Reducing Back Pain While You Sleep

Chronic pain in the neck or lower back greatly affects how well you sleep, and a lack of sleep can make the pain worse. Break the vicious cycle with these tips for getting a good night’s rest.

Numerous studies show that chronic pain in the neck or lower back significantly affects how well you sleep. And a growing body of evidence also shows that lack of sleep worsens pain. Good sleeping posture, like good standing posture, allows the body to follow the natural S-shaped curve of the spine. By contrast, poor sleeping positions can strain muscles and ligaments and increase the risk of having a compressed nerve and back pain. Your mattress affects your sleeping posture.

One study1 found that people with chronic back pain who slept on a medium-firm mattress had less pain and disability than those who slept on a firm mattress. This goes against the common belief that a hard mattress is better for the back.

  • A mattress is deemed “good” if it supports the natural curves of your body, particularly the spine and knees2.
  • A mattress that is too hard will create gaps between it and your body.
  • The result is pressure points that restrict circulation and interfere with sleep by causing the sleeper to move around to restore circulation.
  • Also, beware of an extra-soft mattress.
  • While it may feel plush, a mattress that is too soft may not give your back the support it needs.
  • The bottom line for a good mattress is comfort.

While mattresses wear out at different rates, the Better Sleep Council suggests you may need a new mattress if:

  • You wake up with stiffness, numbness, aches, and pains
  • You had a better night’s sleep somewhere other than your own bed (such as a hotel)
  • Your mattress shows visible signs of overuse (it sags, has lumps, the interior is exposed)

In general, a mattress set that has been in use for five to seven years may no longer provide you with the best comfort and support, says the Better Sleep Council. Keep in mind that people’s bodies change over time, and the need for good comfort and support only increases with age.

Here are some tips for finding a mattress that is right for you.

  • Be sure your mattress supports your lower back and, to some degree, conforms to your body.
  • Always “rest test” a bed before buying it—lie down and stretch out to see how it feels. Get into the position you normally sleep in and make sure your body feels supported and comfortable. Experts recommend that you spend anywhere between five and 20 minutes testing the mattress. Some companies will let you try out a mattress at home for free. Even if you need to pay for this option, it could be money well spent.
  • If your mattress is in good shape but is too hard, a layer of foam or a feather bed on top may solve the problem.
  • If you share a bed, you and your partner should try the mattress together to make sure there is enough room for both of you. A queen or king-size mattress is recommended for two people.

Don’t forget your pillow

Lying in certain positions while you sleep can alter the back’s alignment. For example, sleeping on your stomach puts stress on your neck and exaggerates the curve of the lower back.


  • A better choice that helps maintain the natural curves of your spine is to sleep on your side with your knees bent and a pillow placed between them (illustration A).
  • Another option is to sleep on your back, but keep your knees slightly raised by placing a pillow underneath them (illustration B). This prevents your lower back from overarching by supporting the weight of your extended legs.
  • If you can’t break the habit of sleeping on your stomach, place a pillow underneath your abdomen to keep your spine aligned (illustration C).



  1. Francisco Kovacs. The Lancet, November, 2003.
  2. Better Sleep Council (a manufacturer’s group).