Many patients come to me concerned about waking up with back pain caused by a “bad mattress” or uncomfortable sleeping position.  This is often indicative of an underlying disk problem or arthritic condition. Even those without a spinal diagnosis or chronic pain can experience an achy back or neck after a night of sleep.  What’s worse is that a lack of sleep can actually cause more sensitivity to pain and make mild back pain feel more severe. In general, we recommend a firm mattress with a pillow-top cushion layer for comfort. Back pain from sleeping is caused when strain is put on the spine in one position for a prolonged period of time – most often felt in the lower back. When this occurs, getting out of bed in the morning can be very painful, especially for the first 30 minutes until things loosen up.  How can you avoid this pain? Simple adjustments to your sleeping positions can help make a difference.     Side Sleepers The most common sleeping position for adults is on your side with your hips aligned and legs slightly bent. However, as we sleep, the unsupported top leg tends to fall and rotate the lower spine.