Sleeping and low back pain

Do you have low back pain or discomfort? Do you sleep on your stomach? A majority of stomach sleepers have or have had low back pain/discomfort to some degree.

While sleeping on your stomach, do you do the following?

  1. Sleep with one leg flexed up to one side (bent at the hip and the knee)
  2. Your head is turned to one side
  3. An arm or both are up over or under your head

The following problems occur with the above positions:

  1. Sleeping with a leg flexed at the hip and knee while on your stomach is not only problematic but to sleep in that position, you have to turn that leg outwards at the hip joint. This shortens the very important piriformis muscle in the buttocks causing two problems: if shortened, it can pinch the sciatic nerve when you straighten the leg causing pain and altered sensations down the back of the leg and/or it can lock up the sacroiliac joint causing low back pain.
  2. If you sleep with your head turned, different muscles on either side are shortened. This can cause headaches, reduced range of motion or TOS (thoracic outlet syndrome), where the bundle of nerves and blood vessels get pinched and you wake with numb/tingling hands. Shortened neck muscles can also contribute to other conditions, such as frozen shoulder and rotator cuff issues.
  3. Sleeping with an arm or both up can shorten the anterior deltoid muscle (lifts the arm up in front) and the infraspinatus muscle (external rotator muscle of the shoulder joint). This can cause shoulder pain, frozen shoulder or Thoracic outlet syndrome (TOS).


The best position to be in is on your back with a pillow under your bent knees. This puts your low back flatter on the bed. Arms should be straight down along your sides. Bent elbows can lead to tendonitis of the elbow. A thin or no pillow under your head should be used. Sleeping with a big pillow while on your back will shorten your front neck muscles causing a slouched, head forward posture. Any muscle repetitively shortened, will shorten and cause issues with your body.

Correcting your habits will stop the cause but the existing problems need addressing. Seeing a trained Osteopath/Acupuncturist can help reduce pain/discomfort, rebalance your body and train you in taking better care of your own body.