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Posture for Sleeping: What Position Should You Sleep in for Back Pain?

Updated: May 30, 2020

The average person spends 26 years of their life sleeping. Does that position matter? You bet it does!

Why does your sleeping position cause back pain?

Consider the image below. Unless your mattress is just right (and it rarely is), sleeping on your side will cause your spine to be asymmetrical all night long. This leads to imbalanced muscles and fascia, compensation patterns, and chronic tension or pain.

Side-sleeping is most associated with low back pain and hip pain.

Mattress firmness affects spine alignment when you sleep on your side and can cause back pain.

Meanwhile, sleeping on your stomach can cause neck pain, as you twist or over-extend your neck overnight.

Sleeping on your stomach can cause neck and shoulder pain.

Sleeping on your back is generally the safest and most inherently aligned position. In fact, the human spine developed to allow for back sleeping (cat's and dog's spines are too spikey in the back). But it can still cause problems.

If your low back is injured or sensitive, having your legs straight can cause hyperlordosis (excessive curvature in the low back). This is uncomfortable and creates low back pain or bad posture in the morning.

If you have plantar fasciitis, back sleeping puts your feet in plantarflexion, and when the plantar fascia cools there overnight, it's liable to tear and re-injure in the morning.

So what can you do about it?

Sleep better and prevent pain with pillows.

I absolutely love this guide by Dr. Jo, physical therapist. She covers everything you need to know to successfully sleep on your back, side, or stomach while staying aligned and healthy.

Hint: if you’re sleeping on your side, you need four pillows!

Proper Sleeping Position Tips - Ask Doctor Jo [7:59]

Sleeping posture is something I often discuss with my patients who have neck, upper back, or low back pain. I've heard lots of success stories from side-sleepers who have minimized their low back pain by adding a waist pillow to their bed.

Some people doubt they can use pillow systems like this because they toss and turn all night... but like Dr. Jo says in her video, when you’re properly supported, you will sleep better and won’t need to move around as much. That restlessness is often your body trying to be comfortable and failing.

Adding a pillow to your bed can make all the difference in your posture and chronic pain. If your stiffness, tension, and pain are worse in the morning, this might be exactly what you need.

When the solution is this easy, why not try it?


Jesse Martel is a Licensed Massage Therapist who practices in Seattle, Washington. She has helped many people overcome neck/shoulder injuries and chronic back pain with Upgraded Myofascial Release massage. Treatment includes Aromatherapy, Myofascial Release, Cupping, Lymphatic Drainage, and Kinesiology Tape at one flat rate. Her website is



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