How To Sleep With Lower Back Pain, According to Experts

If your lower back pain is chronic, you might want to look into getting an adjustable mattress. “Sleeping on an adjustable [mattress] that allows the head or feet to be elevated can significantly reduce back pain by up to 45% and improve perceived sleep quality and restfulness,” Dr. Breus says.

5 tips for how to sleep with lower back pain

It may seem obvious, but when it comes to the best sleep position for lower back pain, Dr. Todd Alamin, MD, an orthopedic surgeon at Stanford Medicine, says to sleep in the position that’s least painful. “Our bodies are programmed to figure out what’s comfortable. The reason why we have pain is essentially to tell us that we’re doing something wrong,” he says.

Can’t get comfortable? Below are the five tips to try.

1. Sleep on your side

All three doctors say that most people with lower back pain find sleeping on their side the most comfortable. According to a 2025 review published in Musculoskeletal Care, side sleeping is best for spinal health and can help prevent or reduce lower back pain.

While sleeping on your side, Dr. Morris recommends putting a pillow between your knees to promote hip and pelvis alignment. Doing this keeps the spine, hips, and pelvis all aligned in a neutral position. “It reduces pressure and pull on the lower back,” Dr. Breus adds.

2. Sleep on your back with a pillow under your knees

If you normally sleep on your back, trying to sleep on your side might not feel all that comfortable. Instead of forcing yourself to morph into a side sleeper, Dr. Alamin says to sleep on your back with a pillow under your knees. “This allows the hips to flex up a bit,” he says, explaining that this alleviates some of the pressure on the lower back.

3. Sleep on your back with a small pillow under your lower back

Another way to sleep on your back that Dr. Morris says many people with lower back pain find comfortable is placing a small pillow under the small of your back. “You don’t want to be too aggressive [and use a big pillow], but placing a small pillow under the small of your back can help alleviate some stress in your back while you’re sleeping,” he says.

4. Avoid sleeping on your stomach

Hands-down, stomach sleeping is the worst position if you have lower back pain, according to Dr. Breus. “Stomach [sleeping] offers the least support for the lower back and is not recommended for individuals with chronic low back pain. Lying on the stomach increases lumbar lordosis, which is the inward curve of the lower back,” he says.