You lie down hoping for relief, but your lower back aches whichever way you turn. Then morning comes, and getting out of bed feels like a slow, careful operation. A sore lower back and sleep often get tangled together, but a few changes can make nights and mornings easier.

Your mattress may matter less than you think, but firmness counts

Many people assume a very firm mattress is best for a bad back. A well-known trial compared firm and medium-firm mattresses in people with long-standing lower back pain. Those on medium-firm mattresses reported less pain in bed and less pain on waking than those on firm ones. A mattress that lets your hips and shoulders sink in slightly, while still supporting your waist, seems to suit most backs.

If buying a new mattress isn’t an option, a mattress topper can soften a very firm bed. A board under a very soft or sagging mattress can firm it up.

Positions that take the pressure off

There’s no single best position, but small supports can help your back relax:

• On your back: a pillow under your knees can ease the arch in your lower back.
• On your side: a pillow between your knees can stop your top leg pulling your pelvis and lower back into a twist.
• On your front: a flat pillow under your tummy can stop your lower back sinking into a deep arch.

Why mornings can be the stiffest part of the day

After hours of lying fairly still, your back can feel stiff on waking. This usually eases within the first half hour of moving. It’s a sign your back is ready to move, not a sign that something is wrong.

Getting out of bed

When your back is stiff, sitting straight up from lying can feel uncomfortable. Many people find rolling onto their side first, then pushing up with their arms while swinging their legs over the edge, is much kinder on their back.

Moving in the day helps the night

Staying active during the day is one of the most helpful things for lower back pain, and it may also help you sleep. Your daytime habits and your nights are more connected than they might seem.

Something to try this week

If you sleep on your side, try a pillow between your knees and notice how your back feels in the morning.

What to take away

• Choose a medium-firm sleeping surface if you can.
• Use a pillow under or between your knees.
• Roll onto your side before getting out of bed.
• Keep moving during the day.

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