Best Sleeping Positions for Neck Pain and Lower Back Pain

If you wake up with neck stiffness, back pain, or headaches, your sleeping position may be part of the problem.

You spend roughly one-third of your life sleeping, and how your spine is positioned during those hours has a real impact on pain, recovery, and long-term spine health.

Let’s walk through the best and worst sleeping positions for your neck and back—and why they matter.

Why Sleeping Position Matters

Your spine has natural curves:

The neck (cervical spine) curves inward
The upper back (thoracic spine) curves outward
The lower back (lumbar spine) curves inward

The goal during sleep is to support these natural curves, not flatten them or exaggerate them. Poor positioning can lead to:

Muscle strain
Joint irritation
Disc pressure
Nerve compression

Over time, this can contribute to chronic neck or back pain.

✅ Best Sleeping Positions

1. Sleeping on Your Back (Best Overall)

Why it helps

Keeps the spine in a neutral position
Evenly distributes body weight
Minimizes pressure on discs and joints

How to optimize it

Use a pillow that supports the natural curve of your neck (not too high)
Place a small pillow or rolled towel under your knees to reduce stress on your lower back

Best for

Neck pain
Low back pain
Disc-related issues

2. Sleeping on Your Side (Very Good Option)

Why it helps

Keeps the spine aligned when done correctly
Reduces pressure on the lower back

How to optimize it

Use a pillow that keeps your neck level with your spine
Place a pillow between your knees to prevent spinal rotation
Keep ears, shoulders, and hips in a straight line

Best for

Lower back pain
Pregnancy
Snoring or sleep apnea

3. Side Sleeping in a Fetal Position (Helpful for Some)

Why it can help

Slight flexion may reduce pressure on certain spinal structures
Can be comfortable for people with spine arthritis.

Important caveat

Avoid curling too tightly
Excessive flexion can worsen neck stiffness

🚫 Sleeping Positions That Often Cause Problems

1. Sleeping on Your Stomach (Worst for Most People)

Why it’s problematic

Forces your neck into rotation for hours
Increases stress on the lower back
Flattens the natural spinal curves

If you must sleep on your stomach:

Use a very thin pillow or none at all
Place a pillow under your pelvis to reduce lumbar strain

2. Side Sleeping Without Knee Support

Without a pillow between the knees:

The top leg rotates the pelvis
The spine twists overnight
SI joint and low back pain may worsen

What About Pillows and Mattresses?

Neck Pillows

Should support the natural curve of your neck, not push your head forward
Memory foam or cervical pillows can help some people, but there’s no single “best” pillow for everyone
Read my post on picking a pillow.

Mattresses

Medium-firm mattresses tend to work best for most people
Too soft → poor spinal support
Too firm → pressure points and muscle tension

Comfort and support matter.

Why Pain Can Still Happen—Even With “Good” Sleep Positions

If pain persists despite good sleep habits, there may be:

Underlying joint or disc issues
Muscle imbalances
Nerve irritation
Inflammatory conditions (such as Ankylosing Spondylitis)

Sleeping position helps—but it’s rarely the only factor.

Key Takeaways

Back sleeping and side sleeping are generally best
Neutral spine alignment is the goal
Pillow placement matters as much as position
Small changes can significantly reduce morning pain

If you wake up stiff every day, your body may be telling you something—and it’s worth listening.

FAQ:

Is sleeping on your side bad for your neck?

Side sleeping is not bad for your neck if your pillow keeps your head level with your spine. A pillow that’s too thin or too thick can cause neck strain overnight.

What is the best pillow for neck pain?

There’s no single best pillow, but the ideal pillow:

Supports the natural curve of your neck
Keeps your head aligned with your spine
Matches your sleeping position (back vs side)
Read my post on this here.

Is it okay to sleep on your stomach if I have back pain?

For most people, stomach sleeping increases neck and low back strain. If you can’t avoid it, use a very thin pillow and place a pillow under your pelvis to reduce lumbar stress.

Why do I wake up with neck or back pain even on a good mattress?

Pain can persist due to:

Muscle tension
Joint inflammation
Disc or nerve irritation
Poor pillow support
A mattress helps, but position and alignment matter just as much.

How long does it take for changing sleep position to help pain?

Some people notice improvement in a few nights, while others need 2–3 weeks for muscles and joints to adapt.

Best Sleeping Positions for Neck Pain and Lower Back Pain

Why Sleeping Position Matters