Best Sleeping Position You Need to Know For Lower Back Pain Relief Now

Lower back pain doesn’t just affect your day—it can wreck your nights too. If you’re tossing and turning trying to find a comfortable position, you’re not alone. Poor sleep posture is one of the most common—and overlooked—contributors to persistent back pain.

The good news? A few simple adjustments can make a world of difference. Let’s look at the best sleeping positions for lower back pain, why they work, and what else you can do to finally wake up refreshed and pain-free.

Why Sleep Position Matters So Much

We spend roughly one-third of our lives sleeping. That’s a lot of time for your back to be in either a healing or harmful position.

When you sleep with poor alignment—like twisting your spine, or letting your hips sag—it puts pressure on the small joints and overstretched ligaments in your lower back. Over time, this can aggravate existing injuries or even cause new ones.

Less than 10% of low back pain comes from the spine. Most of it happens when the ligaments holding the bones of your pelvis to the sacrum, the triangular bone at the base of your spine is are overstretched because the joint they form, the sacroiliac (SI) joint, is displaced.

The key to relief? Preventing and correcting the SI joint’s displacement is key to most low back pain relief. 

Best Sleeping Positions for Lower Back Pain

1. Sleeping on Your Back with Knee Support

Why it helps: This position distributes your weight evenly and keeps your spine and your pelvic bones (which form your sacroiliac (SI) joints) aligned. Placing a pillow under your knees helps maintain the natural curve of your lower back.

How to do it:

• Lie flat on your back
  

• Place a pillow or rolled-up towel under your knees
  

• Use a supportive pillow under your head and neck—not too thick

This is often considered the best sleeping position for lower back pain, especially if you have spinal alignment issues or nerve-based pain. Unfortunately, if you snore or suffer from sleep apnea, it can be difficult for you to breathe in that position.

2. Side Sleeping with a Pillow Between Your Knees

Why it helps: Lying on your painful side pushes and holds the displaced pelvic bones and the spine together, thus realigning the SI joints. The pillow between your knees prevents your top leg from pulling on the top pelvic bone which would open up its SI joint, allowing its displacement.

How to do it:

• Lie on your painful side
  

• Bend your knees slightly toward your chest
  

• Place a firm pillow between your knees

This is a great position for people with sacroiliac joint issues, sciatica, or hip instability.

3. Fetal Position (With Modifications)

Why it helps: Curling into a loose fetal position can open up the spaces between your vertebrae and relieve nerve compression, especially for those with herniated discs.

How to do it:

• Lie on your side
  

• Curl your knees toward your chest gently (not tightly)
  

• Place a pillow between your knees for alignment
  

• Use a supportive head pillow to keep your neck neutral

Avoid curling too tightly, as this can over-round your back and restrict breathing.

4. Reclined Position (For Special Cases)

Why it helps: For people with isthmic spondylolisthesis or degenerative disc disease, sleeping in a reclined position can reduce pressure on the spine. It also helps those whose heart or whose lungs are failing as their breathing will be easier: there will be more room for the lungs to expand into the abdomen as they inhale, and less fluid coming up from the legs to overload the heart.

How to do it:

• Use an adjustable bed or wedge pillow
  

• Sleep in a semi-reclined position with your torso elevated
  

• Place support under your knees to prevent hip strain

This isn’t for everyone—but it’s worth trying if other positions haven’t helped.

What to Avoid

If you're dealing with lower back pain, try to avoid:

🚫 Sleeping on your stomach – This flattens your spine and twists your neck.

🚫 Overly soft mattresses – They let your hips sink too low and misalign your spine and your SI joints.

🚫 Pillows that are too thick or too flat – These can throw your neck and spine out of whack.

Bonus Tips for Better Sleep & Less Pain

🛏️ Get the Right Mattress
Aim for medium-firm support. It should cradle your hips and shoulders but still keep your spine and your pelvic bones aligned.

🧘 Wind Down with Breathwork
Simple belly breathing before bed relaxes your nervous system and reduces muscle tension. Try 4-7-8 breathing or box breathing to help you drift off peacefully.

🧴 Use Nerve-Calming Creams
Most pain creams don’t help if the source of pain is nerve-related. QR Cream contains mannitol, which helps calm irritated nerves in overstretched ligaments—often the hidden source of lower back pain.

📚 Learn How to Realign Your Pelvis
Many lower back problems stem from misalignment of the pelvic joints. Gentle realignment techniques—like those taught in Low Back Pain: 3 Steps to Relief in 2 Minutes—can bring fast relief and improve sleep quality.

When to See a Doctor

If your pain is:

• Radiating down your legs, below your knees

• Accompanied by numbness or tingling

It’s time to speak to your healthcare provider. These things mean that there is nerve or spinal cord damage that needs to be addressed.

Below are some warning signs that may require immediate medical attention:

• Severe numbness in the genital area

• Difficulty urinating or loss of bladder and bowel control

• Progressive muscle weakness

• Foot dragging while walking

You Deserve Restorative Sleep

Don’t settle for another restless night or wake up feeling worse than when you went to bed. Your body heals while you sleep—but only if it’s supported properly.

Try the positions above. Make small adjustments to your environment. And above all—listen to your body.

Sleep is one of your greatest tools for healing lower back pain. Use it well.

Want to learn natural ways to reduce back pain fast—without pills, injections, or surgeries?

🎥 Watch my free webinar: 3 Steps to Pain Relief

It’s filled with strategies to help you feel better naturally—starting tonight.

Wishing you deep rest and pain-free mornings,
— Hélène Bertrand, MD (retired)

CLICK HERE TO RECEIVE LOW BACK PAIN RELIEF in 2 MINUTES!

Disclaimer: This content is for informational and educational purposes only and does not substitute professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before starting any new treatment or making changes to your health regimen. Although Dr. Bertrand is a retired medical doctor, she is not practicing medicine or providing medical care through this website.