Best Sleeping Position for Back Pain, Sciatica, & Leg Pain (Great Tips)

This article is a transcribed, edited summary of a video Bob and Brad recorded in April 2025. For the original video, go to https://youtu.be/BEfTc23cOFo

Mike: If you're struggling with back pain, sciatica, or leg pain at night, finding the right sleeping position can make a huge difference.

Brad: That's right. So, we're going to take a trip down memory lane. Bob and I did an excellent video showing how to change your position for less pain; it works very well. Also, Mike and I are going to show you our favorite positions that we use personally to keep us comfortable at night and sleep like a baby.

Mike: Well, let's go back in time. You want to do your fun sound effects.

Brad: Whoa, rooh-roo-roo-roo.

Bob: Hi, I'm Bob Schrupp, physical therapist.

Brad: Brad Heineck, physical therapist.

Bob: Together we are the most famous physical therapists, and probably the ugliest physical therapists, on the internet.

Brad: Oh, Bob. In our opinion, of course. In his opinion.

Bob: All right, today we're going to talk about the best sleeping position for back pain, sciatica, and leg pain. We've already done one on basically the waist up, more the neck.

Brad: The upper body.

Bob: See how I did that, Brad?

Brad: Yeah, you're working on it, Bob.

Bob: Okay, today there are a lot of great tips. So, you want to pay attention, and we've got a lot of them. So, let's start off with, first off, you want to make sure your back is lined up well when you're sleeping. You want to make sure you're not in a rounded-out position.

Brad: Sure.

Bob: So, you want to make sure your mattress isn't saggy.

Brad: Right. If you got a big hole in it, it's a really soft mattress, and it's used, it's a number of years old, you know?

Bob: Right. So, if you want to see if it's going to feel a lot better to get a firmer mattress or a new mattress, you might take your mattress and put it on the floor, because that would kind of give it a solid base.

Brad: Right.

Bob: Or you can do what my wife and I did when we first were married, and we didn't have money, is we took a piece of plywood and we put it between the box spring and the mattress. And that took the sag out of it.

Brad: But you did put the mattress back on?

Bob: We did put the mattress back on.

Brad: Okay.

Bob: And we didn't break the box. So, that worked out really well, actually.

Brad: It's a family show, Bob.

Bob: Yeah, okay. All right. The next thing you may want to try is, when you're sleeping on your back, one thing that some people have recommended- and Mulligan was one of them again, Brian Mulligan- is to actually take a sheet, because you want to keep the back in the neutral position. You don't want it to round out.

Brad: Right.

Bob: So, for some people, especially if they're having back pain and in the throes of back pain, you try this.

Brad: Right. Yep, yep.

Bob: So you start, you take a long sheet, and you roll it up. Start in the front. And then you go around, and it actually doubles up in the back a little bit.

Brad: The whole idea is you want to make a cushion here to take up that space to support that low back so it doesn't go into that hole, if you will.

Bob: Right, it keeps the arch.

Brad: Right.

Bob: And so, you can pin this in place or tape it in place. So, let me show you here. When I'm lying on my back, it provides my back with some support. But beyond that, even when I lie on my side, if you, especially if you have wide shoulders and wide hips, you know, the back is going to sag down like this.

Brad: Right. You get that sag, there's going to be that hollow spot there.

Bob: Right, if this isn't in place, this helps to keep the back aligned nice and straight while you're in this position.

Brad: Sure. Now, the thing about sheets is they're not very soft. If you actually, they make them, they work, I think, a lot better than a sheet. But you know, you can use this.

Bob: You can start with this, and if it works out well, then our camerawoman, Lonnie, come on down to "The Price is Right."

Brad: Yeah.

Bob: This is tied in place.

Brad: This is a McKenzie Lumbar; they call it a lumbar sleep roll. And we got it wrapped around. You tie it in the front. It does not need to be in the front like the sheet does. Just on the sides and the back. Why don't you lie down with it, Lonnie? And Lonnie has never tried one of these before, and she laid down with it just a little bit ago, and she immediately said, what did you say?

Lonnie: Good.

Bob: So, then you can roll on your side, Lonnie. Yep. And the same thing again keeps your back nice and straight when you're on your side.

Brad: Right, it fills in that hollow spot to support that lumbar spine.

