How to Avoid Back Pain While Sleeping

January 16, 2023


Joshua Abrams is a fellowship-trained and board-certified orthopedic spine surgeon who employs new cutting-edge techniques to minimize post-surgical pain and optimize patients’ experience.



Back pain is incredibly common, affecting 8 out of 10 people during their lives. Many factors can contribute to a sore and achy back, but sleep and back discomfort are especially linked. From your sleep position to the mattress and pillow you use, your slumber habits play a significant role in your spine and neck health.

If you’re looking for ways to relieve nighttime back pain, we’ve created this comprehensive guide that outlines the best sleeping positions, exercises, stretches and other remedies. Explore the most effective tips and practices to resolve pain in your upper or lower back while sleeping.

Causes of Nocturnal Back Pain

Back pain while sleeping at night can arise from numerous factors, from your regular sleeping position to an underlying medical condition. Here are some reasons you might be experiencing back pain.

1. Sleeping Positions

Unsupportive sleep positions are among the biggest culprits of back pain, as they put immense pressure on your spine. For instance, sleeping on your stomach makes it easier to twist your neck out of alignment with the rest of your spine. Your lower abdomen could also sink deeper than the rest of your spine and misalign your back, depending on your mattress’s firmness.

2. Bad Mattress

While a proper sleeping position is important, it’s only as good as the mattress beneath it. Experts recommend replacing your mattress every 6-8 years or whenever you notice the following characteristics:

  • Your mattress appears saggy and damaged.
  • Your matress negatively affects your sleep.
  • Your mattress makes more noise than usual.
  • You sleep better in other environments.
  • You consistently wake up with joint or muscle stiffness.
  • You notice an increase in allergies or asthma.

If you’re regularly sleeping on an old, unsupported mattress, it could be contributing to your back pain. Even a newer mattress can lead to back discomfort if it’s too soft or firm to support your sleeping position.

3. Pregnancy

Back pain is common during pregnancy. It’s estimated that over half of all pregnant women experience some level of back discomfort. During pregnancy, your ligaments stretch and soften naturally to prepare you for labor. This process can strain the joints in your pelvis and lower back, causing pain. 

Other factors like changes in the center of gravity, hormones and posture can also evoke discomfort. As your uterus expands and becomes heavier, it alters your center of gravity, making it more of a challenge to maintain balance. 

Weakened stomach muscles and the weight of the baby can pull your lower spine forward, straining the back muscles further. This can trigger an awkward leaning-back posture, elevating pain and strain.

Regular stretching and applying a warm compress on your back can provide pain relief during pregnancy. Medical professionals recommend sleeping on the left side with your knees bent, as it helps reduce discomfort. 

You can also place pillows between your legs, below your abdomen and against the small of your back to relieve back pain when lying down. Back discomfort tends to subside naturally after childbirth.

4. Disc Degeneration

Degenerative disc disease occurs when your spinal structures deteriorate naturally with age. It can also develop from repetitive motion or spinal trauma. Smokers, overweight individuals and people who perform heavy manual labor are often susceptible to degenerative disc disease.

Disc degeneration can lead to multiple intervertebral disc conditions like fragmentation, herniation and cushioning loss. Some common symptoms include the following:

  • Lower back pain, spasms, numbness or tightness
  • Tingling, numbness or weakness in the arms or legs
  • Sciatic pain that spreads into the thighs, buttocks or feet

Degenerative disc disease treatment usually starts with nonsurgical methods such as: 

  • Physical therapy.
  • Cold or heat therapy.
  • Anti-inflammatory medications.
  • Therapeutic pain injections.
  • Wearing a back brace.

If back pain and other symptoms persist despite nonsurgical techniques, your doctor may recommend minimally invasive spine surgery or endoscopic spine surgery.

5. Fibromyalgia

Fibromyalgia is a condition causing pain, stiffness and tenderness throughout the body, including the back. It can also cause a variety of other symptoms, including:

  • Problems with memory and concentration.
  • Tiredness and fatigue.
  • Anxiety and depression.
  • Difficulty sleeping.
  • Numbness or tingling in the hands and feet.
  • Headaches and migraines.
  • Face or jaw pain.
  • Digestive issues like constipation, bloating, abdominal pain and irritable bowel syndrome (IBS).

