Proper spinal support when asleep can bring some relief to back pain, here are some general guidelines that could help however you sleep.

By Dr Nish Manek

Published: Friday, 27 October 2023 at 17:30 PM


Back pain can be hugely frustrating and finding relief for a restful, pain-free night’s sleep can make a big difference. Understanding the importance of proper spinal alignment and support during sleep can help, but it can be hard to separate the marketing ploys of bedding shops from genuine advice. Everyone will be different in terms of what they prefer, but there are some general guidelines that could help… 

How to choose the right pillow

Selecting the appropriate pillow can make a big difference in managing back pain. You need to see what works for you, but the following advice might be useful:

1. Supportive pillows 

Look for pillows that offer adequate support to the natural curves of your neck and spine. Memory foam pillows or those with contouring features can be beneficial for maintaining proper alignment.

2. Adjustable pillows

You might benefit from a pillow that has adjustable loft (height) or firmness settings. This allows you to customise the pillow to your individual needs, ensuring optimal comfort and support.

3. Body pillows

If lower back pain is your biggest problem, placing a body pillow between the knees while sleeping on your side can help align your spine and alleviate pressure. 

Regularly replace your pillow every couple years, as worn-out pillows lose their supportive qualities and can exacerbate back pain.

How to find your right sleeping position

Getting a good night’s sleep can be a huge pain (no pun intended), but sleep is really important for healing and reducing pain sensitivity. The position you sleep in might play a role in promoting spinal alignment and minimising back pain:

Back sleeping 

If you prefer to sleep on your back, use a medium-firm pillow that supports the natural curve of your neck and maintains alignment with your spine. Placing a small pillow or rolled-up towel under your knees can help reduce the strain on your lower back.

Side sleeping 

If you prefer sleeping on your side, choose a supportive pillow that keeps your head and neck in a neutral position. Additionally, place a pillow between your knees to maintain proper alignment of the spine. Try to make sure the pillow’s thickness allows your head to remain level with the mattress, so your neck is not too bent in one direction. 

Stomach sleeping 

Sleeping on your stomach is generally discouraged when you have back pain, as it can strain the neck and lower back. If this is your preferred position, however, use a thin pillow or no pillow at all to prevent excessive neck extension. Placing a pillow under the pelvis can help maintain a more neutral spinal position and additional support can be provided by placing pillows beneath your ankles.


Again, everyone will be different with regard to their personal preferences, but these general guidelines might help. If one position or pillow type doesn’t work for you, don’t despair: try to determine which position(s) benefit you the most, and work on those initially. 

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