Sleep Health, Sleep & Back Pain

July 2, 2020, updated on October 15, 2026

Is Your Sleep Position Causing Your Back Pain?

Written by Shelby Deering

image of person in bed with back pain

Key Takeaways

Sleeping on your back or side helps keep your spine in neutral alignment, whereas stomach sleeping strains your neck and lower back.

An old or sagging mattress loses essential lumbar support, leading to posture misalignment and worsening chronic pain.

Using the right pillow loft—and placing extra pillows between or under your knees—relieves pressure points and supports proper overnight recovery.

Is your sleep position causing your back pain? To find out, focus on the practical factors that affect comfort, support, durability, and sleep quality. Evaluate the materials, construction, fit for your sleep position and body type, care requirements, and any relevant health considerations. Use measurable criteria and current expert guidance rather than relying on a single marketing claim or trend.

There’s a good chance that ever since childhood, you’ve had a favorite sleep position. Maybe you choose to snooze on your back, side, or stomach—and perhaps you haven’t given it a second thought. But if you’re dealing with chronic back pain, it may be time to switch up your sleep position.

Can your sleeping position cause back pain?

“One’s preferred sleeping position can contribute to their back pain,” says Thomas Tozer, chiropractor at Imperium Chiropractic in Wisconsin. Sleeping on your stomach, in particular, is bad for your back, he says, because it’s hard to maintain neutral spinal alignment while in this position.

Additionally, sleeping in the same position in the same spot night after night can lead to back pain. “If someone only sleeps in one position in the same spot in a mattress, and the mattress breaks down over time, then the proper support may be lost,” explains Tozer.

Beyond sleep position and a poor mattress, Tozer cites several other sources of chronic back pain, such as sprains and strains, subluxations in the spine (partial dislocations of the joints), scoliosis, arthritis, and degenerative disc disease. These are all things that can benefit from a visit to your physician.

Whether your back pain is caused by your sleep position or something else, it can lead to major issues with being able to get a good night’s sleep. “Back pain can be a serious problem,” says Tozer. “Sleeping is a critical time for the body to be able to heal and recover from the stresses of the day. The discomfort of back pain can make sleeping difficult, and not having a proper mattress can hinder the process of healing.” (Find out whether going to a chiropractor can improve your sleep.)

Feature / ConsiderationWhat to Look ForWhy It Matters
Firmness / LoftMedium-Firm to Firm (6–8/10)Prevents your hips from sinking and keeps the spine in neutral alignment.
Pressure-Relief NeedModerate to HighCushions shoulders and hips without causing the lower back to sag.
Support NeedHigh (Lumbar Focus)Ensures structural integrity so your body can heal and recover overnight.
Materials to ConsiderLatex, HD Foam, or HybridsDelivers a mix of responsive contouring and long-term durability.

The best sleep positions for back pain

Some sleep positions are truly better for you than others, and Tozer has his preferences. “I don’t recommend stomach sleeping for both low back and neck health,” he says. “I recommend side and back sleeping and varying those positions through the night.”

Sleeping on your back helps keep your head, neck, and spine in a neutral position. That takes the pressure off those areas and makes it a lot less likely you’ll wake up with aches and pains in the morning. Sleeping on your side can also help keep your spine in neutral alignment and minimize back pain.

One 2016 study focused on the effects of sleep positions on back pain in physically active seniors. After four weeks of sleeping in the recommended position (lying on the back), 90% of the participants indicated a significant decrease in back pain.

It may seem nearly impossible to train your body to adopt a sleep position that’s better for your back, but it is doable. Here are Tozer’s tips:

  • Maintain a neutral posture while you sleep. “Sleep in a good, neutral posture—not curled up in a ball,” he suggests. “The head should be in line with the body, especially when sleeping on your side.”
  • Choose the right pillow for your new sleep position. Once you have an awareness of how your spine feels when it’s in a neutral position, you can reconsider your pillow. Tozer stresses that it’s essential to use “the proper pillow depending on your sleeping position or positions.” (Read our guide to choosing the best pillow for your sleep position and learn when to replace your pillows.)
  • Use pillows in creative ways for added support. There’s another way you can utilize a pillow to aid in improved sleep positioning. Tozer recommends sleeping with a pillow between your knees while sleeping on your side and behind your knees if sleeping on your back. That will add comfort and help with maintaining a neutral spine. (Learn how to make your bed and layer your pillows for more comfortable sleep.)

In addition to reconsidering your sleep position, you should also evaluate your current mattress and decide if it’s time to purchase one that could be a lot kinder to your back. Look for “one that offers proper support and adequate comfort,” Tozer explains. (Learn about mattress lifespan here.)

Our best mattresses for back pain

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FAQs

Does body weight change the recommendation?

Yes. Body weight affects how deeply you sink into a mattress or pillow, so the same firmness or loft can feel different from person to person. Use general sleep-position guidance as a starting point, then adjust for body type and comfort.

How can I tell if my sleep setup is supportive enough?

Your head, neck, and spine should feel comfortably aligned without excessive pressure or deep sinkage. Persistent pain, numbness, or tingling should be evaluated by a healthcare professional rather than addressed only by changing bedding.

How to tell if your setup is wrong

Even if you’ve switched to a recommended sleeping position, an improper mattress or pillow setup can still throw your spine out of alignment. Watch out for these warning signs:

  • Waking up in pain or stiffness: If your back or neck feels worse when you wake up than when you went to bed, your bed is likely lacking proper support or pressure relief.
  • Tossing and turning: Frequent repositioning during the night often means your body is trying to relieve pressure points caused by a mattress that is too hard or too soft.
  • Visible dipping or sagging: If your mattress has an imprint where you sleep, it has broken down and can no longer keep your head, neck, and hips in a neutral posture.
  • Neck kinks or headaches: A pillow with the wrong loft (too high or too flat) forces your neck out of line with your spine, straining upper back and neck muscles.

Bonus tips for dealing with back pain

If you’re dealing with back pain, your sleep position may only be one piece of the puzzle. High-quality sleep and other good habits can boost your overall health, which, in turn, may alleviate your aches and pains. Tozer offers these strategies:

  • Stretching before bedtime and doing some stretching before getting out of bed
  • Icing the painful area for 20 to 30 minutes before bed
  • Creating proper sleeping patterns, which involve going to bed at the same time every night
  • No screen time or TV 20 minutes before bedtime
  • Not eating within two hours of bedtime

And remember, you can always seek out an expert opinion to help you navigate your back pain and the sleep positions that may be contributing to it. “Have a proper evaluation of your back pain so you can treat the cause,” Tozer says.

🩺 Medical context and disclaimer


  • Comfort vs. treatment: A supportive mattress is designed to improve sleep quality, promote proper posture, and reduce daily strain, but it is a comfort measure, not a medical treatment or cure for underlying spinal conditions.
  • Seek professional care: Persistent or worsening back pain should always be evaluated by a healthcare provider or licensed professional (such as a doctor or physical therapist) to diagnose the root cause and establish an appropriate medical treatment plan.
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Shelby Deering

Shelby Deering is a Madison, Wisconsin-based freelance lifestyle writer contributing home design and health articles to national publications. When she’s not writing, you’ll find her hiking, running, or walking with her husband and corgi, Dolly.

View all Shelby’s posts

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