The Best Sleep Positions for Lower Back Pain

When you’re dealing with chronic lower back pain, it doesn’t take long to learn which activities aggravate your condition and which foster relief. But it isn’t just motion and action that can influence your back pain; your sleep position can also ease the problem or make matters worse. 

Read on as our Spine Care of Manassas Chiropractic Center expert team discusses which sleep positions are worst for lower back pain — and which are best. 

Lower back pain and sleep positioning 

Your lower back is a complex structure consisting of several interdependent parts. It includes the five vertebrae of the lumbar spine and the shock-absorbing, motion-facilitating discs between them; it also contains supportive muscles, tendons, ligaments, and nerve roots that control lower body sensation.  

 Your lower back works closely with your core to support most of your weight and facilitate movements. Whether sitting, standing, walking, or lying down, your lower back is vital in the normal range of motion and comfort. 

As the leading cause of disability across the globe, lower back pain affects hundreds of millions of people at any given time. This highly disruptive problem is typically a product of ongoing stress related to bad posture, poor sleep positioning, and other back-straining lifestyle habits.  

Sleep positions that are bad for your back 

Good posture means maintaining a neutral spine — whether upright or lying down. Poor posture is any position that takes your spine out of neutral alignment. Viewed from the back, a neutral spine forms a vertical line through the center of your body. From the side, it has three gentle curves along your neck, mid-back, and lower back.  

Good posture maintains these curves; bad posture increases (rounds) or decreases (flattens) them. Sleep positions that take your spine out of neutral alignment and strain your lower back include:

• Lying on your stomach with your head turned to the side 
• Resting on your side with your legs curled to your chest
• Sleeping on your back without effective lumbar support 

These positions are bad for your lower back because they flatten the natural curve in your lumbar spine, placing it and its supporting structures under increased pressure and stress. Of these three positions, sleeping on your stomach is typically the hardest on your lower back.   

Good sleep positions for lower back pain 

Maintaining neutral spinal alignment during sleep starts with a medium-firm mattress that’s in good condition and doesn’t sag. With that essential foundation in place, you can position your body to minimize lower back stress and strain in several ways.

Our chiropractic team recommends the following sleep positions to help you get a good night’s rest without causing lower back pain or making an existing problem worse:    

​​1. On your side with your knees slightly bent and supported

This is the best sleep position for easing existing lower back pain and avoiding new back pain problems. Sleeping on your side with your knees slightly bent (flexed) helps balance your body and reduces pressure on your lumbar spine. Placing a small pillow between your knees helps keep your spine, pelvis, and hips in alignment for maximal comfort.      

To avoid setting the stage for a neck pain problem in this position, you’ll want to rest your head and neck on a pillow that’s just thick enough to keep your cervical spine straight and unflexed — your head shouldn’t angle up or down; and your shoulders should remain on the mattress.

2. Flat on your back with lumbar and knee support, as needed

The second-best sleep position for a neutral, well-supported lumbar spine is flat on your back. Sleeping on your back helps distribute your weight evenly across the widest surface of your body, limiting pressure points. 

 Place a small pillow beneath your knees to prevent your lower back from collapsing into the mattress; you may also benefit from added support beneath your waist. To keep your neck in neutral alignment, place a small pillow beneath your head and neck, and keep your shoulders flat on the mattress. 

3. On your stomach, but only if you have abdominal support

Sleeping on your stomach is hard on your lower back and neck, and we recommend trying other positions and avoiding this whenever possible. If you’re a habitual stomach sleeper, however, there are things you can do to make the position less of a strain on your lower back. 

When you sleep on your stomach, use a thin head pillow, so your cervical spine isn’t extended. It would help if you also placed a thin pillow under your hips and lower abdomen to support your lower back and keep your lumbar spine from sinking out of neutral alignment.  

Gain the upper hand over lower back pain

Remember, just as the wrong sleep positions increase pressure on your lumbar spine, causing discomfort as you try to fall asleep or frequently wake at night, the right positions promote proper spinal alignment, optimal lumbar support, improved comfort, and better rest. 

Ready to improve your sleep posture? We can help. Call or click online to schedule an appointment today with Dr. Lincoln German or Dr. Mikaela Foley at Spine Care of Manassas Chiropractic Center in Manassas, Virginia.