Bob: You can actually do that even if you sleep on your side all the time. And you could actually even just put a small pillow there.

Brad: Sure, yep. Something that's going to be good if it's the right size; it's going to feel good.

Bob: Thanks, Lonnie. She likes it so much; she's going to wear it all day, she said. So she'll be the talk of the town. All right. Another thing that works out quite well, especially for people who are having kind of severe back pain, is to sleep on your back and to put a pillow underneath your legs, or a wedge.

Brad: Yep.

Bob: So let's do it if you do the pillow first. So, I'm sleeping on my back. I would have a pillow.

Brad: We're going to give you the deluxe.

Bob: You might need it under my legs, though. Oh, there we go, yeah.

Brad: Yeah, I knew you'd like that.

Bob: So, a pillow underneath the legs. The hip flexors aren't pulling on the back now like they were. And so, you're not getting as much stress on your back. It would probably be better with two.

Brad: Depends on how thick your pillow is, how big your body is. Bob's a tall guy. He probably needs two.

Bob: Yeah, I need two. And that actually does feel really good, Brad. Really does take some of the stress off the back. But let's show the deluxe position here, Brad.

Brad: This is something I use a lot with patients, and most of them are very happy when you put, I use leg wedges.

Bob: I was really shocked by how good this feels. It's like you said, even if you support the lower legs, it does not feel nearly as good as if he shoves that right up against the buttocks.

Brad: It touches the hamstrings, and there's something about that that helps relax, from what people tell me.

Bob: Oh, it does. This is very comfortable. Back pain or no back pain. And this is going to stop you from sleeping on your side too.

Brad: I have one of these at home, and when I have a back problem, if I'm out working in the yard or doing some stuff that I shouldn't be doing, I get a backache. I use this: I put a cold pack under my back, and then I fall asleep. I wake up later and take the cold pack out, and sometimes I'll take the wedge out and sometimes I won't.

Bob: And if you want to try to simulate that at home without one of the wedges, you could lie on the floor, put your feet up on the couch. It wouldn't be quite the same, but it would still take some of the stress off the back. And you could put your cold pack, or you could put a hot pack, I guess, on that, too.

Brad: Sure, yeah, some people prefer that.

Bob: Cold packs, I think, are quite often better. All right, when you're sleeping on your side, what you may want to do is actually use a pillow between the legs. This is what we call the stacked position. So my legs are stacked on top of each other, and the pillow, again, helps keep the spine aligned and stops the spine from rotating.

Brad: Sure.

Bob: So, it works really well with that. If you're a person that likes to sleep with the leg a little bit forward, then you may want to actually use two pillows and get it up a little bit higher like that.

Brad: Then you got no pillow for your head, Bob.

Bob: I know, that's a problem.

Brad: You need to go buy some more pillows.

Bob: Yeah, you're going to need lots of pillows.

Brad: The other thing about this is it takes stress off the hip.

Bob: Yes, it does.

Brad: If you've got hip bursitis or hip arthritis, this can.

Bob: Very good point, Brad. And what's nice about this, you know, because on the upper extremity we talked about giving the arm support like this, you actually can flip around like this, Brad.

Brad: Sure.

Bob: I mean, it's not that hard to do. You could switch positions.

Brad: And this way, like, if my wife is mad at me and she's not sleeping in bed with me, then I got something to hold on to.

Bob: Aw, isn't that sweet? And I think there are a lot of nights like that. All right. We did all that. Oh, the one thing I was going to mention is, and I don't know why this is, but Brad confirmed this, too. There are a lot of people that, when they're in the throes of back pain, and they're really having a lot of back pain, they sleep in a recliner.

Brad: Yeah.

Bob: The thing we want to remind you: if you're sleeping in a recliner, I don't want you sleeping kind of in a hunched position. Put a throw pillow or something behind your back so you're nice and straight.

Brad: Right. Yeah, back it up as far as you can go. Have that lumbar support there. I don't feel confident in saying "Sleep in your recliner," but there are people who are going to sleep in the recliner.

Bob: Right. And that's what I mean. There must be some merit to it because I've had people that, I mean, a lot of people, and then they probably discover it because they aren't able to sleep, so they get up and watch TV, and then they find out they can sleep in the recliner. And I've even had people, like years later that had to continue to sleep in the recliner because it brings on pain if they don't.

Brad: Yeah.

