Back pain is one of those things that most of us will deal with at some point or another. But often, pinpointing the exact cause isn’t easy.

A whopping eight in 10 adults will be plagued by backaches in their life, according to the American Chiropractic Association. There are various ways to address your discomfort, but often, it makes sense to start by looking at your sleep. Funky sleep positions can create throbbing pressure points and throw your spine out of alignment, both of which can cause or contribute to back problems.

If you regularly wake up with morning stiffness or find that your acute or chronic back pain tends to worsen at night, it’s safe to assume that your sleeping position could be playing a role. So what exactly should you be doing to get yourself in a more back-friendly spot?  Here’s a look at the link between sleep posture and back pain, the best sleeping positions that can help you feel more comfortable, plus other steps you can take to have a good night.

How Can Sleep Positions Cause Back Pain?

The majority of back problems are caused by sprains or strains, according to the National Institutes of Neurological Disorders and Stroke. Those problems can stem from lifting heavy objects (or lifting them improperly), making a sudden awkward movement, or even sleeping in a wonky position. After all, you’re in your bed for long periods each night. If your posture is less than optimal, there’s a good chance it could cause serious discomfort throughout the night and leave you aching in the morning.

When it comes to sleep and back pain relief, it all comes down to alignment. Laying the wrong way puts extra pressure on your neck, hips, and spine, and it can throw off your spine’s natural curve. Both of those things can lead to back problems or make existing issues more unpleasant.

Back pain, especially lower back pain, can have other more serious causes too. Problems like degenerative disc disease or sciatica, arthritis, osteoporosis, and skeletal irregularities like scoliosis can all create significant discomfort. In that case, sleeping in the wrong position will only serve to make the pain worse.

The Poor Sleep-Back Pain Cycle
back pain cycle

Suffering from back pain and the bad sleep that comes with it can quickly morph into a vicious cycle. When your back aches, you might have trouble falling asleep because it’s hard to get comfortable. It’s also common to have trouble staying asleep, since pain can cause microarousals where you wake up briefly to change positions often without even realizing it.

All of that adds up to less quality snooze time. (Around 42 minutes less, according to the NSF.) So when you finally wake up in the morning, you’re not only uncomfortable, you’re still pretty tired— and sleep deprivation tends to make the pain problem worse. People are around 30% more sensitive to their pain when they haven’t logged enough snooze time, according to findings published in the Journal of Neuroscience. Over time, not sleeping enough could even change pathways in the brain that amplify pain and make it feel worse.

Put more simply? Intensifying back pain makes it harder and harder to sleep. And the less sleep you get, the more likely your pain is to feel even worse. It’s a negative feedback loop that can add up to decreased productivity, less energy to do the things you love, and even a higher risk for serious problems like depression.

How To Sleep To Ease Back Pain

For many folks with chronic back discomfort, finding the right sleep position is like discovering the magic key to dreamland. Recent studies show that adults who received information about healthy sleep positions had significantly less back pain compared to those who didn’t get the information. So how exactly should you be lying down? Here’s a look at some of the most optimal sleeping positions.

Side Sleeping

Side sleeping seems to be the best antidote to low back pain. Sleeping on your side promotes proper spinal alignment, the NIH says, and it puts less pressure on your back, neck, and hips compared to some other positions. In fact, a BMJ Open review of four studies concluded that side sleeping offered the most protection from spinal pain and stiffness upon waking.

Not all side positions are created equal though. Ideally, you should curl your knees up into the fetal position and tuck a body pillow between your knees. Both of these things can ease stress on your lower back and hips, which can minimize pressure and pain.

As for which side is best? Some evidence suggests that sleeping on the right side might be optimal. Left side sleepers tend to put more strain on their vital organs, according to findings published in the Journal of the American College of Cardiology.

Back Sleeping

Sleeping on your back can also help ease pain or keep it at bay. Laying flat is a good way to evenly distribute body weight, which could minimize the risk for uncomfortable pressure points, Cleveland Clinic experts note.

Still, there are ways back sleepers can optimize their position even more. Tucking a small pillow under your knees helps to maintain your spine’s natural curve and promote proper alignment. If you still feel straining, tucking a rolled towel under the small of your back can offer extra support.

Stomach Sleeping

Sleeping on your stomach is generally considered the worst position for back pain. Stomach sleepers tend to put more pressure on their backs and push their spine into an unnatural curve, both of which can promote discomfort or make existing discomfort worse. If you love lying on your belly, try tucking a flat pillow under your lower abdomen and pelvis to encourage healthier spinal alignment. But if that doesn’t seem to help, it might be worth skipping stomach sleeping and trying another position altogether.

Other Sleep Tips to Help Your Back

How you sleep isn’t the only thing that can help improve or even prevent back pain from happening. Oftentimes what you sleep on is just as important. Indeed, both the type of mattress and type of pillows you use  can play roles in easing or exacerbating back issues.

Find a Good Mattress

When it comes to the best mattress for back pain, the NIH recommends picking a surface that’s firm but not stiff. A medium-firm option offers steady support for your lower back, which can encourage a more comfortable sleep. Very firm or hard mattresses can actually have the opposite effect, so steer clear. Consider avoiding very soft mattresses, too. Though they might seem cushy, the plush texture could cause you to sink and throw your spine out of alignment.

Are certain mattress materials better than others? It seems so. A memory foam mattress tends to do a better job of conforming to the body’s natural curves, which helps promote optimal spinal alignment and prevent uncomfortable pressure points. That’s not to say you can’t sleep happily on an innerspring mattress. High-quality models with firm textures can be plenty comfortable. You could also add a memory foam topper to an innerspring mattress for extra support, Cleveland Clinic experts say.

Old mattresses, too, can contribute to back problems. Hours and hours of use day in and day out can eventually cause even the best mattresses to sag and become less supportive. So if it’s been more than eight years since you replaced your mattress, consider shopping for a new one.

There are hundreds of different mattresses available today, so narrow down your options by choosing how you want to shop. Would you prefer to choose a bed in-store? Or are you more of a fan of bed in a box mattresses? Whatever your preference, you’ll have plenty of options. You can further narrow down your selection by sorting mattresses by type and firmness.

Pay Attention to Your Pillow

Most consumers spend a lot more time researching the perfect mattress than the best pillow. But pillows play a crucial role in keeping your head and neck properly aligned, which has a direct impact on your spine and back.

The best pillow for firm mattresses tend to be sturdy. Firm mattresses keep your shoulders from sinking down, so a thick, firm pillow will keep your head elevated at the right angle to prevent upper back strain and neck pain, Cleveland Clinic experts say. Latex or memory foam pillows tend to provide more structure and support than softer models made from polyester.

When To Call Your Doctor

back pain call doctor

Switching up your sleep posture can go a long way towards improving back problems. In fact, people with mild or moderate back pain might find that changing their position solves the issue altogether.

What if you’ve made adjustments to your sleeping posture but your pain still hasn’t improved? If your back feels the same after several weeks, it might be time to call the doctor. Your provider can examine your back to figure out what’s causing your pain and help you come up with a more comprehensive plan to manage the problem and get you on the road to recovery.

The Bottom Line

Sleep position can have a significant impact on acute or chronic pain in your back—for better or worse. So if your back is bothering you, take a look at how you tend to lay in bed and consider making a change. A simple shift in your posture might be all you need to get better sleep at night and feel more comfortable during the day.

This article is for informational purposes and should not replace advice from your doctor or other medical professional.