Sleeping Position for Back Problems

Many patients ask me about what mattress they should be sleeping on or how many pillows they should use and what position to sleep in. Here are the answers to those questions and some information to help you to avoid that stiffness in the low back in the morning;

There are many reasons that people might not sleep well, but don’t let it be because your mattress is stopping you. If your mattress is too soft or sags in the middle, your spine and pelvis won’t be getting adequate support, and if your mattress is too firm (especially for ladies) then it will push on your pelvis and shoulders causing pressure at these points. Remember that just because a mattress is right for you, doesn’t mean that it’s the right mattress for your partner.

You may need to consider purchasing the dual pressure mattresses which are available. A good mattress should mould to the shape of your body giving instant pressure relief and comfort without disturbing your sleep.

If you wake in the morning with aches and pains that gradually wear off then it could well be that you are not getting the support from your mattress and the springs or fillings are going or that you are sleeping in a position which would irritate your posture. If you sleep better in other beds ie hotel beds, then it may be a sign that it is time to change your bed.

If you become too hot or cold during your sleep then perhaps consider a mattress which is made from materials which adjust to these changes. There are many different materials which are available to accommodate this these days so make sure that you ask at the bed store. The mattresses which aid temperature regulation are usually breathable and aid a restful nights sleep.

When shopping for a new mattress, the sleep council suggest the following test to see if the mattress is right for you:

  • Set enough time aside to shop for a new mattress and if the mattress is for two, ensure that you both go along
  • Ensure that you have the right size bed for you and your partner
  • Shop for the best value, not necessarily the lowest price
  • Lie on the mattress in the position which you sleep, not just on your back. The MCA advises to lie on the mattress for at least 10 minutes for this test
  • When lying flat on your back on the mattress, if you can easily slide your hand into the hollow of your back, then the mattress may be too firm for you. If this test is too difficult, the mattress may be too soft for you.
  • For a full guide to purchasing a new mattress, see the Sleep Council’s website

The MCTimoney Chiropractic Association recommends buying a mattress from a reputable store and trying a wide variety of mattresses to see what works for you. They suggest trying an ortho mattress for joint support, a memory foam for support and pressure relief and a latex mattress for temperature regulation. Mattress toppers can also give a good combination especially with pressure relief and temperature regulation.


Like your mattress, your pillow should offer support without being too firm. The neck should remain in a neutral position, that is that the neck should stay straight. If you lie on your side, your spine and neck should be in good alignment with no dips or bulges. This is a sign of a good supporting mattress and pillow. If your pillow is too firm, it will push against your head lifting your head up and too far away from the shoulder which you are lying on, this will cause a stretch in the shoulder side which you are lying on and a tightening of the opposite shoulder muscles.
By the same token, if your pillow is too soft, or too slim, this can also stress the neck muscles. This can also narrow the airways and may lead to snoring and a disturbed sleep.

Sleeping on your back or front, you will need slimmer pillows than lying on your side. On your side, the pillow should be the same width as the distance between your head and your shoulder. Pillows which mould to the head and neck to give support, help to aid relaxation and maintain body temperature. It is always a good idea to try different pillows to see what suits your needs. They don’t necessarily have to be expensive but do avoid buying economy pillows which tend to flatten and become lumpy over time- even as the night progresses from one hour to the next!


Your bedroom should be calm and relaxed without any draughts yet well ventilated.

If you watch tv in bed, please watch your posture in respect to your neck and your spine. Try to avoid slouching against pillows or the headboard creating that banana shape when you just slide off your sit bones- very bad! This stresses the low back, the neck and shoulder muscles. Try looking for a v pillow or a specialist pillow or support. This is also true if you read in bed.

Sleep positions

Side-and-Back-PositionsSleeping on your front:

Stresses the neck and upper back and may cause stiffness in those areas on waking. If you must sleep in this position then ensure that your pillows allow you to keep your spine correctly supported and in a neutral position.

Sleeping on your back:

Back is best! As long as you don’t snore! (Or are heavily pregnant!) The spine will be lengthened and shoulders relaxed. In this position, the rib cage is free to expand as you breathe and the muscles are lengthened and relaxed. A pillow under the knees also relaxes hypertonic (tight) back muscles.

Sleeping on your side:

As discussed at the beginning of this rather lengthy blog. If you tend to roll into the recovery position though or sleep with one leg bent and the other straight (still recovery position I guess) then try sleeping with a pillow between the knees to help prevent the pelvis from twisting. Or keep both of your legs straight.


Before getting out of bed in the morning, take your time to stretch out, this will start to warm up your muscles and prepare you to start your day. It could also help to reduce the risk of back strain. If you suffer from stiffness which persists, it may be time to give us a call!  Our Chiropractors are ready to take your call and make back pain a thing of the past.

With thanks to the McTimoney chiropractic association and sleep council.

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