Best Sleeping Positions for Back Pain Relief

The way you sleep plays a key role in how your back feels. Even if a position feels comfortable at first, it can put uneven pressure on your spine over time, especially without the right support from your mattress or pillow.

I’m Hannah Shore, Head of Sleep Science, and in this guide, I’ll share expert advice on how your sleep posture affects spinal alignment and offers small adjustments to help ease back pain while you sleep, drawing on my expertise in biomechanics and sleep health.

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How does your sleeping position affect your back?

Your sleeping position plays a major role in how well your spine and the muscles around it recover overnight. 

Ideally, your spine should stay in a neutral, relaxed position while you sleep. This helps relieve pressure, supports healthy posture, and allows muscles and joints to fully rest.

If your neck or spine is twisted, tilted, or curved out of alignment, it can create uneven pressure on key areas like your shoulders, hips, and lower back - which can often lead to stiffness or pain when you wake up in the morning.

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What’s the best sleeping position for a bad back?

Side and back sleeping are generally the best positions for managing back pain, as they help keep your spine in a more natural, aligned posture. This alignment reduces pressure on your joints and supports better muscle recovery while you sleep.

That said, even the healthiest sleep position can lead to discomfort if your mattress or pillow isn’t offering the right support for your sleep needs. The right sleep setup matters just as much as the position you’re in.

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What’s the worst sleeping position for a bad back?

Front sleeping is the least supportive position for your spine. It flattens the spine’s natural curves and puts added pressure on the neck, shoulders, hips, and lower back, often leading to more discomfort over time.

If you’re a front sleeper, I usually recommend trying to transition to side or back sleeping. But if that’s not possible, don’t worry. Below, you’ll find some expert-backed tips to make front sleeping a little more back-friendly.

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Is sleeping on your side bad for your back?

Side sleeping is one of the most common and potentially back-friendly positions - if your spine stays well supported. Without the right setup, it can lead to misalignment and increased pressure on the lower back and shoulders.

Common issues with side sleeping include:

• Top leg crossing over the bottom leg - If your mattress is too firm, it can elevate your hip unnaturally, which twists your spine.
• How to fix this - Place a pillow between your knees to keep your hips level and spine neutral. A cushioning mattress topper can also help your hips to sink a little further into the mattress, helping with your sleep posture.

• Shoulder droop - An unsupportive pillow or overly firm mattress can cause your shoulder to collapse forward, twisting your upper spine. 
• How to fix this - Use a thicker pillow that maintains your neck and spinal alignment. You could also consider placing a second pillow in front of your chest to prevent your shoulder from rotating forwards.

Here are some of my favourite tips to improve side sleeping:

• Draw your legs slightly towards your chest - keep your knees gently bent, not tightly curled
• Place a pillow between your knees for hip and spine support
• Choose a pillow that keeps your head in line with your chest, not tilting up or down

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Is sleeping on your back bad for you?

Back sleeping is often considered the healthiest sleeping position for spinal alignment, but it only works well if your mattress and pillow support your body’s natural curves. Without the proper support, pressure can build in the lower back, leading to discomfort or stiffness.

Tips to improve back sleeping:

• Choose a flatter pillow that fills the gap between your neck and mattress without pushing your head too far forward
• Place a pillow under your knees to ease pressure on your lower back
• Use a small rolled towel under your lower back for extra lumbar support

Keep in mind, if your mattress doesn’t distribute weight evenly, even this ideal position can worsen pain. A lack of support may increase pressure points and stiffness.

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Is sleeping on your front bad for back pain?

Front sleeping is generally the worst sleep position for a bad back. It flattens your lower back and forces your neck into a twisted position, both of which can increase back pain over time.

If you can’t sleep any other way:

• Place a pillow under your pelvis to support the lower spine’s natural curve
• Try sleeping without a pillow, or use a very thin one to avoid twisting your neck too much
• Front sleeping isn't ideal for back pain, but a few tweaks to your setup can help to put less strain on your back

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The way you sleep has a huge impact on how you and your back feel the next day. Minor adjustments to your sleep position can go a long way in reducing pressure on your back and joints, helping you wake up feeling refreshed.

But remember, even the best position won’t work if your pillow and mattress aren’t suited to your specific sleep needs.