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Best Sleeping Positions for Lower Back Pain

You’ve heard it a million times before. You pick up a box or heavy object and that nagging family member or coworker starts up as vigorously as your tractor.

“Use your legs to squat and lift. Keep your back straight!”

Yes, these lifting techniques are important, but how often do you think about your posture and body mechanics during the hours you are sleeping? After all, these hours comprise 25 to 30 percent of our life! How easy would it be to adjust our back mechanics when we are simply resting? Memorial Hospital of Converse County (MHCC) has some suggestions for sleep positions to create comfort and improve your back function.

The ideal sleep position depends upon what is happening in your spine. You may or may not have received imaging or tests for your back pain. Regardless of whether you have a specific diagnosis or not, MHCC will identify signs that may indicate some of the following conditions. This can help you pick the best sleep position even if you do not have a diagnosis. MHCC does advise that you visit a physician for medical care if your experience back or leg pain that is extreme, comes on suddenly, continues to worsen, or causes bowel, bladder, or sexual dysfunction.


Side-lying may be the most comfortable position if you been diagnosed with sciatica or a pinched nerve. Signs and symptoms that may indicate sciatica or a pinched nerve include pain radiating to a buttock that can extend down the side of the leg and reach the foot. Pain, numbness, tingling, burning, and pins and needles are common nerve sensations resulting from this condition. The sensations or pain are typically one-sided but may present on both sides of the body in some cases.

Medical experts recommend lying on the unaffected side of your body and placing a pillow between the legs to decrease the tension placed on the irritated nerve. This prevents the top affected leg from dropping toward your midline, which can stress the affected nerve. You may also need to keep your legs in line with your torso and avoid flexing your legs at the hip, as this is a position that can irritate sciatica and pinched nerves.

On your Back

You may have been diagnosed with stenosis, which is narrowing of the vertebral canal—which houses the spinal cord—or narrowing of the foraminal spaces where the nerves exit the spinal canal. Signs of this condition include difficulty with prolonged walking or standing and relief when bending forward or sitting.

Maybe you have never heard of stenosis but have been diagnosed with arthritis in the facet joints or vertebrae in your back. Swelling, tenderness, grinding, and dull aching are all common symptoms of back arthritis.

The best sleep position for both stenosis and arthritis is sleeping on the back. This is because both stenosis and arthritis are aggravated by contact and compression of the joints in the back. When lying on the back, the spine is unloaded and there is more separation between the joints. Sleeping in a recliner opens the spinal joints and is another option for positioning. If lying on your back is uncomfortable, side-lying with a pillow between the legs and flexed hips is another viable option.

To increase the amount of flexion in the spine, add a pillow under the knees to prevent the lumbar spine from arching into extension. You can also add a pillow underneath your upper back and elevate your head with two pillows to flex the entire spine.

On your Stomach

If you have a herniated or slipped disc, sleeping on your stomach will likely provide you with the most relief. Most herniations occur in a posterolateral direction, which means they are pushed back and to the side. Common symptoms of disc herniations are back pain worsened with sneezing, coughing, or bending; numbness, tingling, or pins and needles in the buttock, leg, or foot; and diminished reflexes. Sleeping on the stomach places the spine in extension, so the disc is moved opposite the direction it herniated due to mechanics between the vertebrae and discs. Although posterolateral herniations are most common, anterior herniations can occur. In this case, sleeping on the back in a flexed position with the legs elevated is likely the most relieving position so the disc is positioned opposite the direction in which the herniation occurred.

Before you buy an expensive new mattress, you should sleep on some of these tips about body positioning for your back pain. If you have questions about sleep positioning for your diagnosis or symptoms, reach out to MHCC at 307-358-2122 for more information.