Sleep Positions and Lower Back Pain

Regular readers might have noticed by now that I am fairly obsessed with sleep positions. I am also pretty obsessed with lower back pain — the two are intimately connected. In addition, I love asking clients and yoga students to show me their sleep positions. Invariably, people with back problems sleep in a way that exacerbates their problem

If you sleep for any number of hours in one position it is likely to have an effect on the way you feel when you wake up. The effect can be benign if you sleep in a neutral position that doesn’t throw off the natural alignment of the body. But if you sleep in any number of bad sleep positions you will likely wake up with an aching back, sore neck or numb arms.

Today’s post is about lower back pain and how the position pictured to the left will only make it worse. Ironically, I think that many people sleep in this position because of their back pain. As is often the case, when it comes to the body and pain, there is a chicken and egg dilemma as to which came first — the back pain or the poor sleep positions.

In the picture above the woman has her left knee hiked up above her pelvis. I would guess that her left psoas is tight and the knee pulls up high in search of ease or comfort in the groin. But the issue is what this does to the pelvis. As soon as the knees separate the sacroiliac joint of the pelvis is thrown out of balance and will remain that way for the rest of the night. It is no wonder that a person would wake up from this position with an achy back.

I slept that way for many, many years. It still remains a place of comfort for me emotionally. Every morning after waking up with my legs together I usually allow myself a minute or two in the “old me” before I get out of bed.

If you are someone who wakes up with lower back pain or discomfort, pay attention to your sleep position and work on changing it. The effects might not manifest right away ­— getting out of pain is rarely immediate. However, one day, ten or fifteen minutes after getting out of bed, you will realize that you are no longer waking up with that cranky back. Good luck.


Yoga Instructions: Feet Together or Feet Apart.
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  1. I am a female in early 50’s and in the past month have suffered from lower back pain, sometimes so bad, it has woken me in the early hours, and the only way to ease it is to get out of bed and stay upright. The pain subsides quickly, and no more pain for the day. I commonly sleep on either side and have also woken with numb hand/arm. I have not been exercising much lately (yes I know, yell at me!) and have never had back problems in the past. It didn’t occur to me that sleep position may be causing this pain as it has only just become a problem recently. Friends recommend a “grounding sheet”, more so for stress free sleep, but could this possibly assist with muscular pain also?

    • It is amazing what sleep can do. If you have been sleeping the same way for a long time it wouldn’t make sense that this is what is causing the back pain. You need to think about what is different since the pain started. It could be from not exercising but I doubt it. Are your knees together when you sleep? If you have to tie them together with a pillow in between that would be fine. The biggest cause of back pain when sleeping it when one knee is hike up higher than the other. The numb hand arm is from the arm position. These patterns aren’t easy to change but it can be done.

  2. Thanks for the advice “admin”. Yes, there have been times when one knee has been higher than the other, so I will try the pillow trick! Since my comments on 3rd September, there has been some improvement-I have since read somewhere that being under lots of stress can cause back muscles to tighten. The past few months have been stressful,(family matters) but that has improved recently. Although it was mentioned that NOT exercising could have been a cause of the back pain but doubtful, I have been more active recently(perhaps coincidence) and now not waking every single day with back pain! What a blessing!
    Thanks again, your suggestions have been appreciated.

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