How to Prevent Back Pain in Bed

Back pain at night is exhausting. It robs you of sleep, drains your energy, and makes getting through the day feel like hard work. The good news is, it doesn’t have to stay that way. We’ve spoken to our sleep experts to bring you everything you need to know about back pain in bed – what causes it, what makes it worse, and most importantly, what actually helps.

Back pain when lying in bed can come from a surprisingly long list of places. Sometimes it’s your mattress. Sometimes it’s how you’ve been sitting all day. Often it’s a combination of the two. Here’s a rundown of the most common causes:

• Poor posture during the day, including slouching, hunching over a screen, or cradling your phone between your ear and shoulder, puts pressure on the spine that you carry into bed with you.
• An unsupportive mattress can’t keep your spine properly aligned, leaving it out of position for hours while you sleep. For proper support, replace your mattress every 8 years.
• Sleeping in the wrong position is a common culprit, particularly stomach sleeping, which can place excess pressure on the lower back and leave you sore by morning.
• Tight muscles and lack of movement go hand in hand. Staying in one position for too long leads to stiffness, and if you’ve barely moved all day, your back will let you know about it.
• Arthritis can interfere with sleep and often feels more pronounced first thing in the morning, when inflammation has had hours to build during rest. Degenerative disc disease can also cause discomfort at night, though symptoms vary widely from person to person.
• A bed that’s too low means getting in and out puts repeated strain on the lower back every single day. Over time, especially for those with mobility issues, that can add up.
• The wrong pillow won’t fill the gap between your shoulder and head properly, which means your neck and spine fall out of alignment while you sleep, and you wake up paying for it.

Read our guide for a more in-depth look at the causes and solutions of morning back pain.

Lower back pain when sleeping is most often due to poor mattress support or sleeping in a position that puts stress on the lumbar spine. The intervertebral discs in your lower back rehydrate overnight, and a mattress that lets your spine sag disrupts that process, which is why you can wake up feeling worse than when you went to bed.

Middle and upper back aches in bed tend to be more closely linked to daytime posture and long periods of sitting. Hunching over a desk, rounding the shoulders, or looking down at a phone can tighten the upper back muscles. By the time you lie down, those muscles are already irritated.

• Your mattress is visibly sagging or lumpy: Any dips or uneven areas mean your spine is spending the night in a compromised position.
• Your mattress is over eight years old: Most mattresses lose their support around this time.
• You sleep better in other beds: Hotels, spare rooms, a friend’s sofa. If your back feels better away from home, that’s a strong sign.
• You can feel the springs: A pocket spring mattress should offer consistent, cradling support across the whole surface. If you can feel individual coils, it’s time to move on.

A mattress that is too hard puts too much pressure on the areas where you feel discomfort, whereas one that is too soft allows the spine to fall into unhealthy positions for hours at a time. People who suffer from lower back pain when sleeping generally benefit from a firm mattress, as the lower back often needs more structural support. A firm or medium mattress will suit most back pain sufferers, while a memory foam mattress is a popular choice because it provides support where it’s needed and cushions the body where it isn’t.

Explore our guide to the best mattresses for different types of back pain to find the right fit for you.

Getting on top of back pain before it progresses is far easier than dealing with it once it’s settled in. Here are some of the best things to try:

1. Sort your sleeping position: Side sleeping with knees slightly bent is one of the best starting points. It encourages good spinal alignment and takes pressure off the lower back. If you prefer sleeping on your back, placing a pillow under your knees works just as well.
2. Check your pillow height: The gap between your shoulder, neck, and head should be fully supported. When lying on your side, your spine should be as straight as it is when you’re standing. Pillow firmness is personal preference, but depth is non-negotiable.
3. Exercise regularly: Any exercise that strengthens your core will help prevent backache in bed in the long run. Yoga, Pilates, or simply hitting the gym more often all make a difference.
4. Try some stretches before bed: Gentle stretching eases tension in the spine before you sleep. Tight hamstrings are a common culprit for lower back pain, especially after a day at a desk. Place one leg up on the bed, lean forward slowly, and hold the stretch down the back of the leg. Stop if you feel any sharp pain.
5. Consider your bed height: A bed that is too low makes it much harder to get in and out without straining your back. Consider changing to a higher base or an adjustable bed to help you get in and out.
6. Think about changing your mattress: If your mattress is sagging, old, or not supporting your spine properly, it may be the single most effective change you can make.

If you’ve tried all of the above and are still suffering from back pain when lying in bed, our sleep expert Sammy recommends speaking to your GP for medical advice.

When your back pain is caused by something other than your bed, such as a sports injury, arthritis, or a flare-up of an existing condition, the goal shifts from prevention to management. Here’s how to make sleep as comfortable as possible:

• Put a pillow between your knees: If you sleep on your side, a pillow between the knees keeps your hips stacked and stops your top leg from pulling the lower spine out of alignment. Read our guide to find out more about the benefits of sleeping with a pillow between your legs.
• Use a pillow under your knees if you’re on your back: This slight bend in the knee reduces tension across the lower back and takes pressure off the lumbar spine.
• Avoid sleeping on your stomach: With a bad back already in the mix, stomach sleeping puts too much pressure on the lower back and forces an uncomfortable twist in the neck.

Sharing a bed when one of you has a sore back brings its own set of challenges, especially when you have different comfort preferences. One person might need a firmer mattress for lower back support, while the other prefers something softer.

A zip-and-link mattress or a split tension mattress is one of the best solutions here, as it allows each person to have a different mattress firmness on their side without compromising the other. A hybrid mattress, combining springs with foam or latex layers, can also strike a balance between support and comfort that suits both sleepers.

A king size or super king size bed and mattress also gives both of you enough room to find your own comfortable position without disturbing each other through the night.

For more tips on sharing a bed, read our guide on the best sleeping positions for couples. Or find out whether you should consider the Scandi Sleep Method or even a sleep divorce.

Most back pain in bed comes down to small things adding up. How you sit during the day, how old your mattress is, whether your pillow is actually doing its job. None of those are dramatic fixes, but getting even one or two right can change how your mornings feel.