Lumbar support pillow for sleeping: where it helps and where a different pillow is better
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- Thin contoured lumbar pillow for bed. Best for: Back sleepers on a firmer mattress. See options on Amazon
- Knee pillow for side sleepers. Best for: Side sleepers with low back pain. See options on Amazon
- Under-knee bolster. Best for: Back sleepers who want the main support. See options on Amazon
- Slim pillow for under the hips. Best for: Stomach sleepers. See options on Amazon
Match the pillow to your sleep position
| Position | Where support goes | Source advice |
|---|---|---|
| Back | Under the knees, plus a thin support under the low back if there is a gap | Sleep Foundation: pillow or rolled towel under the knees, and a thin lumbar pillow on a firmer mattress. Mayo Clinic: a small rolled towel under the waist |
| Side | Between the knees, legs drawn up slightly | Mayo Clinic and Sleep Foundation: a pillow between the knees; Mayo adds a full-length body pillow is an option |
| Stomach | Under the hips and lower stomach | Mayo Clinic and Sleep Foundation: a small pillow under the pelvis or lower abdomen |
Setting up for back sleeping, step by step
- Lie on your back with your head on a pillow that keeps your neck in line with your chest and back, as Mayo Clinic describes.
- Place a pillow or rolled towel under your knees. Both Mayo Clinic and the Sleep Foundation start here.
- Slide a flat hand under your waist. If there is a clear gap, add a thin lumbar pillow or a small rolled towel there.
- Check that the support sits at the waist, not under the ribs or the buttocks.
- Lie still for a few minutes. Your low back should feel supported, not pushed upward.
If you change positions during the night, a thin pillow is easier to sleep around than a thick one.
Why the mattress matters
The Sleep Foundation says medium-firm mattresses tend to give the best balance of comfort and support for most people with back pain. On a mattress that is too soft, the lower back can sink too deeply, and a lumbar pillow will simply sink with it. On a firmer surface, there can be a gap under the low back, which is when a thin lumbar pillow makes sense. If your mattress is the real problem, see mattress topper for back pain.
Choosing a lumbar pillow for bed
- Thin and low. In bed you are filling a small gap, not creating an arch. The Sleep Foundation specifically says thin.
- Soft edges. A tapered or rounded edge is less likely to dig in as you shift.
- Stays put. Bed lumbar pillows often slide; a slightly grippy cover helps.
- Washable cover. It sits against you all night.
- Try a towel first. Mayo Clinic's small rolled towel is an easy way to test whether low back support helps before buying anything.
Common mistakes
- Using a thick chair-style lumbar roll in bed, which can over-arch the back.
- Placing it at the ribs instead of the waist.
- Skipping the knee pillow. For back sleepers both the Sleep Foundation and Mayo Clinic put the main support under the knees.
- Sleeping twisted. The Sleep Foundation flags twisting positions as hard on the low back.
If you are a side sleeper with back pain, our side sleeper knee pillow guide covers the pillow that usually helps more.
Other options
The Sleep Foundation mentions a wedge pillow to raise the upper body as an alternative to an adjustable bed. Some people find a wedge more comfortable than flat back sleeping; see wedge pillow for back pain. For back sleepers who need more lift under the knees, see under knee pillow.
What to look for when you buy
Thin contoured lumbar pillow for bed
Best for: Back sleepers on a firmer mattress
The Sleep Foundation suggests a thin lumbar support pillow beneath the lower back for back sleepers on a firmer mattress.
Watch out: Too thick and it arches the back; skip it on a very soft mattress.
See options on AmazonKnee pillow for side sleepers
Best for: Side sleepers with low back pain
Mayo Clinic and the Sleep Foundation both recommend a pillow between the knees; the Sleep Foundation says it keeps hips, pelvis and spine in better alignment.
Watch out: Pick a height that keeps the top knee level with the hip.
See options on AmazonUnder-knee bolster
Best for: Back sleepers who want the main support
Both sources put a pillow or rolled towel under the knees for back sleepers.
Watch out: Very high bolsters can feel awkward for people with hip stiffness.
See options on AmazonSlim pillow for under the hips
Best for: Stomach sleepers
Mayo Clinic suggests a pillow under the hips and lower stomach for stomach sleepers.
Watch out: Changing to side sleeping may suit some people better.
See options on AmazonQuestions people ask
- Should I sleep with a pillow under my lower back?
- If you sleep on your back on a firmer mattress and feel a gap, a thin lumbar pillow may help, per the Sleep Foundation. Put the main support under your knees.
- Can you use a lumbar pillow when side sleeping?
- Side sleepers usually do better with a pillow between the knees, which Mayo Clinic and the Sleep Foundation recommend.
- Is a rolled towel as good as a lumbar pillow?
- It is a good test. Mayo Clinic suggests a small rolled towel under the waist for back sleepers.
- What mattress firmness is best for back pain?
- The Sleep Foundation says medium-firm mattresses tend to suit most sleepers with back pain.
- What is the best sleeping position for lower back pain?
- The Sleep Foundation ranks side sleeping with a knee pillow first and back sleeping with a pillow under the knees next.
Sources
- How to Sleep With Lower Back Pain (www.sleepfoundation.org/physical-health/how-to-sleep-with-lower-back-pain), Sleep Foundation
- Sleeping positions that reduce back pain (mayoclinic.org), Mayo Clinic
- Back pain (nhs.uk), NHS