How to Sleep with Lower Back Pain

Getting enough sleep is hard on a good night. When you add lower back pain to the mix, sleep becomes exponentially more challenging. Over time, the combination of fragmented sleep and chronic pain can lead to sleep deprivation and really take a toll on your body.

The good news is, while it may be hard, it’s not impossible. Those with chronic low back pain may find some relief (and shut-eye) by changing their sleeping positions, swapping out an old mattress, and making small but important changes to their sleep environment.  

“The relationship between sleep and lower back pain is intricate and has garnered attention in recent research,” says Dr. Jordan Burns. “Optimizing sleep posture and mattress selection plays a pivotal role in managing lower back pain. Choosing a mattress with appropriate support can significantly impact spinal alignment during sleep, contributing to pain relief.”

Types of Lower Back Pain

Back pain can fall into two categories: chronic and acute.Verified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source

Acute low back pain is often the result of a sudden injury or event and typically only lasts for a few days up to a few weeks.

Chronic low back pain typically lasts for three months or longer. In many cases, it can be hard to pinpoint the cause, as it often occurs without an inciting incident. The most common causes of chronic pain in the lower back may be conditions like arthritis of the spine, back injuries, or degenerative disc disease. 

Common Symptoms Of Lower Back Pain 

The most common symptoms of low back pain include:Verified Source World Health Organization (WHO)United Nations agency whose stated goal is to improve the health of all.View source

• Increased pain with activity 
• Pain that travels down to your butt, legs, and feet
• Muscle spasms 
• Persistent low back pain upon waking 

Common Causes of Morning Back Pain 

Bad sleeping positions

A supportive sleeping position can be a make or break when it comes to quality sleep and keeping back pain in check. If lying flat on your back or sleeping on your stomach is what you need for a good night’s sleep, those positions aren’t doing your back any favors. In fact, those sleeping positions aren’t the best for keeping you back in proper alignment. 

“Recent meta-analyses,Verified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source including those published in ‘The Spine Journal,’ emphasize the influence of sleep positions on lower back pain,” Dr. Burns says. “For individuals with existing back issues, adopting a side-sleeping position with adequate pillow support for the knees can reduce spinal strain. These findings underscore the importance of tailoring sleep habits to address and prevent lower back pain.”

Pregnancy

It takes a lot to make a human, but expectant mothers may struggle to get the shut-eye they need from back pain.Verified Source Medline PlusOnline resource offered by the National Library of Medicine and part of the National Institutes of Health.View source Poor sleep and lower back pain are most acute during the second and third trimesters when baby bumps make it almost impossible to get comfortable and fall asleep. The good news is the back pain and sleep disturbances that accompany pregnancy go away after giving birth. 

Your Mattress

Anyone who regularly wakes up with nondescript lower back pain might consider assessing the state of their mattress. Old mattresses may have run their course in terms of the support they offer, and if you’re sleeping on a mattress that’s not appropriate for your preferred sleeping position, lower back pain will always be an issue. 

“Practical adjustments to sleep routines can make a significant difference for those suffering from lower back pain,” says Dr. Burns. “Utilizing a mattress with medium-firm support, combined with strategic pillow placement, promotes a neutral spine position. Additionally, gentle stretching or relaxation techniques before bedtime can help alleviate muscle tension and enhance sleep quality.”

Bad Posture

While most people rarely consider how their daytime habits and activities may affect after their sleep, they can, and they do. More specifically, bad posture when sitting at a desk all day or poor standing posture can really take a toll on your back and spine, with pain worsening enough at night to stymie your sleep. 

Fibromyalgia

Fibromyalgia is a chronic illnessVerified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source that causes widespread pain across the body, physical exhaustion, poor sleep quality, and cognitive impairment in those who suffer from it. Lower back pain is another common symptom of fibromyalgia.  

SEE ALSO: Best Mattress for Fibromyalgia

Disc Degeneration

Degenerative disc disease is an age-related medical conditionVerified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source that often results from normal wear and tear on your body. Essentially, the discs (aka shock absorbers in your spine) wear away or wear down. While some people may experience relatively little pain associated with the condition, others may experience intense and chronic pain (specifically, lower back pain) that worsens in the morning. 

How Are Sleep and Lower Back Pain Related?

Considering sleep and its ergonomics, it’s not hard to see that low back pain and poor sleep are inextricably linked. And you don’t have to take our word for it; study after study has linked the two. One study, in particular, showed that a medium-firm mattress could reduce back pain and improve sleep quality by almost 50 percent.Verified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source

Beyond illustrating the link between back pain and impaired sleep, research also shows that those with sleep disorders are more prone to pain. More specifically, one studyVerified Source Oxford AcademicResearch journal published by Oxford University.View source showed that patients with obstructive sleep apnea (OSA) and chronic pain had more insomnia symptoms and worse sleep quality than those without, while another showed that patients with OSA were more likely to experience fragmented sleep, which in turn was related to increased pain intensity. 

The Best Positions for Low Back Pain

While you might think that one position wins over the other, we found that side sleeping, back sleeping, and the fetal position all have their merits. Ultimately, the most supportive position is the one that affords proper alignment for better sleep. 

Back Sleeping

Back sleeping may be spine-neutral, but if you attempt it without proper support in the form of a firmer mattress for back sleepers, you may be putting undue stress on your lower back.

To keep your back pain in check, try placing a pillow underneath your knees to help you maintain proper spinal alignment and alleviate pressure in the lumbar spine. 

