Back Pain at Night? Try This!

Are you having a difficult time falling asleep or staying asleep at night due to back pain? Many individuals with back pain show a bi-directional relationship with sleep disturbance. This means that having back pain can make it more difficult to get a good night’s sleep – it may be difficult to fall asleep, or you wake up throughout the night with pain when you try to switch positions. It also means that if you are someone who is naturally not a good sleeper, you are at higher risk for developing back pain. Sleep is an incredibly important function for health, and if you are not getting enough hours or the hours spent in bed are disrupted, it heightens activity in the area of the brain responsible for pain generation, and can amplify physical discomfort.


It is best to select a mattress with medium-firm support if you are prone to back pain. This is especially true if you find it more comfortable to sleep on the floor than to sleep on your bed – this is often an indication that the mattress is not offering enough support. Sometimes this is due to the age of the mattress. The lifetime of a mattress is around 10 years, so if you are using a mattress that is older than this, it may be time to consider investing in a new one. While you are shopping for a new mattress, avoid thick pillow tops – this may be counter-intuitive as we associate comfort with cushioning, but your spine will likely respond better to firmness that can support your joints in their natural alignment.

If you sleep with a partner, and you have the space for it, a king size mattress can make all the difference for your sleep quality. We have a tendency to want to sleep away from our partner if they are in close contact, which means for the most part sleeping on one side. With the extra space that a king size mattress allows for, you may find you can comfortably sleep toward or away from you partner, or on your back, providing several options that create more symmetry for the body.

Belly Sleepers

If you are a belly sleeper, now may be a good time to begin training yourself out of that – there are a couple of issues with sleeping on the belly. The first is related to the neck, also known as the cervical spine. When you are sleeping on the belly, in order to be able to breathe comfortably, you much rotate your head drastically to one side. Imagine spending 8 hours in a row checking your blind spot and how stressful this would be for the neck – the same can be said for this sleep position.

The second issue is related to the low back. When we are lying face down, it presses the low back, also known as the lumbar spine, into extension. If you already have joints that are irritated in positions such as back bending (you can test this for yourself from a standing position), it is not going to feel good for your body to have the joint surfaces pushing against one another throughout the night. This is a common reason that people experience back pain at night, and wake feeling stiff and achy.

Sleep Postures to Relieve Back Pain at Night

Try these two sleep postures if you are experiencing back pain at night.

  1. Side lying with a pillow between the knees – this position helps to keep the pelvis in a more neutral alignment. This is particularly true for women. We tend to have wider pelvises than men, which positions the hip joints further apart. When lying on the side, in order for the knees to touch, it places quite a strain on the sacroiliac joints of the pelvis and the soft tissues surrounding the pelvis. Placing a pillow between the knees can help to reduce the pull on these structures. Keep the knees bent here, and exaggerate the knees drawing toward the chest to open up the joints of the low back.

2. On your back, with a pillow underneath the knees – this position helps to take tension out of the posterior chain. When the back is sore, the connective tissue all along the back body can tighten up, and lying flat on the back is like pulling a piece of dental floss taut from both ends. We want to add a bit of slack to the line so there isn’t so much tension. One way we can do that is by introducing a bend in the knees. The use of the pillow allows the knees to be supported in this bent position, which reduces tension in the back body in addition to encouraging more flexion in the lumbar spine, similar to side lying with the knees bent up toward the chest. This opens up the joint spaces in the low back which can help to relieve irritated joints.

I hope you will find these tips useful for getting a good night’s sleep. Interested in learning more about optimizing your rest? Check out this video I created on setting up your space to have a deeper sleep.