If your back hurts when you wake up, your sleep position likely isn’t supporting your spine. At least 50% of individuals with insomnia - the most commonly diagnosed sleep disorder - suffer from chronic pain.

You can’t control every movement while you sleep, but you can control how you set yourself up.

Here’s how to reduce strain tonight.

 

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Best Sleeping Position for Lower Back Pain

For most people, experts agree that the best position is on your back with a pillow under your knees.

When you lie flat with your legs straight, your low back often arches excessively. That increases compression in the lumbar spine.

Putting a firm pillow under your knees:

• Gently reduces the arch in your low back

• Relaxes hip flexors

• Decreases pressure on lumbar joints

Your head pillow should keep your neck neutral, not pushed forward and not cranked back or tilted sideways. If your pillow is too thick, it’s going to shift your head forward, which is the equivalent of “tech neck”, so use a thin pillow. You want your ears to be pretty much in line with your shoulders.

 

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Should You Sleep With a Pillow Under Your Lower Back?

No.

Placing a pillow directly under your lower back increases arching. Most people with back pain already sit and stand with too much extension. Supporting that curve overnight only reinforces this.

If you need support, put the pillow under your knees instead. That changes pelvic position more effectively.

 

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Why Does It Hurt to Lie Flat on Your Back?

If lying flat makes your back ache, it’s usually because your spine rests in extension.

Common reasons:

• Tight hip flexors

• Pelvis tilted forward

• Rib cage flared upward

• Weak abdominal control

When muscles relax during sleep, gravity exaggerates these positions. The result is hours of passive compression.

The knee pillow fix often solves this immediately.

If it doesn’t, your daytime posture likely needs attention too. We help our members address this starting with the Back & Core Program.

 

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How to Sleep on Your Side With Lower Back Pain

Side sleeping can work as long as you prevent rotation.

To do this, use three supports:

1. A pillow thick enough to keep your neck straight

2. A firm pillow between your knees

3. A pillow to hug in front of you

Without the knee pillow, your top leg drops forward and rotates your pelvis. That pulls on your low back for hours.

Without front support, your top shoulder collapses forward.

The goal here is to keep your spine aligned and don’t let it twist.

 

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Is Sleeping on Your Stomach Bad for Back Pain?

Stomach sleeping is the hardest position on your spine because it:

• Forces neck rotation

• Increases low back arching

 

If you won’t change this habit:

• Use a very thin pillow (or none at all) under your head

• Place a soft pillow under your low abs/pelvis

• Rotate slightly toward your side instead of staying fully flat

It’s not ideal. But it reduces strain.

 

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Does Lying on the Floor Help Back Pain?

A firm surface can sometimes reduce excessive arching if your mattress is very soft.

But sleeping on the floor long-term isn’t a solution. If you feel better on a hard surface, that tells you your spine struggles with extension control.

The goal isn’t harder surfaces, but better positioning. That said, if you get an amazing night's sleep consistently sleeping on the floor, do what works!

 

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How to Alleviate Back Pain While Sleeping (Quick Checklist)

Before bed:

• Back sleeper? Pillow under knees.

• Side sleeper? Pillow between knees.

• Neck neutral, not pushed forward.

• Avoid excessive arching.

If you wake up during the night, reset your position. These small adjustments can make a big difference over 6–8 hours.

 

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If Your Back Still Hurts in the Morning

Pillow changes help.

But if your ribs flare and your pelvis tilts when you stand, or your back arches during daily movements, those patterns show up during sleep too.

You can’t out-pillow poor positioning habits.

Inside the MoveU Membership, the Back & Core program teaches you how to:

• Stack your rib cage over your pelvis

• Control lumbar extension

• Improve breathing mechanics and brace your core

• Build strength without reinforcing imbalance

Better movement during the day makes better rest at night. So by all means, start with this guide to reduce sleep disruption tonight — and use this checklist to support deeper, more restorative rest overall — but if stiffness keeps returning, it’s time to address the root cause.