The Best Sleeping Positions For Lower Back Pain & The Worst

Sleep is the building block of your overall health and well-being, and so is your spine.

If you’re suffering from debilitating back pain, finding the right sleeping position can be a game-changer.

Searching for the best sleeping position for lower back pain usually leads to finding articles which focus on two points:

1. Sleeping on your stomach is bad for your neck and back.
2. You should always sleep in a position where your spine is its natural curvature.

But is there any merit to these claims?

Let’s find out.

Key Takeaways

Sleeping on your side, and in the fetal position have been found to be the best sleeping positions for lower back pain, sleep apnea and more. The fetal position provides complete support to your spine and is also great for your vital organs.

This position may sometimes cause neck discomfort if your pillow is too thick or too thin. Try to sleep on a pillow where your ears are straightly aligned with your body.

The way you sleep at night can either alleviate or increase lower back pain, making it crucial to understand the best and worst sleeping positions for lower back pain.

What’s The Most Common Sleeping Position?

Lying on the left or right side is the most common sleeping position in people aged 3-45.^<1> There are various factors that are associated with preferred sleeping positions such as:

• Age
• Body Mass Index (BMI)
• Pain and Discomfort
• Other health conditions

Sleeping on the stomach is very uncommon in older adults(35-80) compared to their younger counterparts. This can be due to various factors such as age related pain and discomfort and even respiratory issues.

Your movement throughout the night

We shouldn’t generalize best or worst sleeping positions because of several factors.

Young healthy men change positions around 32 times during a single night and adopt approximately 7 different sleeping positions, with similar variations recorded in women.^<2>

Which makes it near impossible to maintain a “neutral spine position” . Even if you woke up in the same position you went to bed in, doesn’t mean you slept in that same position throughout the night.

We always twist and turn and change positions and it is perfectly natural.

Can Certain Sleeping Positions Cause Pain?

Yes. Every person has different preferences and which position they find comfortable for uncomfortable. But there isn’t a one size fits all answer.

You can easily find many articles telling you that one or the other position is bad for sleeping, like sleeping on your stomach.

Multiple studies have found no correlation between sleep positions and spinal problems.^<3>

Another study in 2018 found no correlation between sleeping positions and glenohumeral joint pain or rotator cuff tendinopathy. This included the prone position (lying on your stomach) with arms extended overhead.^<4>

Sleeping on the stomach had no effect on waking and cervico-thoracic symptoms, while sleeping upright caused discomfort and sleeping on the side was protective.

We cannot make generalizations for everyone based on these studies because there are limitations with self-reporting and studies have small sample sizes.

There’s not enough research to suggest that a sleep position is a protection or a risk factor for neck, back, shoulder or arms symptoms.

Should you avoid certain positions if you have pain?

Yes, you can choose your own preferred position that alleviates your discomfort. If you have lateral hip pain, sleeping on that side can cause pain, and sleeping on the opposite side will be more comfortable.

If you have shoulder problems, you may find it relaxing to rest your arm on a pillow by your side when you sleep.

Now notice that none of these positions are inherently bad but their usage can be minimized temporarily if you’re dealing with a specific pain or discomfort.

You might choose your sleeping position for a health condition, but generalizations cannot be made because our bodies can respond differently.

With that said, here are the best and the worst positions reported for people with lower back pain:

The Best and the Worst Sleeping Positions For Lower Back Pain

Sleeping on the Side

Many people prefer sleeping on their sides, and it has been found to be one of the most protective and healthy sleep positions. Let's take a closer look.

The Pros:

• Ideal for Spine Support: Sleeping on your side can help maintain a straight spine, which is generally good for lower back health.

• Reduced Sleep Apnea: Side sleeping is known to reduce the occurrence of sleep apnea, which can also worsen your lower back pain if left untreated..

• Recommended for Pregnant Women: Pregnant women often find relief in side sleeping, particularly on their left side. This position enhances blood circulation to vital organs and the fetus while reducing the risk of complications.
• Brain Health: Although not directly related to lower back pain, side sleeping has been associated with helping the brain flush out toxins and proteins. This position may reduce the risk of neurodegenerative diseases like Alzheimer's and Parkinson's.

The Cons:

• Skin Aging and Wrinkles: Over time, there are some studies to suggest that sleeping on your side without the proper pillowcase might contribute to skin aging and the formation of wrinkles. This is because one side of your face is constantly being folded and stretched.
  
  Consider using a satin pillowcase to minimize friction.

• Neck Pain: Insufficient pillow support can cause neck pain in side sleepers. Ensure that your pillow adequately supports your neck to avoid discomfort.

It's important to note that the thickness and quality of your pillow can also affect your comfort and spinal alignment while sleeping on your side.

