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How to Sleep with Back Pain

Is back pain hindering your sleep? Get the best tips, advice, and methods to relieve back pain and sleep better.

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When it comes to health and wellness, sleep is an essential facet. Sleeping is beneficial in many ways. It improves our brain function, mood, exercise performance, boosts our immune system, reduces the risk of health problems, and reduces inflammation.

Sleep is essential, but pain proves to be a hindrance. Studies show 67-88% of people with chronic pain disorders have sleep troubles. What's more, at least 50% of people with insomnia experience some form of chronic pain.

There is a connection between sleep disorders and pain. The American Chiropractic Association lists back pain as the leading worldwide cause of disability. If you're like 80% of the entire human population that experiences back pain, you know the cycle it can cause.

A man sitting on a bed holding his back in pain

Back pain leads to poor sleep, which leads to poor mental and physical conditions. This impacts your daily life.

Surprisingly, most back pain is not caused by severe medical conditions such as cancer or arthritis. Most back pain is from bad posture, poor sleep positions, or other lifestyle habits. In this guide, we’re going to break down a few best practices, tips, and products you can use for back pain treatment and improved sleep. 

Sleeping Positions for Back Pain Relief

Your sleep position matters. Not only does it affect back pain, but it can regulate the quality of sleep you get. If you struggle with back pain, adjusting your sleep position is one of the core areas you need to focus on.

Improper sleep positions can cause your body to misalign, making the pain worse. These sleep positions may help with upper, middle, and lower back pain.

A woman sleeping in bed with a knee pillow

On Your Side with a Pillow Between Your Knees

If you find it uncomfortable to lay on your back, sleeping on your side may be helpful.

  • Sit on the edge of the side of your bed.
  • Pivot your body so your legs are on the bed and you’re now sitting.
  • Lay down, so your right or left side of your body is touching the mattress.
  • Place the pillow between your legs.
  • For added support, try using a smaller pillow if you find a gap between your waist and the mattress.
  • Make sure you switch between sides. Doing so prevents issues such as muscle imbalance and scoliosis from forming. A common cause is sleeping too much on the same side.

How this helps: Side sleeping won’t necessarily reduce pain by itself. The key here is the pillow between your legs for back pain. It helps align your spine, hips, pelvis, and back.

Better alignment means reduced back pain. Specialized leg pillows for back pain make this position more comfortable.

A graphic of a person sleeping in a fetal position

On your side in the Fetal Position

Sleeping in the fetal position is excellent if you have a herniated disc.

  • Sit on the edge of the side of your bed.
  • Pivot your body, so your legs are on the bed, and you’re now sitting.
  • Lean yourself back, so the backside of your body is now touching the mattress.
  • Roll over slowly onto your side.
  • Bend your knees toward your chest and bring your torso to a curled position.
  • Be sure to switch sides periodically.

How this helps: Herniation is a painful condition that occurs when disks in the spine come out of their usual place. Herniated disks can cause nerve pain, weakness, and more.

By curling your body in the fetal position, you open space between vertebrae. This position helps the herniated disk(s) go back into place. You can add a leg pillow for lower back pain if experiencing chronic back pain.

A graphic of a man sleeping on his stomach

On Your Stomach with a Pillow Under Your Abdomen

Sleeping on your stomach is considered to be one of the worse ways to sleep with lower back pain if done improperly. However, if you can’t sleep in any other position, use these steps:

  • Sit on the edge of the side of your bed.
  • Place a pillow where your stomach will be. 
  • Pivot your body so your legs are now on the bed, lean back, so your backside touches the mattress.
  • Slowly rotate your body until your frontside is touching the mattress and your stomach is on the pillow.

How this helps: This position is most beneficial to those with degenerative disc disease. It may relieve any pressure placed on the space between discs.

Be cautious with this sleep position. Without the pillow placement, your back doesn't get the needed support. This can cause more back pain when lying down. Sleeping pillows for back pain provide that needed support to ease back pain and promote healing.

A man sleeping in bed with a pillow under his knees

On Your Back with a Pillow Under Your Knees

Sleeping on your back is most recommended since it’s considered the healthiest position.

  • Sit on the edge of the side of your bed.
  • Place a pillow on the bed where your knees will be.
  • Pivot your body, so your legs are now on the bed. Lean back, so your backside is touching the mattress.
  • Adjust the pillow so it’s under your knees and in a comfortable position.
  • Placing a rolled-up towel under your lower back is an added option for more support.

