Back pain has a funny way of sneaking up on you after 50. One day you’re dancing all night and up the next morning ready to tackle the yard. Then suddenly, one wrong move—like bending to pick something up—and you’re out of commission for a week.
Many things can aggravate back pain, and a poor night’s sleep is at the top of this list. If you’ve ever tossed and turned all night only to wake up stiff, sore, or achy, we have some good news: A few small tweaks to your sleeping position can help you wake up rested and pain-free.
Let’s look at some strategies you can put into action—starting tonight.
Understanding back pain in adults over 50
As we get older, our bodies go through various changes—and so do the structures that support our spine. Some reasons back pain becomes more common after 50 include:
Degenerative disc disease: This a condition where the cushioning between spinal discs naturally wears down over time.
Osteoarthritis: This is a common joint condition that occurs when the protective cartilage that cushions the ends of bones wears down over time. In the spine, the discs between vertebrae lose water and become narrower, causing pain and inflammation.
Osteoporosis: Loss of bone mass and weaker bones can lead to small fractures, especially in the spine.
Spinal stenosis: This is a narrowing of the spinal canal that puts pressure on the spinal cord and surrounding nerves.
Spondylolisthesis: With this condition, one spinal vertebra slides out of position and puts pressure on the vertebra below it.
Muscle stiffness or strain: This can be the result of decreased flexibility or repetitive movements.
Why sleep posture matters more after 50
The younger we are, the more easily we can bounce back from a night sleeping in an awkward position. But as the years pass, our spinal flexibility decreases, and recovery takes longer. “These positions become painful because they test your range of motion, which tends to narrow with age,” said Scott Bautch, DC, a Wisconsin-based chiropractor, in an interview with SilverSneakers.
What does this mean for you? Your nightly sleeping position matters more than ever. The right posture can reduce pressure on your spine, relax tight muscles, and help you wake up feeling refreshed—not worse.
What are the best sleeping positions for back pain relief?
Your sleep position can either support your spine or strain it. Here are some of the best sleeping positions for back pain relief, especially if you’re over 50:
1. Sleeping on your back with a pillow under the knees
This position helps maintain your spine’s natural curve and reduces pressure on your lower back.
How to do it: Lie flat with a firm pillow under your knees to keep them slightly bent. You can also place a rolled towel under your lower back for added support.
✅ Tips:
Take your time easing into this position to avoid muscle strain.
Try a wedge pillow for better elevation and support.
2. Side sleeping with a pillow between the knees
Sleeping on your side can align your spine when done properly.
How to do it: Use a supportive head pillow to keep your neck in line with your spine. Place a firm pillow between your knees to prevent your top leg from twisting downward.
✅ Tips: An adjustable bed can help elevate your upper body slightly. This is especially helpful if you have acid reflux or trouble breathing while lying flat.
3. Fetal position
This curled-up posture can benefit those with herniated discs or spinal stenosis, as it opens up space between vertebrae.
How to do it: Lie on your side and gently pull your knees toward your chest. Use a pillow to support your neck.
✅ Tips: Avoid curling your body too tightly. Aim for a relaxed curve to avoid putting strain on your back or hips.
4. Semi-reclined position
For some people, sleeping in a reclined position can reduce pressure on the spine.
How to do it: Use an adjustable bed or a supportive recliner. Place a cushion behind your lower back for lumbar support.
✅ Tips: This sleeping position for back pain may be especially helpful if you have hip discomfort. It can also ease lower back pain that worsens when lying flat.
What are the worst sleeping positions for back pain?
Now that we’ve covered the best sleeping positions for back pain, you might be wondering which sleep habits may be doing you harm.
The least back-friendly way to sleep is on your stomach. This position is hard on your spine and neck. It forces your back into an unnatural arch and strains your neck as you turn your head to the side.
“But being on my stomach is the only way I can sleep at all!” you might be exclaiming right now. If you have back pain but must sleep on your stomach:
Use a very thin pillow or none at all under your head.
Place a pillow under your pelvis to reduce pressure on your lower back.
Other common sleep mistakes among older adults
Even with good intentions, many of us fall into bad habits that can intensify our back pain at night. These include:
Using multiple or overly high pillows that push the head forward.
Sleeping on an unsupportive mattress that sags in the middle.
Neglecting to replace pillows or mattresses that have lost their support.
6 expert tips for sleeping better with back pain
Often, small changes can bring big relief from an aching back. Here are six strategies that can help you sleep more restfully:
1. Choose the right mattress
In general, look for a medium-firm mattress, which supports the spine without being too hard. Take advantage of trial periods offered by many mattress companies. If you’re unsure what specific type of mattress is best for you, talk to your doctor or a sleep specialist.
2. Select the right pillow
Try memory foam or orthopedic pillows for better support. Make sure your pillow keeps your neck aligned with your spine—not pushed up or down.
3. Do gentle bedtime stretches
Before you turn in, perform a few light stretches targeting your lower back and hips. Focus on gentle, slow movements to avoid strain.
4. Manage nighttime pain
Heat therapy (like a warm shower or heating pad) before bed can help relax tense muscles. Over-the-counter (OTC) pain relievers can be effective in easing discomfort, but always consult your health care provider first.
5. Create a sleep-friendly environment
Keep your bedroom cool, dark, and quiet and use a white noise machine if needed to block out distractions. Stick to a regular sleep schedule as much as possible, which means going to bed and waking at roughly the same time each day.
6. Practice healthy lifestyle habits
Keep your joints and muscles strong by exercising regularly, with a focus on strength, flexibility, and balance. Aim to achieve and maintain a healthy weight to reduce strain on your back. And don’t overlook your mental health—since chronic stress and anxiety can worsen pain.
When to call your doctor
Your back pain may persist despite efforts to adjust your sleeping position and practice smart sleep habits. If the pain starts interfering with daily activities, or it becomes more severe, it’s time to seek professional help. You should also call your doctor if you experience any of these back pain warning signs:
- Pain that radiates down your legs
- Numbness or tingling in the legs or feet
- Sudden, severe pain after a fall or injury
- Problems with urination or bowels
- Fever and/or sudden unexplained weight loss
Your health care provider or a back pain specialist can help rule out serious medical conditions and recommend targeted treatments or therapy.
If you’re among the 16 million American adults with chronic back pain,1 there’s reason to be optimistic—because relief is within reach. While you may not be able to turn back time, you can take steps to wake up feeling stronger, rested, and ready for whatever the day brings.
Sleep and back pain: FAQ
What if I wake up in pain during the night?
Try gently changing positions or using pillows to support your back and legs. Even a slight shift in angle can relieve pressure points.
How do I roll over or get out of bed without straining?
Use the log-roll technique: Bend your knees, roll to your side, and then push up with your arms as you swing your legs off the bed.
Do specialized pillows or mattresses really help?
They may. A sleep setup that’s tailored to your personal sleep style and health needs can greatly improve your comfort and back pain. Take the time to explore your options and read product reviews before you buy. Many mattress sellers will let you try out their products at no cost.
Are there any home remedies that actually work for back pain?
Yes—heat therapy, gentle stretching, and topical creams can help. Just be sure to talk to your doctor before using over-the-counter medications regularly.
Sources
1. National Council of Aging
2. Healthy Policy Institute. Chronic Back Pain. Found on the internet at https://hpi.georgetown.edu/backpain
2025
Discussion about this post