How to Sleep With Lower Back Pain: Positions, Pillow Tips, and Night Triggers

The misery that accompanies lower back pain is only compounded when you can’t sleep. There is nothing quite like that state of pure lethargy when your body knows it needs sleep, but your back won’t allow it. Every roll, every shift, and every unnatural angle you attempt to muster becomes excruciatingly painful. You worked so hard all day long trying to avoid discomfort, only to lie down at night and have your body abandon you. The good news is that learning how to sleep with lower back pain isn’t some kind of back pain you’ll never understand. Instead, with a few minor tweaks and adjustments, you can begin sleeping comfortably through the night.

Your body is strong and resilient, and even if you’ve been experiencing restless nights for weeks or months on end, it’s never too late to enjoy rejuvenating sleep once again. No more surviving each night, wondering how your body will feel in the morning. By simply making small improvements to spinal alignment and the sleeping environment, waking up energized and ready to take on your day will become second nature.

Discover the Best Sleeping Position for Lower Back Pain

The first step to waking up pain-free is to commit to proper sleeping positions. Think of your spine like a bridge; if the pillars on either side aren’t even, the bridge encounters more stress. Similarly, when your hips, pelvis, and shoulders aren’t aligned through the night, your spine suffers. To help you sleep comfortably with lower back pain, we have outlined tips for what to do based on your favorite sleeping position.

How To Sleep On Your Back With Lower Back Pain

Sleeping on your back is ideal for many because it allows for the most symmetry throughout the body. When you lie flat on your back, your body is resting on its largest surface area, creating the least amount of pressure. However, many people mistake sleeping flat on their back as the best sleeping position.

Instead, by adding a pillow under your knees, you can dramatically improve any discomfort you might feel when your spine is exposed to the mattress. By propping your knees up with a pillow, you create a slight anterior tilt in your pelvis. Not only does this allow your lower back to flatten out, but it also helps relax the surrounding muscles as well. Another trick you can use to sleep comfortably on your back with lower back pain is by placing a small towel roll in your lower back.

How To Sleep On Your Side With Lower Back Pain

Let’s be honest, side sleeping is the most popular sleeping position for a reason; it just feels good. However, if you don’t provide enough support for your upper leg when lying on your side, it can rotate forward. Not only can this place tension on your lower back, but it can also tilt your pelvis into awkward positions as well. That awkward feeling you experience when waking up is commonly referred to as being “locked up”.

To keep your hips, pelvis, and spine in an anatomical position, place a hard pillow in between your knees. This will prevent your upper leg from rotating forward and allow the muscles around your spine to release some of their guarded tension. The fellowship-trained specialists at Northern Colorado Spine & Sport have treated hundreds of patients here in Loveland, CO, who have reported that this positional change was what helped them get their first solid night’s rest in years. This approach is a core part of our manual therapy and lifestyle guidance.

Find the Best Pillow For Lower Back Pain & Neck Support

While your pillow may not seem like it makes a huge difference, it can make or break your spinal alignment for the entire night. When trying to determine what the best pillow is for lower back pain, it’s important to remember that your neck is connected to your lower back. If your neck is crunched up or lies too far backwards, your lower back will pay for it with muscular spasms.

Keep Your Neck Aligned for a Pain-Free Back

Ideally, your pillow should fill the gap between your head and mattress without pushing your chin towards your chest or your forehead towards the sky. Cervical pillows are especially great for keeping your neck stacked on top of your thoracic and lumbar spine. By using a pillow with a slight “wave” to it, your neck is both supported while your head rests inside of a pocket of space. This allows your brain to rest easy knowing your nervous system is fully intact.

Find the Right Mattress Firmness

Just like your pillow, sleeping on a mattress that is too soft or too hard can create additional pressure on your hips and shoulders. Although we may love sinking into a plush mattress, they often provide insufficient support for a full 8 hours of sleep. Too hard and you’ll feel like your hips and shoulders are creating painful pressure points on the mattress.

It is generally agreed upon by clinical research that a medium-firm mattress provides the most benefits to the human body. Not only will this type of mattress provide enough cushion for your hips and shoulders, but it will also be firm enough to prevent your spine from resting in a “hammock” position. Visualize your mattress as a strong hand cupping your body from beneath, giving you the security you need to release your body’s physical tension.

Night Time Triggers You’re Sleeping Through

Sometimes what you put your body through during the night can be just as painful as your sleeping position. There are certain “triggers” that your body picks up on that tell your muscles it’s time to become angry and inflamed.

Stomach sleeping is one of the worst positions you can consciously enter into if you’re having back pain. In order for your head to breathe, you must turn it 90 degrees for hours on end. This creates extreme tension in your neck. Not only that, but because your midsection wants to fall towards the mattress, your lower back is subjected to extreme arching as well.

Imagine someone who has worked their whole life to get out of horrible situations; they’re not going to pick a lifestyle that continuously stresses them out. Stop stressing your body out by sleeping on your stomach. If you need something on your chest, try wrapping yourself with a body pillow while you side sleep.

What You Do Before Bed Affects How You Sleep

Even the activities you do before bed can contribute to how to sleep with lower back pain. If you watch TV or work out intensely before bed, you are leaving your muscles in a state of high “tone”. Essentially, your muscles are primed and pumped for action, which tells your body it needs to be ready for the challenges of the night.

Sitting in a slouched position on the couch for hours before bed can preload your discs and ligaments with stress that will carry over to bedtime. Create a nightly “wind-down” ritual to help your body transition from “fight or flight” mode to “rest and digest” mode. This can be as simple as performing some gentle physical therapy exercises or taking 2-3 minutes to breathe into your diaphragm.

When To Seek Professional Help Near You in Loveland, CO

Sometimes, there is nothing wrong with admitting your body needs help. Although you may have tried your best to fix your nighttime pain with pillows, gravity, and do-it-yourself YouTube videos, there could be an underlying reason your back acts up at night. At Northern Colorado Spine & Sport, the goal is to do more than offer a quick fix.

Every patient who walks through the doors has different goals; some want to return to playing golf, others just want to sleep without waking up in pain. The job of the physical therapist is to use thorough evaluations to determine exactly why your back is hurting at night and create a custom plan to reverse the damage. If you are struggling with low back pain, professional intervention is often the most efficient path to recovery.

If you’re tired of back pain controlling your life, it’s time you fought back. You are meant for more than lying in bed thinking about how great life would be if you could relax. Contact our office today to book your consultation and take the first steps towards a life driven by possibility, not pain.

Also Read:

• Top Physical Therapy Exercises for Lower Back Pain
• Physical Therapy for Upper Back Pain in Loveland, CO
• 7 Daily Habits That Make Back Pain Worse
• How Physical Therapy Helps You Recover from Lower Back Pain

FAQs related to Sleeping with Lower Back Pain

What is the best sleeping position for lower back pain?

While every person is different, most people find that sleeping on their side with a firm pillow between their knees allows for the most neutral position for the spine.

Should I purchase a new mattress if I experience pain at night?

Not always. If you haven’t already tried altering your pillows or placing a medium-firm mattress topper on your mattress, try one of these solutions first. If your mattress is visibly sagging or over 7–10 years old, then it may be time to buy a new one.

Can a pillow help my lower back pain?

Yes! Pillows act as spacers that help keep your joints in their ideal position. Placing a pillow under your knees or waist takes the mechanical stress off your discs and muscles.

When should I stop trying to correct my pain at night?

If you experience any numbness, tingling, or weakness in your legs, or if your pain is severe enough that you lose considerable sleep each night, seek help from Northern Colorado Spine & Sport in Loveland, CO, immediately.