Fibromyalgia commonly affects women, middle-aged individuals and those with rheumatoid arthritis (RA) and lupus. People who have experienced traumatic or stressful events or repetitive injuries may also be at risk of fibromyalgia. Other possible risk factors include genetics and obesity.

While there isn’t a cure for fibromyalgia, your doctor may prescribe pain relievers and muscle relaxants to reduce discomfort. They may also suggest physical therapy, acupuncture and massaging.

How to Relieve Back Pain While Sleeping

Finding the best position to sleep in or doing some quick stretches before turning in for the night can help alleviate back pain. If you are wondering how to relieve upper or lower back pain while sleeping, consider the techniques below to reduce discomfort and support better rest.

1. Stretch Before Bed

Research shows that stretching can help improve lower back pain, decrease stress and promote better sleep. Try doing some stretches before bed, such as:

  • Plank

    Lie facedown on the floor, aligning your forearms and elbows with your wrists. Lift off the floor and push yourself into your upper back, keeping your chin close to your neck. Crunch your abs tightly and hold this position for about 30 seconds. Contract your thighs and glutes as well. Lower your body and repeat if desired.

  • Mini-cobra

    Lie on your stomach with your palms on the floor below your shoulders and your forearms and elbows close to the body. Slowly push yourself up with your arms, keeping your neck straight and your head facing forward. Hold for 10-15 seconds, then repeat if desired. 

  • Knee bends

    Squat down like you’re trying to sit back in a chair. Bend your knees at a 90-degree angle and ensure they don’t stick out past your toes. Exhale as you bend down, then inhale as you return to a standing position. Repeat about 10 times.

2. Exercise Throughout the Day

Daily physical activity is also essential for managing back pain. Anything that gets you on your feet and keeps you moving — like walking, swimming or biking — is great for back health and sleep quality. Try to avoid exercises that involve frequent twisting or putting pressure on the spinal discs, like crunches, golf, running or lifting heavy weights.

If you have an office job that involves extended sitting periods, remember to take regular breaks. Stand up and stretch at least once every 30 minutes. A standing desk can also help alleviate pressure on your back during the workday.

3. Consider Over-the-Counter (OTC) Medications

OTC pain relievers like aspirin, Tylenol, Motrin or Advil can be effective for short-term back pain relief, as well as helping you develop a consistent sleep pattern. Many of these medications come in a “PM” version with special medicines to help you sleep.

Prescription sedatives like zolpidem, suvorexant, eszopiclone and zaleplon can also help you develop a normal sleep routine. Only use these medications as part of a comprehensive treatment plan and under your doctor’s guidance.

4. Try Topical Remedies

Topical remedies like turmeric or peppermint essential oils may help relieve your nocturnal back pain. Remember to dilute them with olive or jojoba oil so they don’t irritate your skin.

5. Change Sleeping Positions

As mentioned previously, your body’s placement may be contributing to your back pain during sleep. You might need to adjust your sleeping position to promote better slumber through the night.

If you’re wondering how to sleep for better posture and less back pain, here are the best practices for each sleeping position:

  • Stomach

    If you prefer to sleep on your stomach, consider forgoing a head pillow and placing a thin pillow under your abdomen. This may help prevent misalignment. However, you can put a pillow beneath your head if it doesn’t put excessive strain on your back.

  • Back

    Back sleeping can help keep the spine straight, but pain can still emerge if you don’t properly support the spine’s curvature. Try placing a pillow beneath your knees to prevent this risk. You can also support your neck with a pillow and place a small, rolled towel beneath the small of your back for extra support.

  • Side

    Laying on your side is considered the best way to sleep for back pain. Those who sleep on their side typically experience fewer back pain symptoms. When sleeping on your side, try placing a small or full-length body pillow between your legs and bringing them up slightly toward your chest in a fetal position.

6. Invest in a New Mattress and Pillows

Traditionally, many doctors recommended firm mattresses to support better back health. However, a study found that those with lower back pain had the lowest sleep quality when using hard mattresses.