Bob: So, there's not much you can do if that's the issue.

Brad: Yeah, I'm not going to advocate it, though, unless that's what works, I guess.

Bob: All right. The final thing we talked about is: is it okay for you to sleep on your stomach? You know, a lot of people think, oh, you can't sleep on your stomach. It puts your back in too much of a swayback. That's usually not the case. Quite often, if you've been sleeping on your stomach and you don't have back pain, I'd go ahead and keep doing it. Wouldn't you, Brad?

Brad: We're always concerned about the neck, because your head is twisted one way or another. So we oftentimes say avoid sleeping on your stomach because of the neck, not so much the back.

Bob: Right.

Brad: Unless you have a big saggy bed and you're sleeping in a kind of a hole in reverse, maybe that would be undesirable.

Bob: Might try sleeping with a pillow underneath your stomach. I mean, again, if you're having a lot of back pain, sometimes it's weird, the positions that help you.

Brad: Right, exactly. Sleeping on the floor, some, and I've had people with back pain sleep on the floor because it's a firm surface. Gets that spine in line. And I had this one woman; she slept on the floor for over a month, and she felt better sleeping on the floor than in her bed.

Bob: Did she use a full mattress or anything?

Brad: No, it was carpeted.

Bob: It was carpeted. I know Mulligan recommended that too. To go and sleep on the floor.

Brad: Whoa, and we're back. Anyways, Mike, it is your turn to show your favorite sleeping positions. Go ahead.

Mike: So, I just went over what we had in the previous video of my favorite sleeping positions. And one I use frequently is the pillow between the knees because it helps keep me in a nice posture. I like to roll around at night: back, side, stomach. This normally keeps me in a side position.

Mike: If the pillow is not there and I'm having back pain for some reason, which has happened a few times in my life, I end up rotating like this, and then I'm sleeping like this, and my spine is all twisted, and it does not feel good when I wake up.

Mike: So having that pillow there just helps me prevent it from ever happening, even if I roll a little bit, as you get stuck here, and it keeps my back more aligned and feeling good.

Brad: Right. Now, you're going to find out I have a little more involved routine. I don't know if it's because of my age. Or what.

Mike: 'Cause you're old.

Brad: Yeah, I guess that may be something. But actually, just last night, this is what I used: sleeping on my side because my shoulders are a little more sensitive for whatever reason, maybe because I swim too much. I take a pillow right here in front of me, and I'll go like this or like this, and I'll get my top arm comfortable. This arm I'll pull out. If I go like this and sleep right on the shoulder, it's uncomfortable. So there, there. And then can I have another? Where's another pillow? I can't reach it.

Mike: Well, I'm glad you're talking about your shoulder, but this is a back pain video, Brad.

Brad: Well, it all works together. Believe me, because if I can't sleep comfortably, my back hurts.

Mike: I also hug a pillow, by the way.

Brad: If I put a pillow behind my back, it keeps me in a good position. Otherwise, I start rolling around, then I get that twist in my back, and that's uncomfortable. But like Mike, as well, I will use the pillow between my knees, which is comfortable. And on my back, usually I'm very comfortable on my back. But sometimes, if I do have a sore back because I did something silly out working on the lawn or something of that nature, I take, I used to take pillows like this, like that. And if I had a really sore back, I would put a cold pack underneath my back to start.

Brad: I wouldn't fall asleep with the cold pack on usually. Take that out, put it on the floor, and fall asleep. And then later on in the night, after I'm falling asleep and things are going well, I oftentimes will get this off because I'll go to my side and sleep. The other thing that works really well: I have one of these leg wedges, and they just work better than pillows, and I fall asleep like this sometimes with the cold pack. I've been doing pretty good with that. I've been behaving well. And then, again, if you're rolling around, it does get in the way. My back will be fine after I fall asleep and things settle down, and I can roll a little bit right to left.

Mike: Does your poor wife have any pillows, or do you just?

Brad: Well, sometimes I use her, too.

Mike: She's a pillow?

Brad: Well, no, she's very comfortable, anyway. Hope she doesn't see this episode. But anyway, I'm going to shut up.

Mike: So those are your tips for sleeping with back pain. If you're still having back pain and would like to try some stretches or exercises, you can watch another video.

Brad: Good choice. "Absolute Best 10 Stretches For & Perfect Posture."

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