Back Pain and Bedtime: The Crucial Role of Sleep Position in Spinal Health

Back Pain and Bedtime: The Crucial Role of Sleep Position in Spinal Health


Discover the vital connection between your sleep position and back pain in this informative blog. Learn how to ensure proper spinal alignment whether you’re lying on your back or side, helping you wake up feeling refreshed and pain-free.

Your nightly slumber should be a time of rest and rejuvenation, but for many, it’s a battle against back pain that seems to strike as soon as your head hits the pillow. The culprit? Your sleep position. In this comprehensive guide, we’ll delve into the crucial role of sleep position in spinal health and explore how to ensure neutral spinal alignment whether you’re lying on your back or side.

Understanding Spinal Alignment:

Proper spinal alignment is key to reducing back pain and promoting overall spinal health. When lying down, your spine should maintain its natural curvature, with the neck, upper back, and lower back all in alignment. This neutral position minimizes strain on the muscles and ligaments surrounding the spine, allowing for optimal relaxation and restorative sleep.

Laying on Your Back:

Achieving neutral spinal alignment while lying on your back starts with choosing the right mattress and pillow. Opt for a mattress that provides adequate support for your body weight and sleeping position. A medium-firm mattress is often recommended for back sleepers as it offers a balance of support and comfort.

When it comes to pillows, choose one that supports the natural curve of your neck while keeping your head aligned with your spine. A pillow that is too thick can cause your head to tilt forward, while a pillow that is too thin can strain the muscles in your neck and upper back.

Additionally, consider placing a small pillow or rolled-up towel under your knees to help maintain the natural curvature of your lower back. This can relieve pressure on the lumbar spine and reduce discomfort while you sleep.

Sidelying Position:

For those who prefer to sleep on their side, maintaining neutral spinal alignment can be achieved by ensuring that your head, neck, and spine are all in a straight line. Start by choosing a supportive mattress that allows your hips and shoulders to sink in slightly, keeping your spine in a neutral position.

Use a pillow that fills the space between your neck and the mattress, providing support and preventing your head from tilting down or up. Placing a pillow between your knees can also help keep your hips and pelvis in alignment, reducing strain on the lower back and hips.

It’s important to avoid curling up into a fetal position while sleeping on your side, as this can round your spine and lead to discomfort. Instead, try to keep your body as straight as possible, with your legs slightly bent at the knees.

Here is a video that demonstrates how to have success in these positions.

Other Potential Sources of Nighttime and Morning Back Pain:

While sleep position plays a significant role in back pain, it’s essential to consider other potential sources of discomfort that may arise during the night or upon waking in the morning.

Sleeping Environment: Factors such as room temperature, lighting, and noise levels can impact sleep quality and contribute to back pain. Creating a comfortable and conducive sleep environment, free of distractions, can promote better sleep and alleviate discomfort.

Sleep Disorders: Conditions such as sleep apnea or restless leg syndrome can disrupt sleep patterns and lead to morning back pain. Addressing underlying sleep disorders with the help of a healthcare professional can improve sleep quality and reduce discomfort.

Poor Posture/Balance of Activity During the Day: Slouching or sitting for extended periods with poor posture can strain the muscles of the back, leading to stiffness and discomfort during sleep. Incorporating proper ergonomics and regular breaks to stretch and move throughout the day can help alleviate back pain.

Stress and Tension: Mental and emotional stress can manifest physically, causing muscle tension and stiffness in the back. Practicing relaxation techniques such as deep breathing, meditation, or gentle stretching before bed can help reduce stress levels and promote better sleep quality.

By addressing these additional factors alongside sleep position, individuals can take a holistic approach to managing nighttime and morning back pain, leading to improved overall sleep quality and spinal health.


Your sleep position plays a significant role in spinal health and can either alleviate or exacerbate back pain. By ensuring neutral spinal alignment whether you’re lying on your back or side, you can promote better sleep quality and wake up feeling refreshed and pain-free. Remember to invest in a supportive mattress and pillow, and consider using additional supports such as pillows under your knees or between your legs to maintain proper alignment. With these simple adjustments, you can turn your nightly slumber into a restorative experience for your spine.

A man in a green t - shirt smiles in front of a gym.

Dr. Ross Gentry


"This is Physical Therapy for Athletes. We relieve pain and ensure you're ready to do what you love"

Want To Get Relief Faster?

Choose which option works best for you.

Scroll to Top