Choosing the right pillow is crucial to minimize the side effects.

Sleeping on the Back

Sleeping on your back is often considered one of the best positions for maintaining a healthy spine and reducing the risk of lower back pain.

The Pros:

• Least Stressful Position: Sleeping on your back appears to be the least stressful position for your spine. It allows your body to maintain a neutral alignment.

• Neck Support: Proper pillow thickness is key when sleeping on your back. Avoid pillows that are too thick, as they can elevate your head excessively and cause neck tension and headaches.

• Posture Improvement: Back sleeping helps improve your overall posture, especially if you consciously maintain a straight position.

• Preventing Facial Wrinkles: Unlike side sleeping, back sleeping minimizes contact between your face and the pillow, reducing the risk of facial wrinkles.

• Lower Back Support: If you suffer from lower back pain, slightly bending your knees and placing a small pillow beneath them can support the natural curve of your lower back.

The Cons:

While back sleeping is generally beneficial for the spine, it may not be the most comfortable position for everyone. Some individuals find it difficult to fall asleep or stay asleep in this position.

Additionally, for those with sleep apnea, back sleeping may worsen the condition.

The Fetal Position: A Common Choice

The fetal position is a variation of the side sleeping position and it is quite popular, especially among women. You sleep lying on your side with your knees drawn towards your chest and your chin tilted down, like a baby.

The Pros:

• Comfort for Vital Organs: Sleeping in the fetal position is often chosen for its comfort, especially when it comes to the positioning of vital organs.
• Reduced Snoring: This position can considerably reduce snoring, providing a quieter night for you and your sleep partner.

Sleeping on the Stomach

A significant portion of the population prefer to sleep on their back, while sleeping on your stomach is often discouraged, if you’re not experiencing any side effects or discomfort there’s no need to worry.

The Pros:

• None for Spinal Health: Unfortunately, there are few, if any, advantages to sleeping on your stomach when it comes to lower back pain.

The Cons:

• Unnatural Spinal Position: Sleeping on your stomach is considered the most unnatural position for your spine. It can lead to a curved and strained neck position, resulting in neck pain and discomfort.

• Jaw and Mouth Issues: Stomach sleeping often requires you to turn your head to the side to breathe, which can cause stress on your jaw and mouth, potentially leading to jaw-related issues.

• C-Spine and L-Spine Strain: The continuous rotation of your head and the arch in your lower back can put significant strain on both your cervical (neck) and lumbar (lower back) spine. This can result in neck pain and lower back discomfort.

• Airway Complications: Stomach sleeping increases the likelihood of airway collapse during sleep, which can lead to difficulty breathing and potentially worsen sleep apnea symptoms.

• Not Recommended During Pregnancy: Pregnant individuals should avoid sleeping on their stomach as it can cause unnecessary pressure on the growing belly and hinder blood circulation to the fetus.

• Exacerbates Neck Pain: If you already suffer from neck pain, stomach sleeping can exacerbate the problem due to the unnatural head and neck positioning.

To mitigate the adverse effects of stomach sleeping, some people find relief by placing a pillow below the waist area to straighten the spine into a more natural position. However, it's generally recommended to transition to a different sleeping position for better spinal health.

Additional Considerations for Better Sleep and Lower Back Pain:

• Nasal Breathing: Practicing nasal breathing during sleep can improve the quality of your sleep and overall health.
• Grounding: Some individuals find relief from lower back pain by practicing grounding, which involves connecting with the Earth's surface by walking barefoot on soil.
• Go for 100% natural hemp-based supplements like cannabidiol (CBD) and (CBN):
  Full-spectrum CBD oil with terpenes has been reported to be one of the most potent supplements for managing aches and discomfort. CBN oil is often called the “sleepy cannabinoid” because of its ability to induce rest and relaxation.

References

^<1> De Koninck J, Gagnon P, Lallier S. Sleep positions in the young adult and their relationship with the subjective quality of sleep. Sleep. 1983;6(1):52-59. doi:10.1093/sleep/6.1.52

^<2> Kubota, T., Ohshima, N., Kunisawa, N. et al. Characteristic features of the nocturnal sleeping posture of healthy men. Sleep Biol. Rhythms 1, 183–185 (2003). https://doi.org/10.1046/j.1446-9235.2003.00040.x

^<3> Cary, D., Briffa, K., & McKenna, L. (2019). Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review. BMJ open, 9(6), e027633. https://doi.org/10.1136/bmjopen-2018-027633

^<4> Holdaway LA, Hegmann KT, Thiese MS, Kapellusch J. Is sleep position associated with glenohumeral shoulder pain and rotator cuff tendinopathy: a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):408. Published 2018 Nov 23. doi:10.1186/s12891-018-2319-9