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Back Pain

Best Sleep Positions for Back Pain

14 July 2026 · By Nhlamulo Khosa, BSc Physiotherapy (UCT)

How you sleep affects how you feel in the morning. Small changes to position and pillow support can transform your day and make treatment stick.

Side lying: usually the easiest

Sleep on your side with a firm pillow between your knees and one supporting your head so your neck is neutral. This is the most spine friendly position for the majority of patients.

Back sleeping

Place a pillow under your knees to reduce pressure on the lower back. Use a supportive but not overly thick pillow under the head so your neck stays neutral.

Stomach sleeping (generally not ideal)

Stomach sleeping forces the neck into rotation for hours at a time and often aggravates low back pain. If you cannot switch, use a very thin pillow and slide a small cushion under one hip.

Mattress and pillow basics

A medium firm mattress suits most patients. Pillows should keep your neck aligned with your spine, whether you lie on your back or side. Any pillow that is more than five to seven years old is due for retirement.

If you're in Centurion or Midrand and want personal guidance, our physiotherapist offers same day appointments in clinic in Eco Park, Centurion, or at your home.

Frequently asked questions

Is a memory foam mattress better for back pain?+

It can be, but the perfect mattress varies from person to person. Medium firm is the safest general rule.

Do orthopaedic pillows help?+

Some patients love them. If your current pillow supports your neck well, you do not need to spend money on one.

Why is my back always sore in the morning?+

Common causes include mattress choice, sleep position, dehydration and inflammatory conditions. A physio assessment can narrow it down quickly.

Book with N S Physiotherapy

In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.

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