteoporosis weakens bones, making them more vulnerable to fractures. Degenerative disc disease leads to increased pressure on spinal nerves and joints, causing inflammation, spinal instability, and the development of bone spurs. ​

Scoliosis, a condition characterized by an abnormal curvature of the spine, can cause severe back pain.

While these are some of the more common causes, there are a variety of health reasons why a person may have back pain.

Injuries

Injuries from accidents or sports can also lead to back pain. Herniated or slipped discs, where the soft tissue between the vertebrae protrudes, can press on nerves and cause pain. Muscle or ligament strains from heavy lifting or sudden movements are other common causes. 

Lifestyle factors

Also, lifestyle factors like lack of exercise, obesity, and smoking can increase back pain by reducing flexibility and weakening muscles​​.

Back sleeping for back pain

Sleeping on your back can promote spinal alignment by distributing your weight evenly across the body, which reduces pressure on the spine and joints.

Back sleeping tips:

Of course, firmness feels different depending on your body type, so higher-weight people may need something firmer, while lower-weight people may need something softer that offers the support and cushion they need. 

Side sleeping for back pain

Side sleeping can help reduce pressure on the spine, especially if you use the right pillow and mattress. It’s also a potentially good position for reducing snoring and sleep apnea.

Side sleeping tips

Fetal position for back pain

The fetal position, another form of side lying, has you curl up on your side with your knees drawn toward your chest and may provide relief for people with herniated discs and other lower back issues. 

Fetal position tips

Stomach sleeping and back pain

Sleeping on your stomach is generally not recommended for back pain because it can strain the neck and spine. But for those who find it comfortable, you’ll typically want to look for a medium-to-firm mattress to support your hips and keep your spine aligned. Here are some other tips for back pain prevention while stomach sleeping.

Stomach sleeping tips

Additional tips for better sleep with back pain

Managing back pain while trying to get a good night’s sleep can be challenging. But a few small changes  can make a significant difference. Here are some additional tips to improve sleep quality when dealing with back pain.

Choosing the right mattress and pillow

Selecting the right mattress and pillow is crucial for spinal alignment and comfort. A medium to slightly firm mattress often provides the best support, preventing the spine from sinking into positions that cause pain. Hybrid mattresses can be particularly beneficial because they provide the support and cushion to conform to the body’s shape while providing targeted support. 

Our tips for choosing the right mattress and pillow:

Optimize sleep environment

Creating a good sleep environment can make getting to sleep and staying asleep easier. Consider these factors:

Proper sleep hygiene

Establishing good sleep hygiene practices can improve sleep quality, helping to reduce how much pain you feel. This means following behaviors and habits that are helpful to your overall sleep experience, including:

Pain management techniques

Incorporating pain management techniques into your routine can help ease back pain before bed. Consider the below:

Stretching: Gentle stretching exercises before bed can relieve muscle tension and improve flexibility. Focus on stretches that target the lower back, hamstrings, and hip flexors​.

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Always consult your health care team before beginning any new therapies. They can recommend the best type for your specific condition.

Lifestyle changes

Making lifestyle changes can also contribute to better sleep and reduced back pain.

Bottom line

Back pain can greatly impact your sleep quality and overall well-being, but the right strategies can help make a difference. Creating a good sleep environment is crucial. Start by talking to your doctor about the best sleeping position for your specific needs. Ensuring your spine is aligned with a quality mattress and pillow can help support and prevent future back pain. Incorporate good sleep hygiene practices, pain management techniques, and lifestyle changes, like regular exercise, a balanced diet, and weight management. By taking these steps, you may be able to achieve better sleep quality, reduce discomfort, and enhance your overall health.

Have questions about this article? Email us at reviewsteam@ncoa.org.

