There is a great debate on how to sleep properly, the kind of mattress and pillow. Sometimes even blankets and covers. The main reason to all these is that rest and recovery are crucially important for us. This is to be able to maintain productivity. This is why we try to find ways to maximize sleep and rest.

The ideal situation is for us to be able to wake up with no pain in our bodies. It is as a result of the time we are to sleep and rest. This however is not the case as it is estimated that 58% of adults experience muscle pain related sleep disturbances.

Many times, pain at night and in the morning is the hangover of your postural habits and movement behaviors. Causing you lower back pain in the first place. This is inclusive of your sleeping position as it is a posture assumed for a considerable amount of time.

These are some tips and tricks we give patients to test out on their own to determine if it’s a useful strategy to manage their pain and discomfort levels. We encourage the use extra pillows in order to modify sleeping positions and achieve proper alignment.

I will briefly go through some of the more common positions and the modifications that can be made.

Side Sleeping — this posture is highly recommended as it maintains alignment of the spine. It is easily maintained with little discomforts encouraging uninterrupted sleep.

While there are many variations of sleeping on your side, the most comfortable position involves bending your knees. This is done slightly upward towards the chest area. Consider placing a pillow between your legs to relieve pressure on your hips and lower back. Especially if you are suffering from back and hip pains. Also try sleep on your shoulder blade instead of directly on the shoulder. This reduces the pressure on the shoulder joint and neck.

Sleeping position for the back

Also the height of the pillow in relation to your shoulder and neck. As shown below.

Back Sleeping — this pose may induce lower back pain and even episodes of apnea (cease breathing). Cease breathing interfere with normal sleep and restfulness. However if this is your preferred sleeping position, placing a pillow under your knees can help flatten your back. It can open up the spaces where irritated nerves traverse, giving them a break. However you can substitute the pillow with a rolled-up bath towel (longwise) underneath the small of your back to maintain your natural low back curve at night. Note that this position can make snoring more severe.

Stomach Sleeping – this is not ideal for someone with neck pain. Because muscles and joints receives a lot of pressure in this pose. This leading to numbness, tingling sensation, aches and irritated nerves. If you do, however, prefer sleeping on your stomach when it becomes uncomfortable on your back, place a pillow underneath your hips and waistline. Much like the pillow underneath your legs as a back sleeper, the pillow opens up space for the nerves in your low back to decompress and reduce tension.

Sleep on Different Surfaces
There’s lots of mattress “science” regarding what is best for you — a lot of “if, then that.” It may become an expensive experiment, but the only way to know if the surface you’re sleeping on is right for you is by, yes, once again, testing it out!

If you’re having back pain with your current mattress and you’ve tried the strategies above and below, then you may want to nestle in other nests. A great way to know if you’re mattress is a problem for you is to sleep on a guest bed, your child’s bed, a futon, and the sofa. Traveling is a good opportunity to try out beds of different firmness levels. (After COVID19)

If you discover an alternate surface makes a drastic difference, you may want to consider a new mattress or replacing your existing one.

Change Your Daytime Behaviors

Your daytime postural and movement behaviors are likely the reason why you have low back pain at night in the first place. Simply, making it a point to move and frequently change positions throughout the day to avoid negative effects associated with prolonged poor postures and sedentarism can make all the difference between suffering from lower back pain or not.

Opposed to focusing on sleep positions, it’s important to address why your back pain is plaguing you in the first place. If symptoms persist consult your Physiotherapist to certify the cause of your back pain and to get further advice and treatment. Book an appointment with us

Joy W. Waihenya
Chiropractic & Physiotherapy Health Centre


  1. Prevalence of sleep disturbance in patients with low back pain.
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The Best Sleeping Position For Back Pain?

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