Posture Insights

For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?

Sleep With A Pillow Between The Legs

Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.

The Benefits

Some potential benefits of sleeping with a pillow between the knees.

Reduce Back and Hip Pain

When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.

Reduce Sciatica Symptoms

Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.

Reduce Herniated Disc Symptoms

A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)

Improve Posture

Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body's natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)

Pregnancy

Pregnancy pain in the back and pelvic girdle is due to: (Danielle Casagrande et al., 2015)

• Increased weight leads to increased pressure on joints.
• Significant change in the center of gravity.
• Hormonal changes make connective tissues more lax.

Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.

Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.

What Causes Disc Herniation?

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. https://doi.org/10.3233/WOR-152243

American Academy of Orthopaedic Surgeons. (2021). Sciatica. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/sciatica

Penn Medicine. (2024). Herniated disc disorders. Penn Medicine. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/herniated-disc-disorders

University of Central Florida. (N.D.). The best sleeping position for lower back pain (and the worst). UFC Health Services. https://ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. https://doi.org/10.1371/journal.pone.0260582

Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. https://doi.org/10.2147/NSS.S145777

University of Rochester Medical Center. (2024). Good sleeping posture helps your back. Health Encyclopedia. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460

Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. https://doi.org/10.5435/JAAOS-D-14-00248

Standford Medicine. (2024). Sleeping positions during pregnancy. Standford Medicine Children's Health. https://www.stanfordchildrens.org/en/topic/default?id=sleeping-positions-during-pregnancy-85-P01238

O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). https://doi.org/doi:10.1186/1471-2393-15-S1-A4

In today’s society, its easy to identify a strong, confident individual by the way they carry themselves. From strong leaders to popular group members, we can look at many of these people and see their confidence. Aside from personality, there’s one main factor that commonly defines these individuals; posture. The body language we display to others is a powerful source of communication. Posture can say more about an individual than words. An upright posture can be a subtle signal of self-assurance to everyone around you, but more importantly, a proper posture reveals health from within.

Good posture is an essential component of your health. The spine is the key to a strong and healthy posture. Hippocrates, the father of modern medicine quoted, “Look first to the spine for the cause of all disease.” For many years now, it’s been acknowledged that spinal health can therefore influence your overall health. The spine, also referred to as the vertebral column or spinal column, is composed of a series of bones called vertebrae which are stacked one upon another. The spine functions to protect the spinal cord as well as to provide overall support to the structures of the body, allowing you to stand upright, bend, and twist.

Sciatica Sleep: Poor sleep can leave the body feeling off and unable to function. Not getting the proper amount of sleep can decrease health, decrease work or school productivity, and cause burnout. If it becomes chronic, it can have serious side effects on the brain and body that include:

• Chronic Fatigue
• Memory problems
• Body discomfort, pain
• Exacerbation or trigger disease

Sciatica Sleep

When sleeping, certain positions/postures can place added pressure on the spine, irritating the nerve. The best sleeping positions maintain the spine's natural curve and are different for everybody. For example, many individuals sleep on their side. They do not start sleeping this way, but they end up on their side and wake up in pain to find their sciatica flaring up. Other individuals can turn on a specific side, and the symptoms fade or go away.

Positions

The best sleeping position for one individual may not be the best for another. A lot of this depends on the placement of the injury/pinching that can affect how certain sleep positions work, causing no symptoms, while other sleep postures generate all kinds of symptoms, especially pain. Individuals are recommended to sleep in the position that works for them, provided with the correct posture.

Side Sleepers

• Side sleepers are recommended to place a pillow between their knees for healthy sleep and pain avoidance results.
• A pillow between the legs helps to prevent twisting.
• A firm pillow will work or a soft pillow folded in half.
• It is also recommended to consider a small pillow under the waist to maintain the alignment between the ribs, hips, and the spine.

Back Sleepers

• Back sleepers can benefit from a pillow under the knees to maintain a neutral curve of the spine.
• This keeps the legs slightly elevated helping prevent the legs from tilting the pelvis and pulling the spine out of a neutral position.
• Individuals that sleep on their back but end up on their side, are recommended to use a large pillow or body pillow placed on the side they turn on to prevent this.

Stomach Sleeping Not Recommended

• Sciatic pain can become worse with sleeping on the stomach.
• Sleeping on the stomach can collapse the spine and the pelvis as there is no support underneath. This causes damage to the nerves, increasing symptoms and pain levels.
• Try to avoid sleeping on the stomach until the sciatic nerve has healed or try to train the body to sleep on the side or back.

Non-Surgical Spinal Decompression Can Help Sciatica Sleep Symptoms

Non-surgical spinal decompression therapy relieves pressure on the sciatic nerve, spine, and surrounding muscles by pulling/stretching them in small increments. The decompression creates negative pressure within the discs that floods the area with an abundance of nutrients to activate and expedite the healing response.

• The chiropractic physical therapy team uses motorized medical equipment with sensors linked to a computer-aided system to perform the procedure.
• The equipment is designed to adjust the pull force accordingly to prevent muscle resistance.
• The adjustable table also allows the spine to be stretched at different angles to target all areas of the back.

Relieves Pressure On The Sciatic Nerve

• Decompression stretches the nerve out and increases the space around the impinged and inflamed nerve.

Pain Relief

• Decompression relieves tension in tight, spasming, or injured muscles.
• Stimulates the nervous system to release the body's natural pain killers.
• Spinal tissue healing from fluids, cells, and other substances that enter the damaged tissue.

Restores Disc and Joint Alignment

• Decompression realigns the joints and discs, preventing pain, inflammation, mobility/flexibility problems, and dysfunction.

Encourages Sleep

• There are toxins in the body, and decompression causes these toxins to be expelled.
• This causes exhaustion because the body needs time to adjust after expelling the negative energy.
• After a short time, energy levels will return.
• The decompression relaxes the entire body which allows for more restful sleep.

DRX9000

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Kim, Shin Hyung et al. “Risk factors associated with clinical insomnia in chronic low back pain: a retrospective analysis in a university hospital in Korea.” The Korean journal of pain vol. 28,2 (2015): 137-43. doi:10.3344/kjp.2015.28.2.137

Radwan, Ahmed, et al. “Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; a systematic review of controlled trials.” Sleep health vol. 1,4 (2015): 257-267. doi:10.1016/j.sleh.2015.08.001

Santilli, Valter, et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001