How this helps: Sleeping on your back is considered the best sleeping position because it promotes even weight distribution across the broadest part of your body. The pillow keeps your spine neutral and keeps a curve in your lower back. When in this position, your head, neck, and spine are neutralized, and pressure is reduced.

A woman laying on her back in bed on a wedge pillow

On Your Back in a Reclined Position

Investing in a reclining bed or wedge pillow can help when sleeping in this position. While this may not be best for back pain, it is helpful if you have isthmic spondylolisthesis.

How this helps: Isthmic spondylolisthesis is a condition that occurs when a vertebra slips over the vertebra below it. Placing yourself in a reclining position creates an angle between your thighs and trunk. This position reduces pressure on the spine. 

Sleep Aids and Back Pain Products Worth Trying

The right sleep aid can make a significant difference in your sleep quality. Sleep products can help improve your posture, provide instant back pain relief, and reduce insomnia. We’ve compiled a list of sleep devices and back pain relief products to offer the best way to sleep with back pain.

A wedge pillow on a bed

Orthopedic Pillows

Have you ever wondered why we use pillows when sleeping? They provide the needed head and neck support for the upper portion of your spine. Surprisingly, no pillow suits every person. Having the proper pillow that meets your specific needs is vital to healthy sleep.

We’ve broken down various types of pillows for back pain by sleep position to aid in your decision. While we’re on this topic, don’t forget to change your pillow every 18 months. While pillow protectors are suitable barriers, pillows can still hold things like mold and dust mites that trigger allergies.

If you Sleep on Your Back

Thinner pillows are ideal for back sleepers. Pillows with extra padding at the bottom offer neck support for better alignment. When it comes to materials, memory foam is perfect as it molds to your neck.

Another option is a water pillow. These specialized pillows provide firm support for both your neck and head.

An additional option for back sleepers is wedge pillows for back pain. These are triangular-shaped pillows that allow you to sleep in a reclined position. They can also elevate your legs and promote circulation and alignment of the neck, shoulders, and hips. These could be considered the best pillows for back pain given how universal they are in relieving lower, middle, and upper back pain.

Semi roll cushions or cervical pillows are great orthopedic pillows for back pain. They can provide support for your knees, lower back, and neck. You can place them under your knees for leg support, under your lower back for lower back support, and under your neck for neck support.

A great way to use a cervical pillow is to place it under your back and slowly slide yourself up and down. This exercise can help align your back and reduce pain. Knee pillows for back pain are great as they help align your spine and reduce pressure on the lower back.

A close up of a knee pillow between a woman’s legs

If you Sleep on Your Stomach

While this position is the worst position to sleep in, you may not be capable of sleeping in any other position. If that’s the case, try to aim for the thinnest pillow possible.

An alternative to try is using a body pillow to sleep on your side. The pillow will mimic having something against your stomach while the rest of your body becomes aligned. This position can put a strain on your back. Adding proper support is essential to prevent further pain.

If you Sleep on Your Side

Side sleepers should try to aim for a firm pillow. If you’re looking for even more comfort, a pillow with an extra-wide gusset will reduce the space between your ear and shoulder. Also, don’t forget to add a firm pillow between your knees.

A rolled towel can be used as a substitute. Creating alignment throughout your entire body should be your primary focus. Body pillows for back pain can also be excellent for natural back pain relief. They aid in aligning your spine and offer ample back support for the avid side sleeper.

Knee pillow for side sleepers
A mans hands lifting up a mattress

Mattresses

We often take our mattresses for granted. After all, we spend a lot of time on them. Sleeping on the proper mattress is a significant necessity, especially if you suffer from back muscle pain. But no mattress for back pain is the same.

Your mattress purchase may even be different than that of someone with the same type of back pain. Your mattress, because of the support it provides, may be considered the ultimate back pain relief machine. To help, use these tips to make the right mattress choice:

Your Focus Should be on Good Sleep Posture

Having good sleep posture is vital to reducing back pain. Good sleep posture keeps your spine aligned, allowing muscles and ligaments to relax and recover while you sleep. Focus on a mattress that offers adequate support for you.

