Advice

Yes, but it depends on how you sleep.

Sleeping on Your Stomach

• Stomach sleeping often strains the lower back by forcing the spine into an arched position.
• Using a pillow under your head can exaggerate the arch in your back and increase pressure on the spine.
• In this case, sleeping without a pillow under your head may help reduce lower back pain.
• It’s often recommended to place a thin pillow under the hips or pelvis to further relieve lumbar pressure.

Sleeping on Your Back or Side

• For back or side sleepers, going without a pillow can disrupt spinal alignment.
• Sleeping without a pillow may cause your neck to bend unnaturally, putting strain on the spine and leading to stiffness or discomfort.
• In these positions, the head needs support to stay aligned with the rest of the spine.

The Key – Maintain Neutral Spinal Alignment

The main goal while sleeping, regardless if you use a pillow, is to keep your spine in a neutral, aligned position. Poor alignment can lead to…

• Increased tension in the lower back
• Muscle fatigue or spasms
• Discomfort upon waking

Even if you use a pillow or not, the priority is to support the natural curves of your spine.

Recommended Sleep Practices for Lower Back Pain

If you sleep on your back

• Use a medium-support pillow under your head to keep your neck aligned
• Place a pillow under your knees to ease lower back pressure

If you sleep on your side

• Use a firm pillow that keeps your head level with your spine
• Place a pillow between your knees to reduce hip and spine rotation

If you sleep on your stomach (not ideal)

• Avoid using a pillow under your head, or choose a very thin one
• Place a pillow under your hips to reduce lumbar strain

Sleeping without a pillow may help relieve lower back pain if you’re a stomach sleeper, especially when combined with hip support. But for back and side sleepers, removing your pillow can cause misalignment and make pain worse.

For most people, the key to relieving back pain during sleep is not simply eliminating the pillow but choosing the right pillow and sleep position to maintain proper spinal alignment.