Sleeping With Lower Back Pain

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Mattress Nerd consulted Dr. Steven Knauf, D.C. to ensure that this article met our editorial standards

Poor sleep hygiene can take a massive toll on your overall health. In addition to a weaker immune system, higher rate of depression and exhaustion, and increased chances of obesity, sleep deprivation can also cause significant lower back pain.  

Our lower back deals with a lot of stress throughout the day, and if you’re not careful, it can suffer from a significant amount of abuse at night as well. That’s why it’s crucial that you take the proper steps to understand the relationship between lower back pain and health, and also address it so that you don’t have to deal with it for much longer. 

Read on to find out more, and get ready to improve your sleep quality and potentially say goodbye to waking up with lower back pain.

How Lower Back Pain Can Affect Sleep

The relationship between lower back pain and sleep wellness is almost cyclical. If you have lower back pain, you may have a more difficult time finding a comfortable sleep position. This can lead to tossing and turning all night, which can prevent you from falling and staying asleep, meaning you don’t achieve proper REM while you rest. 

However, if you’re not sleeping correctly, then you can also put your back health in jeopardy, keeping the cycle going. You need to address the cause of lower back pain and break the chain. One of the keys to getting a better night’s sleep is evaluating your sleeping position. 

Does Your Sleeping Position Cause Back Pain?

There are several primary sleep positions: back, stomach, side, and combination. Everyone has their own preferred sleep position that keeps them most comfortable. Unfortunately, the wrong sleep position can cause back pain or aggravate existing back pain. Here is an analysis of each sleeping position’s impact on back health.


When we sleep on our backs, our whole body is flat and straight, and thus when supported well, our spine is properly aligned. Due to this alignment, you have less chance of waking up with lower back pain. 

The one thing to keep in mind is that this tends to work best with a medium-firm mattress, which gives enough support to your neck, shoulders, hips, and legs. If you’re sleeping on your back on a mattress that is too soft, your hips can sink in and your shoulders may round, throwing off your spinal alignment and causing stress on your back.

Another way to improve your sleep posture on your back is to put a pillow underneath your legs if they are sinking too low. This technique elevates them and helps ensure proper alignment and decreases stress on the joints and muscles in your lower body.


When you’re stomach sleeping, your hips dip into the mattress, and your neck has additional strain from keeping your head turned to the side. If you’re sleeping on a mattress that’s too soft, your hips may sink in too deep, throwing off your spinal alignment and possibly leading to back pain. You want a nice, firm mattress so that you can get the support you need to keep your body straight.

Similar to back sleepers, stomach sleepers can place a thin pillow underneath their hips to help elevate them and lessen the amount of stress on their lower back and hips. They should also stay away from super soft mattresses, such as those made from memory foam.


As with back and stomach sleepers, mattress firmness must be considered if you sleep on your side. Side sleepers need a soft mattress that cushions your hips and shoulders so that they are even with the rest of your body. Sleeping on a mattress that’s too firm will cause your hips and shoulders to be elevated, going against the natural curve of your body and throwing off your spinal alignment. 

As with stomach and back sleepers, a pillow can do wonders for your back health. Placing one between your knees will keep your hips and lower back aligned and reduce stress to those areas. Additionally, having the right size pillow for your head makes a huge difference, ideally the pillow should allow just enough space between the mattress and your head to provide room for the shoulder you’re laying on, keeping your head straight.

Can a Bad Mattress Cause Back Pain?

It’s not just your sleeping position that can take a toll on your back health. It’s also the materials used in your mattress’s construction. Sleeping on the wrong type of mattress can lead to you waking up with back pain, and unless you change something, you could be dealing with this back pain for a very long time.

Memory foam mattresses and latex mattresses are on the softer side, so if you’re a stomach or back sleeper, they may not be good for your back health. Conversely, innerspring and coil mattresses are much firmer, meaning that side sleepers won’t get the right amount of hip and shoulder support that promotes good spinal wellness. 

In addition to the materials used in the mattress, you need to look at the age as well. Older mattresses will develop an indentation if you’ve been sleeping on them for a long time. As your body sinks into the mattress, you become more prone to spinal mis-alignment and lower back pain. 

It’s advised that you follow the mattress manufacturer’s recommended flipping and rotating schedule, and you shouldn’t hold onto a mattress for too long. Most mattresses last for approximately 10 years, but this is entirely dependent on the materials used and the manufacturer.

Lower Back Pain and Leg Pain

Your legs and your back share a nerve known as the sciatica nerve. This nerve branches from your back, down your hips and buttocks, and down each of your legs. A poor sleep position can tighten muscles or aggravate previously injured discs in the spine which may irritate the sciatic nerve, causing pain down your leg. You need to look out for both your back and your legs as you sleep as it may lead to some nasty symptoms.

Getting Better Sleep with Lower Back Pain

There are numerous ways to modify your sleep habits to avoid or lessen lower back pain. Check out these helpful sleep tips. 

  • By sleeping on your side in a neutral position with your legs slightly bent (almost like the fetal position), you can reduce pressure on your lumbar spine. You can also put a small pillow between your legs to help keep your hips and low back aligned.
  • Avoid alcohol and caffeine at least six hours before you go to bed. Both of these substances can cause you to toss and turn, potentially irritating your spine.
  • Ensure you’re getting at least 8 to 9 hours of sleep each night. This gives your spine enough time to decompress and relax.
  • As you’re going to bed, you can try various relaxation techniques such as breathing exercises and meditation to put your body into rest mode and to lighten the pressure on your back.


Low back pain can make life much more difficult than it needs to be. Luckily, there are methods that may offer pain relief so that you can get the good night’s sleep you deserve. Remember, if pain persists or worsens make sure to discuss it with your healthcare professional.

Meet Our Medical Reviewer

Dr. Steven Knauf, D.C.

Steven Knauf, D.C. is Executive Director of Chiropractic and Compliance at The Joint Chiropractic. Dr. Knauf began working at The Joint in 2011. After spending four years as a chiropractor in-clinic, he took the role of Senior Doctor of Chiropractic for 13 of The Joint Corp. clinics and, subsequently, was elevated to a director position at the corporate office.