Overly soft mattresses can also be troublesome. A soft mattress that accommodates your body’s natural curves may support joint alignment, but in some cases, you might sink in too deeply. This can cause painful, twisted joints.

Your mattress shouldn’t be too soft or too firm. Research suggests that medium-firm mattresses are best for lower back pain. Latex and memory foam mattresses can also be effective choices. They conform to your body and cradle pressure points, helping support and align your spine.

Similarly, an unsupportive pillow can induce unwanted neck and back pain. Stomach sleepers often prefer thinner pillows to avoid contorting their necks. Meanwhile, side and back sleepers can tolerate thicker pillows as long as their spines remain neutral.

Ultimately, researching and trying out different mattresses and pillows is the best way to determine the ideal types, thicknesses and brands for your back pain. You can go to a mattress showroom and test different models, but remember that what feels comfortable momentarily doesn’t always indicate a good night’s sleep. 

Observing how you feel after using different pillows and mattresses in hotels, other people’s houses or other environments away from home is often a more reliable method. 

You can also try placing a plywood board below your mattress to suppress bedspring movement or place your mattress on the floor. These strategies can help you determine whether a firmer mattress would feel more comfortable than your current one.

When to See a Doctor

In most cases, back pain subsides within a few weeks and doesn’t warrant serious concern. However, if your lower, mid or upper back pain while sleeping doesn’t improve with self-care techniques like exercise, topical remedies or changing your sleeping arrangements, it may be time to seek medical care. You should also see a doctor if you’re experiencing the following symptoms:

  • 1. Numbness, Tingling or Weakness

    If weakness, tingling or numbness accompany your back pain, it could indicate nerve irritation or damage. You could have a condition that stimulates nerve pressure, like spinal stenosis or a herniated disc. Nerve pain can cause permanent damage when left untreated, so it’s important to see a doctor when it persists despite OTC pain relievers.

  • 2. Unexplained Weight Loss

    Back pain and unexplained weight loss may suggest a more serious condition, such as:

    • Endocarditis: Endocarditis is an infection of the heart’s inner lining from fungi, bacteria or other germs.
    • Spinal tuberculosis (TB): Spinal TB — or Pott’s disease — is a spinal infection that can cause the vertebrae to collapse.
    • Cancer: While spinal tumors are rare, you should still visit a doctor if you have unexplained weight loss alongside back pain.
  • 3. Fever

    A tight, achy back from the flu isn’t uncommon, but back pain and an unresponsive fever could mean an infection such as meningitis, osteomyelitis or spinal epidural abscess. A spinal infection requires immediate medical care.

  • 4. Chronic or Severe Pain

    You should see a doctor if your back pain continues for over a week. Likewise, you should pursue medical care if the pain is severe, especially when it interrupts sleep or worsens over time. Additionally, back pain that shoots down your leg could indicate a damaged disc.

  • 5. Bladder or Bowel Control Problems

    When paired with bladder or bowel control difficulties, back pain can signify a rare but serious disorder called cauda equina syndrome. This occurs when the lower spinal cord’s nerve roots are compressed and paralyzed, affecting sensory and motor function. It can develop from spinal stenosis, a tumor, a fracture or herniated disc in the lumbar region.

    Cauda equina syndrome is a medical emergency requiring immediate attention. It can result in permanent paralysis when left untreated. Your doctor will need to perform a procedure called surgical decompression to reduce pressure and restore nerve function.

Schedule an Appointment at DISC

Knowing how to sleep with upper or lower back pain is important for your overall health and well-being. At Desert Institute for Spine Care (DISC), we specialize in both traditional and minimally invasive spine procedures designed to ease symptoms and restore your lifestyle.

We serve multiple locations in Arizona, including Phoenix and Scottsdale, and treat each patient with cutting-edge surgical techniques and compassionate care. When you schedule an appointment at one of our centers, our team will help you determine the best treatment plan based on your pain levels, symptoms and condition.

Whether you’re experiencing upper, lower or mid back pain while sleeping, our skilled and compassionate team at DISC can assist you. Contact us today to set up an appointment!


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