Posterior pelvic tilt is when the pelvis rotates backwards, which can reduce the natural curve of the lower back.
When learning how to sleep with posterior pelvic tilt, focus on comfort by adjusting your sleeping position and pillow support rather than forcing your pelvis into a particular position.
What Is Posterior Pelvic Tilt?
Posterior pelvic tilt describes a position where the pelvis rotates backwards, which can reduce the natural curve of the lower back.
Research into pelvic positioning supports this relationship, with one study finding that posterior pelvic tilt reduced the lumbar curve by an average of 9° (Levine and Whittle, 1996).
Not everyone with this pelvic position experiences symptoms. However, if you do have lower-back, hip or pelvic discomfort, aim to find a relaxed sleeping position rather than consciously trying to "correct" your pelvis overnight.
The Best Sleeping Position for Posterior Pelvic Tilt
No single sleeping position for posterior pelvic tilt works for everyone.
Both back and side sleeping can be comfortable depending on your symptoms, pillow placement and personal preference. A 2025 review found that both back sleeping and well-supported side sleeping may be comfortable options for people experiencing lower-back pain (Saini, Rai and Sen, 2025).
Experts suggest trying different positions to see what feels best. The right posterior pelvic tilt sleeping position should allow you to relax without forcing your lower back or pelvis into an uncomfortable posture.
How to Sleep on Your Back With Posterior Pelvic Tilt
Back sleeping can be comfortable, but be careful not to assume that more support beneath your knees is always better.
Try placing the Groove Combination Pillow beneath your legs or knees and adjusting its height until you find a comfortable position. If lots of knee elevation feels uncomfortable through your hips or lower back, reduce the support rather than forcing the position.
Side Sleeping With Posterior Pelvic Tilt
When considering how to sleep with pelvic tilt, side sleeping is another option worth experimenting with.
Research into sleep posture has found that side sleeping was generally associated with fewer waking spinal symptoms, although the evidence is still limited (Cary, Briffa and McKenna, 2019).
Place the Groove Combination Pillow between your knees or thighs to support your legs and reduce excessive rotation through the pelvis.
It’s best to keep your knees comfortably bent rather than pulling them tightly towards your chest.
Should You Put a Pillow Under Your Knees?
You can, but the amount of support matters. A pillow beneath the knees may make back sleeping more comfortable for some people, while others may prefer less elevation.
The adjustable Combination Pillow allows you to experiment with the level and position of support until your legs, hips and lower back feel comfortable.
Getting Your Head and Spine Comfortable
The best pillow for posterior pelvic tilt isn't necessarily one designed specifically for the pelvis. Your head and neck also contribute to how comfortable your overall sleeping position feels.
As an alternative sleep aid, the Groove Adjustable Pillow has four adjustable layers. Back sleepers can experiment with a lower loft, while side sleepers may need more height depending on factors such as shoulder width, body shape and mattress compression.
If you choose to use an adjustable pillow, rather than chasing "perfect" alignment, choose a height that feels naturally supportive. There is no perfect posture for everyone.
Should You Put a Pillow Under Your Lower Back?
A small amount of lumbar support may feel comfortable for some people, but avoid deliberately forcing a large arch into your lower back.
If you experiment with lumbar support, keep it gentle and stop if it increases discomfort. If you experience discomfort or pain that increases, contact your doctor or medical practitioner for professional advice.
Sleeping Positions That May Make Symptoms Worse
If you're experiencing posterior pelvic tilt back pain sleeping, pay attention to positions that consistently aggravate your symptoms.
Sometimes, the following positions may cause discomfort:
- Tightly curling into a ball
- Deliberately forcing your pelvis into a particular posture
- Remaining in any position that noticeably increases lower-back or hip discomfort
The best advice is that if something starts to feel uncomfortable, do not force yourself to suffer through it.
Can You Fix Posterior Pelvic Tilt While Sleeping?
No sleeping position or pillow can correct posterior pelvic tilt.
If your pelvic position is associated with pain or movement difficulties, daytime movement, mobility and strengthening may be more relevant. That said, it’s always good to find a supporting sleeping position.
A physiotherapist or another appropriate healthcare professional can provide advice based on your individual symptoms.
When Back or Pelvic Pain Needs Professional Advice
Seek professional advice if pain persists, worsens or significantly affects your sleep or daily activities.
Seek prompt medical attention for symptoms such as:
- Progressive weakness or numbness
- Bladder or bowel changes
- Saddle numbness
- Significant trauma
Last Thoughts
Finding a comfortable sleeping position with posterior pelvic tilt can take a little trial and error, so don't worry about getting everything perfect straight away.
Explore the Groove Combination Pillow and Groove Adjustable Pillow to experiment with your support and find a sleep setup that feels right for you!
References
- Cary, D., Briffa, K. and McKenna, L. (2019). Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review. BMJ Open, [online] 9(6). doi:10.1136/bmjopen-2018-027633.
- Levine, D. and Whittle, M.W. (1996). The Effects of Pelvic Movement on Lumbar Lordosis in the Standing Position. Journal of Orthopaedic & Sports Physical Therapy, 24(3), pp.130–135. doi:10.2519/jospt.1996.24.3.130.
- Saini, Y., Rai, A. and Sen, S. (2025). Relationship Between Sleep Posture and Low Back Pain: A Systematic Review. Musculoskeletal care, [online] 23(2), p.e70114. doi:10.1002/msc.70114.
