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Finding the best sleeping position for back pain could be the difference between waking up refreshed or spending the night in a restless cycle of tossing, turning, and regretting skipping those stretches your physio recommended. While a supportive mattress for back pain and the right pillow are essential, your sleeping position is just as important when it comes to spinal alignment, joint health and pain relief.
It’s not about finding a magic cure-all. The best sleeping position for back pain for you depends on where the discomfort is, how you breathe at night, and what actually feels sustainable – because breaking bad habits can be hard. But by understanding how back sleeping, side sleeping, and stomach sleeping affect your spine and muscles – and by making a few smart tweaks – you can set yourself up for a far more restful sleep and a pain-free morning.
And if you’ve ever rolled out of bed with lower back pain and a vague suspicion your mattress might secretly be your nemesis, you’re not alone, which is why we’ve asked sleep experts at some of the top bed and mattress brands for their insight on the subject – but they’ll also be the first to tell you that how you sleep is just as important as what you sleep on.
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Meet the experts:
Do certain sleeping positions exert more pressure on our joints?
Not all sleeping positions are created equal. As Silentnight’s sleep expert, Kathryn Pinkham, explains, “Pressure-mapping research shows that certain sleeping positions can affect how much strain is placed on our joints. How we position ourselves in bed changes how weight is distributed across the body, which can influence comfort, spinal alignment, and joint health.”
In practical terms, stomach sleeping may pile stress onto the lower back and neck, side sleeping can overload the shoulder and hip if your mattress is too firm, and back sleeping – often the most evenly balanced for body weight – can be even better with a small pillow or rolled towel under the knees for extra lower back comfort.
Anne Marie Boyhan, sleep expert with DFS, agrees, noting that sleeping posture can either give your spine a much-needed rest or “aggravate it” depending on whether you’re keeping it in a neutral position. “When you sleep, your muscles and spinal structures finally get a chance to rest and repair. If your spine isn’t supported in a neutral position, that downtime can actually strain muscles, put pressure on joints and irritate nerves.”
Dr Hana Patel, NHS GP and resident sleep expert at Time4Sleep, adds that “Different sleeping positions generate different surface contact, putting pressure on various joints. The three basic sleep positions – supine (lying on your back), side, and prone (lying on your front) – require different types of support when it comes to your mattress. Unsupported sleeping positions, like sleeping on your stomach, can place stress on the spine and lead to back pain.”
Does the way you sleep influence back pain?
Absolutely – and often more than people realise. The wrong position can take a mild ache and turn it into something that lingers all day. Anne Marie describes waking up after a poor night’s sleeping posture feeling “as though your back has been twisted and contorted all night”. She’s even experienced it herself, visiting a chiropractor every few months for spinal alignment, and incorporating floor stretches like lying on her back with her knees towards her chest, or gently rotating “window wipers” from side to side.
For Hana, avoiding unsupported postures is key, especially those that let the lower back hang without extra support. Over time, she says, this can contribute to imbalances in the back muscles, irritate nerves and turn occasional low back pain into something more persistent.
It’s also worth noting that certain medical conditions – such as a herniated disc, sciatica or degenerative disc disease – can flare up more depending on your sleeping posture. For example, sleeping in a reclined position using an adjustable bed can sometimes ease sciatic nerve pressure, while adding a small pillow under the knees can help reduce strain for back sleepers. Even subtle tweaks like these can be enough to improve spine alignment and overall comfort.
Think of your sleeping posture like your daytime posture: you wouldn’t sit at your desk twisted to one side for eight hours without expecting discomfort, so why would you spend all night in an unsupportive position? Making a conscious effort to change how you sleep might feel awkward at first, but your back will thank you for it in the long run.
Which sleeping positions should be avoided by those suffering from back pain?
Here, the experts are unanimous. Kathryn calls stomach sleeping “one of the most common culprits for waking with discomfort”, as it forces the spine into extension and twists the neck, placing extra stress on the lower back. Sleep on your tum and you might end up dealing with neck pain along with the nagging twinge in your back.
Anne Marie is just as clear: “Sleeping on your stomach is the big one to avoid. It forces your neck into rotation for hours at a time and flattens the natural curve of your spine… positions where your lower back hangs without support, like lying twisted halfway between your stomach and your side, can create asymmetrical strain.”
Hana echoes this, advising: “If you have back pain, you should try to avoid lying face down to avoid increased pressure on your spine and neck. Instead, try sleeping on your side with the knees drawn up (fetal position), or on your back with a small pillow underneath the back of the knees to maintain the natural curve of the lower back.”
Kathryn also warns of the link between discomfort and disrupted sleep: “Pain or pressure in bed can lead to frustration, which over time creates a negative association with bedtime. This cycle can make it harder to fall asleep and stay asleep, further impacting rest and recovery.”
Are there any sleeping positions that aid breathing?
Your sleeping posture can affect far more than your back. Kathryn explains that back sleeping can worsen snoring and mild sleep apnoea, as gravity pulls the tongue backwards and narrows the airway. Side sleeping, she says, can help reduce symptoms, though it’s not a complete solution for medical conditions like sleep apnoea.
Hana adds that those with breathing issues may find symptoms worse when lying on their back. She points to studies showing sleeping on the right side is linked to fewer awakenings, while the left side can reduce acidity and reflux symptoms. She also notes that the NHS generally advises against sleeping on your front for breathing, spinal and neck reasons.
For Anne Marie, side sleeping isn’t just about pain relief – it’s also “the sweet spot between comfort and support”. Pairing it with a pillow between the knees keeps the hips level, eases lower back tension, and can even reduce shoulder pain. And while she originally switched to this position for comfort, she still swears by the same pregnancy pillow she bought years ago for maintaining that perfect neutral position through the night.
If breathing is a concern – whether due to snoring, mild sleep apnoea or just general congestion – it’s worth experimenting with side sleeping, slightly elevating the upper body, or using an adjustable bed to find a position that balances airway openness with spine comfort.
Is there a universally best sleeping position?
None of the experts believe there’s one best position for everyone, but side sleeping comes closest to covering most bases for chronic pain, back pain relief, spine alignment and breathing. Anne Marie sums it up: “Side sleeping is like giving your spine a hug. It keeps your back in a neutral position, reduces strain on muscles and discs, and it naturally opens up your airways.”
For back sleepers, Hana suggests lying flat with a small pillow or rolled towel under the knees to protect the spine’s natural curve and reduce tension in the lower back. Those with sciatica or degenerative disc disease may find a slightly reclined position – easily achieved with an adjustable bed – can help relieve pressure.
Kathryn’s parting advice is to be guided by your own comfort: “Listen to your own body – if you have aches or pain anywhere then adjusting your sleeping position to avoid pressure on that area could improve your sleep quality.”
The real key is finding a sleeping posture you can maintain consistently without discomfort, pairing it with the right mattress and supportive pillow to keep your spine aligned. And if that means investing in a medium-firm mattress, trying out a knee pillow or even rethinking your entire sleeping set-up, the benefits – from better sleep to reduced back pain to an overall uplift in your wellbeing – are well worth it.
