Insomnia and back pain can be alleviated by placing pillows correctlyThis morning I landed on a blog promoting use of a wooden pillow for intestinal health and insomnia relief. No joke. You’re supposed to lie face down with the “pillow” under your lower stomach and gently shake the abdominal area from side to side. This rocking motion supposedly helps with digestion and spinal alignment, relaxing you and helping you fall asleep.

Pardon my skepticism, but frankly the adjective wooden does not belong in the same sentence as insomnia relief. I’ve blogged about wooden pillows elsewhere and am no more convinced I should place one under my stomach than under my neck!

But I know from experience that pillows can make a difference between a good night’s sleep and a bad one. A reader suffering low back pain and insomnia wrote in with a question about pillows a few days ago, prompting me to do a little research. Here’s what I found out.

Low back Pain and Insomnia

That pain can interfere with sleep is a no-brainer. But there seems to be an especially tight and complex relationship between back pain and insomnia or disturbed sleep. Recent studies from Korea and the United Kingdom suggest that 43 to 47 percent of patients diagnosed with chronic low back pain or chronic back pain also suffer insomnia. A large study conducted in Japan found that low back pain is significantly associated with poor sleep quality and sleeping less than 6 hours a night.

Insomnia also places people at greater risk for the development of low back pain, Israeli researchers found recently. Other investigators have shown that just as low back pain can disturb sleep, so disturbed sleep tends to increase the intensity of pain. This creates a vicious circle: pain disturbs sleep, leading to greater pain, leading to further sleep disturbance, and on and on.

But strategic placement of pillows can alleviate back pain by straightening out the spine and keeping it in alignment, relieving pressure on pain-sensitive areas and creating conditions where you’re more likely to get a decent night’s rest.

Stomach Sleepers

If you like sleeping on your stomach, the pillow supporting your head and neck should be fairly flat. If it’s got too much loft, you wind up sleeping with your neck cranked too far to the side, torquing the upper spine and straining muscles in the neck.

Straighten out the lower spine by sleeping with another fairly flat pillow under your stomach.

Back Sleepers

The pillow supporting your head, neck, and shoulders should be thicker if you prefer sleeping on your back. In its natural position, the human neck curves slightly forward, say doctors writing on This curve should be maintained during sleep. A too-high or too-low pillow causes muscle strain in the neck. It can also obstruct breathing and result in snoring.

To straighten out the spine in the lower back, take one or more thick pillows and place them under your knees. Flattening out the spine this way relieves pressure on the pain-sensitive joints in the lumbar area.

Side Sleepers

If you prefer to sleep on your side, the pillow supporting your head and neck should be fairly thick. Otherwise the upper spine will be unnaturally bent.

Use of a knee pillow is critical for side sleepers with low back pain. Side sleepers often sleep with bent knees, and without use of a knee pillow, there’s a tendency for the upper leg to fall forward, twisting the lower spine and aggravating lumbar pain. Placing a small, firm pillow between the knees straightens out the spine and will allow for greater comfort and a better night’s rest.

I’m a side sleeper myself, and to avoid low back pain I use a variation of this suggested to me by a physical therapist. Instead of positioning my legs one on top of the other, I pull my top knee forward so it’s at right angles with my torso and place the knee on a small, thick pillow. This helps me sleep through the night and wake up in the morning pain free. Sleeping on the left side in this position is recommended for pregnant women, too.

Pillows flatten out over time and may cease to provide the support you need. My husband teases me about running through pillows likes hotcakes, but expert opinion is on my side. When your pillow loses its loft, it’s time to add stuffing or buy a new one.

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.


  1. I have had multiple back surgeries and it was suggested I use a pregnancy pillow. It provides support from your knees to your head. Invaluable for side sleepers – it keeps the spine aligned and is the correct height. The only drawback- my bed canine bed buddies love to sleep in the bottom curl.



    1. Thanks, Sheila, for this suggestion. The pillow you’re describing sounds like it would work for many side sleepers.



  2. So I can sleep however I prefer, as long as I use the pillow and pillow placement that fits my position?



    1. That sounds about right. Not long ago a paper was published claiming that sleeping on the side facilitates removal of toxins from the brain. I’m taking this claim with a grain of salt! (I do, however, prefer to sleep on my side.)



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