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Nadia Alibhai, osteopath: 'Change your sleep set-up to ease back pain'


Nadia the Osteopath enlightens us on sleeping pain-free


Wellbeing with Nadia - HELLO!
Cropped Image of Senior Woman Suffering From Backache in Morning Sitting on Bed, Panorama With Free Space. Lower Back Pain in Elderly Person. Woman Feels Back Pain Massaging Aching Muscles. Mature Woman Feeling Morning Discomfort in Aching Back in the Bedroom.© Getty Images
By Nadia Alibhai
August 5, 2025
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If you've ever tried to drift off to sleep with a nagging ache in your back, you'll know how frustrating it can be.

Back pain doesn't just affect how we move during the day, it can also seriously impact the quality of our sleep and, in turn, how we feel emotionally and physically.

So often, my patients tell me they were tossing and turning all night, unsure how to position themselves for relief. The good news? A few simple tweaks to your evening routine, sleep setup and daily movement can make a world of difference.

beautiful woman with dark hair posing with pillows
Nadia shares her advice for sleeping with back pain

1. Find the right sleep position

The ideal sleeping position depends on where your pain is, but here are some general pointers

  • Back sleepers: Pop a pillow under your knees. This helps keep the spine in a more neutral position and takes pressure off your lower back.
  • Side sleepers: Tuck a pillow between your knees to stop your top leg from pulling your spine out of alignment. I am currently using a body support pillow by The Woolroom. The body support pillow is filled with organic wool, offers natural temperature regulation, hypoallergenic comfort and excellent support for a healthier, more restful sleep.
  • Stomach sleepers: If you can, try to break the habit as it can strain your neck as well as leave your lower back feeling achy but if you can't sleep any other way, place a slim pillow under your lower belly to reduce strain and either have a very thin pillow or no pillow at all under your head.

2. Invest in the right support

Your mattress and pillow matter more than you think. A mattress that's too soft may let your hips sag, while one that's too firm could put pressure on your joints.

Aim for medium-firm support (think Goldilocks, not too soft, not too hard), while on the pillow side, a supportive pillow should keep your neck aligned with your spine, not tilting up or down. 

Black woman suffering with back pain while sitting at home© Getty Images
The way we sleep can impact our back

3. Wind down with gentle movement

It might feel counterintuitive, but gentle movement and stretching in the evening can help relax the muscles and ease tension before bed. Here's a bedtime stretch sequence I love:

Three-night-time stretches to ease back pain

1. Knee-to-chest stretches

Lie on your back and gently hug one knee into your chest for 20 to 30 seconds. Switch sides.

2. Pelvic tilts

Lie on your back with your knees bent. Slowly tilt your pelvis to flatten your lower back into the floor, then release. Do 10–15 slow reps.

3. Child's pose

On all fours, sit your hips back toward your heels, stretch your arms forward and breathe deeply. Hold for a minute.

These movements help decompress the spine, release tension, and calm the nervous system, perfect just before bed.

woman in pink crop top with her hands on her back© Getty Images
How we sleep can impact our back

4. Heat it up or cool it down (safely)

A warm bath or heating pad about 30 minutes before bed can work wonders. Heat increases blood flow and is great to relax tight muscles and soothes sore tissues. Just avoid falling asleep with a heating pad on, set a timer or use a microwavable one that cools naturally.

If you have swelling, sciatica or disc problems, cooling your back down can ease the pain and help to decrease inflammation. I always recommend getting examined by your healthcare practitioner for a diagnosis of your condition.

5. Watch your daytime habits

Don't forget, what you do during the day affects how you sleep at night. Try to:

  • Stay active with gentle walking or mobility exercises.
  • Limit sitting for long periods—get up every 30 to 60 minutes for a quick stretch.
  • Hydrate, but reduce fluids right before bed to avoid waking up for the toilet

Back pain can feel all-consuming, especially when it starts stealing your sleep. But with small, consistent tweaks to your routine, you can create a nighttime environment that supports healing and rest. Your body wants to feel better; it just needs the right tools.

Sweet dreams and happy stretching!

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