Sources

  1. Percentage of U.S. Adults Who Reported Having Chronic Low Back/Sciatic Pain as of 2022, By Age. Statista. Jan. 29, 2024. Found on the internet at https://www.statista.com/statistics/1447559/chronic-low-back-pain-among-adults-by-age-us
  2. Elflein J. Negative Impacts Associated With Chronic Lower Back Pain (CLBP) According to Adults in the United States in 2022. Statista. April 12, 2023. Found on the internet at https://www.statista.com/statistics/1368800/associated-clbp-negative-impacts-among-adults//niosh-science-blog/2019/07/08/lbp
  1. Low back pain. World Health Organization. June 19, 2023. Found on the internet at: https://www.who.int/news-room/fact-sheets/detail/low-back-pain
  2. Iker K. Low Back Pain Among Workers: The Problem and What to Do About It. Centers for Disease Control and Prevention. July 8, 2019. Found on the internet at https://blogs.cdc.gov/niosh-science-blog/2019/07/08/lbp
  1. Katz, J. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. The Journal of Bone and Joint Surgery. April 2006. Found on the internet at
  2. https://pubmed.ncbi.nlm.nih.gov/16595438/
  3. National Institute of Arthritis and Musculoskeletal and Skin Disease. Back Pain. Found on the internet at https://www.niams.nih.gov/health-topics/back-pain
  4. Mayo Clinic. Back Pain. Found on the internet at https://www.mayoclinic.org/symptoms/back-pain/basics/causes/sym-20050878
  5. University of Rochester Medical Center. Good Sleeping Posture Helps Your Back. Found on the internet at https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460
  6. Cary D, et al. Identifying Relationships Between Sleep Posture and Non-Specific Spinal Symptoms in Adults: A Scoping Review. BMJ Open. June 28, 2019. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609073
  7. Whibley D, et al. Sleep and Pain: A Systematic Review of Studies of Mediation. The Clinical Journal of Pain. June 2019. Found on the internet at https://journals.lww.com/clinicalpain/fulltext/2019/06000/sleep_and_pain__a_systematic_review_of_studies_of.14.aspx
  8. Melone L. 7 Easy Fixes for Snoring. WebMD. Nov. 15, 2023. Found on the internet at https://www.webmd.com/sleep-disorders/features/easy-snoring-remedies
  1. Mount Sinai. Obstructive Sleep Apnea. Found on the internet at https://www.mountsinai.org/health-library/report/obstructive-sleep-apnea
  2. Radwan A, et al . Effect of Different Pillow Designs on Promoting Sleep Comfort, Quality, & Spinal Alignment: A Systematic Review. European Journal of Integrative Medicine. February 2021. Found on the internet at https://www.sciencedirect.com/science/article/abs/pii/S1876382020314505
  3. Centers for Disease Control and Prevention. NIOSH Training for Nurses on Shift Work and Long Work Hours: Create a Good Sleep Environment. March 31, 2020. Found on the internet at https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod6/02.html
  4. Baniassadi A, et al. Nighttime Ambient Temperature and Sleep in Community-Dwelling Older Adults. Science of The Total Environment. Nov. 15, 2023. Found on the internet at https://sciencedirect.com/science/article/abs/pii/S0048969723042468?via%3Dihub
  5. Zhou E. Does Sleeping With an Eye Mask Improve Learning and Alertness? Harvard Health Publishing. Feb. 21, 2024. Found on the internet at https://www.health.harvard.edu/blog/does-sleeping-with-an-eye-mask-improve-learning-and-alertness-202402213017
  6. Ian M. Colrain, et al. Alcohol and the Sleeping Brain. Handbook of Clinical Neurology. Feb. 21, 2018. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259
  7. Shechter A, et al. Blocking Nocturnal Blue Light for Insomnia: A Randomized Controlled Trial. Journal of Psychiatric Research. Oct. 21, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703049
  1. Keillor, J. Using Heat and Cold for Pain. Mayo Clinic Connect. February 11, 2021. Found on the internet at https://connect.mayoclinic.org/blog/take-charge-healthy-aging/newsfeed-post/using-heat-and-cold-for-pain/
  2. Advanced Orthopaedic Associates. Heat and Cold Therapy for Pain Management. Jan. 5, 2023. Found in the internet at https://aoaortho.com/heat-and-cold-therapy-for-pain-management
  1. Princeton Orthopaedic Associates. Unlocking Back Pain Relief – Causes and Solutions for Upper and Lower Back Discomfort. Found on the internet at https://www.princetonorthopaedic.com/unlocking-back-pain-relief-causes-and-solutions-for-upper-and-lower-back-discomfort
  2. Zuraikat FM, et al. A Mediterranean Dietary Pattern Predicts Better Sleep Quality in US Women from the American Heart Association Go Red for Women Strategically Focused Research Network. Nutrients. Sept. 16, 2020. Found on the internet at https://www.mdpi.com/2072-6643/12/9/2830
  3. Alnawwar MA, et al. The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review. Cureus. Aug. 16, 2023. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503965
  1. Centers for Disease Control and Prevention. Older Adult Activity: An Overview. Found on the internet at https://www.cdc.gov/physical-activity-basics/guidelines/older-adults.html
  2. Lee CA, et al. The Relationship Between Change of Weight and Chronic Low Back Pain in Population over 50 Years of Age: A Nationwide Cross-Sectional Study. International Journal of Environmental Research and Public Health. April 9, 2021. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069450
  3. Green BN, et al. Association Between Smoking and Back Pain in a Cross-Section of Adult Americans. Cureus. Sept. 26, 2016. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081254
Lauren Sherman, M.S., is a health content writer with a master’s degree in human genetics from the University of Colorado Anschutz Medical Center, laboratory experience from National Jewish Health, and clinical experience from Children’s Hospital Colorado.
Suzanne Gorovoy Medical Reviewer
Suzanne Gorovoy is a clinical psychologist, behavioral sleep medicine specialist, and member of the Sleep and Health Research Program at the University of Arizona College of Medicine. She received her graduate degree in School Psychology from Teachers College at Columbia University, her PhD in Clinical Psychology from Case Western Reserve University, and completed a postdoctoral fellowship in Behavioral Sleep Medicine at the University of Arizona College of Medicine.
Susan Stiles
Susan Stiles Reviewer
Susan Stiles, PhD, provides leadership in the design and development of consumer products that inspire, educate, and activate older adults. She’s been instrumental in bringing the Aging Mastery Program® to market and scaling it nationwide via strategic alliances and business partnerships. Stiles has 20+ years of experience in design thinking, multimedia, strategic communications, and management consulting.
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