A "Firm" Mattress isn't Always Best

When it comes to back pain, a major misconception is a firm mattress is best. There is no data or studies to support this. One study involving 300 people with lower back pain found that those using a “medium-firm” mattress had the least amount of discomfort than those using a “firm” mattress for 90 days. If you have trouble deciding, go with a “medium-firm” mattress.

Take Your Time Deciding

Finding the right mattress can take time. If you sleep on a friend’s or a hotel mattress and wake up pain-free, be sure to get the mattress’s model number. Another option is to purchase a mattress with a money-back guarantee. It’s become common for companies to offer free refunds on returns from 30 to 100 days.

Don't Stick with Your Old Mattress too Long

A study of 62 people sleeping on new mattresses for 28 days found all participants had slept better, regardless of the mattress. Researchers found the average age of participant's old mattresses was 9.2 years. The key takeaway? Make sure you change your mattress if you've had it for 9+ years.

Price Matters: Avoid Cheap Mattresses if Possible

While it can be painful to spend a large amount of money on a mattress, it can make a significant difference. The same study mentioned earlier found that people who slept in cheaper beds had increased lower back pain than those sleeping in medium to high-priced beds. If your back pain is intense, consider a higher-priced bed.

Consider Different Mattress Materials

We live in a day in age where traditional spring mattresses aren’t the only options. Other types of mattress materials include memory foam and latex, airbeds, and hybrids that use a combination of materials. It might be worth stopping by a mattress store to try out the materials available. 

When it Comes to Firmness, Your Sleeping Position Matters

Good sleep posture is essential, but having a mattress that accents your sleep position is vital too.

  • Side sleepers need a softer mattress with a range of 5.5 to 6.5 firmness rating.
  • Back sleepers should aim for a solid medium-firm mattress in the 6 to 7 firmness range.
  • Stomach sleepers need more support, thus require a firmer mattress with a 6.5 to 7.5 firmness range.
A man with upper and lower back pain

Pain Management Products

Using a pain relief product before bed can keep your pain at bay so you can get quality shut-eye. Below, we’ve compiled drug-free pain relief options that are proven to reduce back pain. Use these each night or during the day to keep back pain levels low.

A TENS unit with its accessories

TENS Units

TENS units for back pain relief are at #1 in this guide because of their proven effectiveness, affordability, and ease of use. TENS units work by blocking pain receptors in the treatment area, so you don’t feel pain. Users can target the area in pain using electrodes they stick around the area. They then turn the TENS device on, which delivers electrical impulses to the electrodes.

Another advantage of TENS units is that treatments are customizable. All of the TENS units we carry give users the ability to control the intensity, pulse rate & duration, and timer. The pain relief you can get can also last a few hours, getting you through the night. TENS units can be used as often as needed, with little risk of side effects.

A woman holding a hot/cold wrap on her back

Hot & Cold Therapy

Hot and cold therapy is by far one of the most common methods of pain relief. If your back pain stems from muscle or joint damage, this treatment may help. When it comes to deciding which is best, try to follow these best practices:

Hot Therapy for Back Pain
  • Heat therapy is better for chronic muscle and joint pain from arthritis.
  • Moist heat therapy is 4x quicker in reducing pain than dry heat (2 hours in contrast to 8 hours of dry heat.
  • Dry heat is safer to use for more extended periods.
Cold Therapy for Back Pain
  • Effective in reducing inflammation and numbing pain by decreasing blood flow.
  • Most helpful in treating recent joint or muscle injuries when applied within 48 hours.

Heat or cold for back pain? When it comes to selecting ice or heat for back pain, the answer is both. Both hot and cold therapy can be used in unison to relieve muscle aches and pains. Some of the best back pain relief products double as both, being placed in the freezer for a cold compress and microwave for a hot compress.

Use cold to reduce inflammation and any pain. Use heat to improve blood circulation and promote healing.

A red light therapy device with its lights on

Red Light Therapy for Back Pain

Red light therapy is a safe and effective method of back pain relief. Red light therapy products use low-levels of red light to penetrate deep into the skin, muscles, joints, and even bones. When exposed to red light therapy, our cells get a significant energy boost. This makes them much more efficient in healing and reducing back pain.

Red light therapy is generally safe with few side effects. It can be used up to three times per day per target area.

A study conducted on patients with chronic lower back pain resulted in the mean pain score dropping from 6.9 of 10 to 3 of 10 after using red light therapy. The placebo group saw a drop from 7.4 of 10 to 6 of 10. Thus, proving the effectiveness of red/infrared light therapy for back pain.