SEE ALSO: Best Pillows for Back Sleepers

Side Sleeping 

With a good mattress for side sleeping that alleviates pressure points, those who sleep on their side may have the best chance of keeping back pain at bay. While you should start with a medium firm mattress that cradles your hips and supports your body’s natural curve, you can further reduce pressure on the lumbar spine by sleeping with a partial bend in the knees or sleeping with a small pillow between your knees.

In a pinch, you can also use a rolled towel to help with alignment. Taking things a step further, sleeping in the fetal position can go a long way towards alleviating any extra stress on your back. 

SEE ALSO: Best Pillows for Side Sleepers

How to Sleep with Lower Back Pain

Beyond adjusting your sleeping position to any as outlined above, you can also take care when getting into and out of bed, upgrade your bedding, and lean into good sleep hygiene. 

Be Mindful of How You Get Out of Bed

While most advice on reducing lower back pain while you sleep is focused on sleep itself, those who regularly suffer from pain should also be mindful of how they get out of bed. 

To get out of bed properly :

• Roll onto your side, keeping your knees together. 
• Push your upper body off the bed as you swing your legs to the floor
• Stand up, lean forward from your hip, and gently roll onto the balls of your feet.

Upgrade Your Mattress and Pillows 

When you’re looking for pain relief, your mattress and pillow combination matters — unfortunately, though, there is no one-and-done answer. The best mattress is always a function of your preferred sleeping position, so that means different things to different people. 

Typically, side sleepers should opt for a mattress with a medium firmness, while back and stomach sleepers should opt for firm mattresses to help maintain spinal alignment and prevent sinking around the hips. Soft mattresses usually don’t provide enough support for your lower body, so most people should steer clear.

While your mattress matters, so too do pillows. Generally, stomach and back sleepers do better with a thin pillow, and those who prefer to sleep on their side should opt for a thicker pillow.

“Choosing the right mattress and pillows is paramount for managing lower back pain during sleep,” says Dr. Burns. “Research in ‘The European Journal of Physical and Rehabilitation Medicine’ suggests that a mattress with individualized support and aresponsive pillowVerified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View sourcefor neck and lumbar support can contribute to a restorative sleep environment. These considerations empower individuals to address and mitigate lower back pain proactively.”

Don’t Sleep on Your Stomach

Stomach sleeping is the most challenging sleeping position to maintain good spinal alignment, and it is exponentially harder to do so without the right mattress. So, if you regularly sleep on your stomach, you might consider making a change for the sake of your back and your sleep. 

Practice Good Sleep Hygiene 

If you inadvertently wake up at night, both your pain and ambient noise and light may prevent you from getting back to sleep. So, before bed, think about prepping your sleep environment to reduce potential sleep disruptions and improve sleep hygiene.

Do your best to eliminate excess noise and light; wear earplugs or a sleep mask if you need to. And set your bedroom temperatureVerified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source between 60 and 67° F.   

When To See Your Doctor 

While the suggestions outlined above won’t take away your back, they can go a long way toward decreasing your discomfort enough to get some sleep. If your low back pain continues to impede your shut-eye, it may be time to see your primary care doctor. Together, you can explore treatment options or rule out more serious issues. 

FAQS

How should I sleep to relieve lower back pain?

To relieve lower back pain during sleep, try sleeping on your side with a pillow between your knees to maintain spinal alignment. Alternatively, sleeping on your back with a pillow under your knees can also help take pressure off your back. Investing in a mattress that provides adequate support and aligns the spine can contribute to better sleep posture and reduced lower back pain.

How do you maintain proper alignment while sleeping?

Achieving proper alignment during sleep involves choosing the right mattress and pillows. Opt for a mattress that supports the natural curve of your spine and promotes even weight distribution. Place a pillow under your head to keep it level with your spine and use additional pillows strategically to support other body areas. Experiment with different sleeping positions and pillow configurations to find what works best for you.

If alignment issues persist, consulting with a sleep specialist or healthcare provider is advisable.

What exercises help lower back pain?

To alleviate lower back pain, consider exercises that strengthen your core muscles, such as pelvic tilts, bridges, and planks. Gentle stretching exercises like cat-cow stretches and knee-to-chest stretches can also help.

However, it’s crucial to consult with a healthcare professional or a physical therapist before starting any exercise routine for personalized guidance.

How do you tell the difference between hip pain and lower back pain?

Differentiating between hip and lower back pain can be challenging as they often share similar symptoms. Generally, hip pain is felt on the outside of the hip and upper thigh, while lower back pain tends to be centralized in the back. If movement aggravates the pain, it’s more likely to be hip-related.

Consulting with a healthcare provider can provide a more accurate diagnosis based on a thorough examination.

What causes lower back pain just above the buttocks?

Lower back pain just above the buttocks may stem from various causes, including muscle strains, ligament sprains, or issues with the sacroiliac joint. Poor posture, herniated discs, or underlying medical conditions can also contribute.

If the pain persists or worsens, seeking professional medical advice is recommended to identify the specific cause and appropriate treatment.

Conclusion

While lower back pain can hinder your sleep, there are things you can do to get back to bed. The best sleeping positions for lower back pain are on your side with a slight bend in the knee or the fetal position. Beyond changing your sleep position, think about investing in a new mattress for better support while you snooze, and finding techniques to make sure your sleep environment is cool, dark, and quiet.