How Should I Be Sleeping When I Have A Back Spasm?

What are best sleeping positions? What is the best mattress? What is the best pillow? Those are one of the most asked questions I hear from the patients. In this blog I will try to answer them.

Three phases of sleep

Let us look in to sleep itself first. In order to have good night rest, our brain must go through three different phases: shallow sleep, deep sleep and rapid eye movement (REM) phase. One cycle of those three phases takes around 90 minutes. In ideal world we should have 4-5 cycles during one sleeping session therefore healthy sleep should be 6-8 hours long. Unfortunately, we all know that we do not always we get that nice long sleep or sometimes we are struggling to fall asleep. Good night sleep is critical for our wellbeing. Lack of sleep causes increased levels of stress hormones and make us more vulnerable to the pain.

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What sleeping position is best when I have lower back pain?

Most likely is that if you are in pain or you just injured your back, you are going to want to sleep on your back. About 75% of general population sleep on their side however in more acute stages that might be too painful. If you decide to sleep on your back the number one rule is that you should have a thin pillow. If the pillow is too bulky it might put your head in a forward position and over time that might create neck pain.

So, the thing to remember here is that the spine should be in as straight or neutral position as possible. Let us move on to lower back alignment. When you lay on your back with straight legs, that will increase curvature of the lumbar spine and might be too sore. We want a little bit of hip flexion here. What I suggest is to take bigger pillow this time and simply put it under your knees. Now lower legs are supported in slight bend position which takes out some tension from lower back.

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Best Sleeping Position for Better Sleep and Health

When it comes down to side position – we need to increase the height of the pillow. Again, the reason being to keep the spine as straight as possible, so neck is leaning too far to the side. What I then suggest you to do is to get the other pillow and put it between your legs. This will stabilize lower back so its not in twisted position. If you feel that on the side position your spine is sagging, you might support it by small pillow or folded, not too thick blanket under your waist. Keep in mind our main rule- spine in neutral.

When sleeping on the side, some people feel like they might roll over night to the front or back. I would suggest then to put one extra pillow behind the back to stop you from rolling backwards. The other pillow (or big teddy bear) might go in front of you and be used as arm rest. Furthermore, holding or cuddling to something makes us more secure.

Thanks for reading, I would love some questions to answer so please email me at or book a taster session with me by calling 01932 355529 and ask for Mike, if I’m with patients I will call you straight back

Mike-Sports Massage Therapist

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