Packaging for kinesiology tape

Kinesiology Tape

As we’ve mentioned before, having proper back support is vital to reducing pain. This is why we’ve included kinesiology tape, a specialized type of type most commonly used by athletes. Kinesiology tape is effective in pain relief as it stabilizes and supports muscles and joints. It differs from athletic tape and braces as it is much more flexible, giving you more range of motion and comfort.

Many believe kinesiology tape is useful for compressing and decompressing skin. This stimulates the release of enkephalin and blocks pain pathways in the injured area. Many believe it also creates space between the skin and joints. This reduces pressure and improves blood flow and lymphatic circulation.

Another reason kinesiology tape works for back pain is its thought to retrain muscles and joints, so they perform optimally. This is why many athletes use this type of tape while training and playing.

A man with a pillow against his head

Sleep Hygiene Best Practices and Tips

Sleep hygiene will always be at the core of how to relieve back pain. Having poor sleep hygiene is proven to negatively affect both mental and physical health, including your back. These sleep tips offer some guidance and best practices on how to treat back pain, improve sleep, and enhance your overall quality of life. Combine these with the mentioned natural remedies for back pain, and you'll be on your way to a painless sleep.

Focus on Your Alignment

Regardless of the position you choose, having your spine aligned is the biggest key. Be sure you focus on keeping your ears, shoulders, and hips aligned. Keep gaps between you and the mattress at a minimum by adding pillows. Try to sleep on your back, given that's the most proper way to sleep.

Move with Caution when Switching Positions

Misalignment can occur from twisting and turning. Ensure you move your entire body together by keeping a tight and pulled-in core. Pull your knees to your chest when rolling over.

Avoid Caffiene After Noon

Caffeine is the enemy of a good night’s sleep. If it doesn’t keep you awake, it will prevent you from going through the essential stages of sleep. Thus, you’ll wake up as if you didn’t get a full eight hours.

Use Pain Management Before Bed and Throughout the Day

Don’t let the pain come for you in the night. Ensure you try to reduce your pain before bed so it is diminished and doesn’t keep you up.

Stick to Your Sleep Routine, Even if You don't Sleep Well

It’s very tempting to hit snooze after a rough night’s sleep. Don’t do it! You must stick to your sleep schedule, so your circadian rhythm stays intact.

Try Yoga or Stretching Before Bed

Stretching or yoga for back pain can do wonders for mild and severe back pain. Stretching your back muscles improves blood flow, prevents further injury, and can aid in rehabilitating your back to healthy conditions.

Don't Exercise Close to Bed

While exercise can reduce back pain and strengthen muscles, doing it too close to bed can inhibit sleep. Exercising late in the day risks having too much adrenaline to sleep well.

Be Careful When Getting Out of Bed

Moving too quickly or carelessly may aggravate the pain even more. Roll over on one side and use your arms to push up. Then swing your legs out and slowly get out of the bed. Reverse this movement when getting back in.

Work on Strengthening Your Core

This reduces any stress put on your back and the chances of experiencing muscle spasms while sleeping. Stronger muscles are more capable of bearing the weight of daily activities, thus reducing reinjury chances.

Back pain can have many adverse effects on your sleep, mental, and physical health. But if you apply these methods on how to heal back pain into your nightly sleep routine, you can minimize the effect pain has on your quality of life. If you’re curious to learn more about pain management and sleep, check out these other great resources:

About the Author

Head shot for Brandon Landgraf

Brandon Landgraf is the Digital Marketing Manager for Carex Health Brands. He finds passion and fulfillment in creating content that enhances, improves, and enlivens others' quality of life. All of his written work is formulated to not only offer essential advice and tips but back it with proven studies and experts. His mission is to connect with readers and provide steps to make their lives better.

About Carex Health Brands

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Carex is your one-stop shop for home medical equipment and for products that assist caregivers with providing the best possible support and care for their loved ones. Carex Health Brands has been the branded leader in in-home, self-care medical products for over 35 years. Our goal is to improve the lives of our customers by bring them quality products that bring dignity back to their lives. With our three nationally distributed brands, Carex Health Brands serves national, regional and independent food, drug and mass retailers along with wholesalers, distributors and medical dealers.

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