The right sleeping position, mattress, posture, and activity level can all help you get a good night’s sleep, even with lower back pain. Developing healthy habits throughout the day and at bedtime can create the optimal conditions for proper rest.

Healthy Habits for a Good Night’s Sleep

The average adult needs between seven and nine hours of sleep each night, but preparing for a good night’s sleep begins as soon as you open your eyes in the morning.

The same spinal objective during sleep applies to waking hours. Keep the spine neutral and avoid twisting motions as much as you can. When you move, use your core muscles, legs, and arms instead of your back or neck. For example, when changing positions in bed, keep your body straight and controlled as you move. Press up with your hands to rise and move slowly and gently.

Good posture during the day can alleviate lower back pain and contribute to better rest at night. Maintain awareness of your body’s alignment while sitting as well, and keep your head, shoulders, and hips in a vertical line. When sitting for extended periods, be sure to get up and move around every 20-30 minutes. Inactivity can lead to stiffness, soreness, and loss of flexibility. Stretching can increase strength and flexibility and work to prevent lower back pain.

Creating a bedtime routine to address your environment, pain, and stress level can create optimal conditions for a good night’s sleep. The National Sleep Foundation found that people who experience pain are “more likely than others to say environmental factors make it more difficult for them to get a good night’s sleep” (“Pain And Sleep”). Before bed each night, adjust the light, ambient noise, and temperature to create a sleep-inducing atmosphere.

Pain and stress management are also enormously beneficial to a good night’s sleep. Applying heat to the lower back before bed can aid injured tissue, decrease stiffness, and relieve discomfort. Stress can be a source of back pain in itself, but can also cause sleeping difficulties on its own. Managing stress throughout the day by staying active, stretching, and taking the time to breathe will help prime your body for a good night’s rest.

Sleeping Positions for Lower Back Pain

Both back and side sleeping are recommended to help alleviate back pain, but stomach sleeping should be avoided if possible. Nevertheless, finding the most comfortable position for your body is most important. To properly support your spine and keep it in a neutral position, use pillows to prop up your legs, pelvis, or back.

If you are a side sleeper, tuck a pillow between your legs to keep the weight of the top leg from twisting the spine. If you are missing support between your stomach and the bed, try wrapping a rolled towel around your waist to fill the gap. Body pillows can also be helpful for side sleepers.

Back sleepers can place a pillow under their knees to keep the weight of the legs from arching the back. If there is not enough support for your lower back in this position, you may place a rolled towel underneath the small of your back.

While stomach sleeping is not recommended for people with lower back pain, if it is the most comfortable position for you, you may place a pillow under the lower abdomen and pelvis to keep your spine aligned. You may or may not use a pillow under the head to keep the neck in line with the rest of the body.

The Best Mattress for Your Back

Selecting the best mattress is similar to choosing the right sleeping position: it boils down to your preference. Firmness and material are the two primary options to consider.

Though firm mattresses are often the initial recommendation for back pain sufferers, a 2003 study testing the pain relief benefits of different medium and firm mattresses concluded that “medium firmness improves pain and disability among patients with chronic non-specific low-back pain” (Kovacs, Francisco et al.). Many people with back pain find firmer surfaces to provide the support they need, but body type is important to consider as well. People with wide hips may feel more relief with a softer surface, as this will allow the body to fall into alignment, while people with narrow hips will benefit from a firmer surface.

Your mattress should support your shoulders, buttocks, and heels to ensure their proper alignment. Consider your pillow as well; it should support your head and neck, keeping them in line with the spine. When choosing which material is best for your body, personal preference reigns. Memory foam, latex, innerspring, air, and adjustable beds are all viable options. According to a Consumer Reports survey in 2016, “people with arthritis, back pain, and neck pain were happiest when they slept on an adjustable air mattress… which lets users precisely control the firmness” (Friedman, Lauren).

As a general rule of thumb, you should consider replacing your mattress every ten years. You may want to reevaluate it after five years or anytime you feel your body’s needs may have changed.

Ultimately, the most important thing a person with lower back pain can do to get a good night’s sleep is make it a priority. Be aware of your body’s alignment during the day and make an effort to maintain good posture. Stay mobile and in tune with your pain and stress levels. Create a relaxing environment that provides the physical support your back needs without applying pressure. Don’t forget to consult with your doctor for more personalized recommendations.