
Keeps hips level so the lower back stops twisting.
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Lower back pain and stiffness after a night on your side

When you sleep on your side, your top knee slides forward and down. That pulls the pelvis out of line and twists the lower spine for hours. A knee pillow holds your legs hip-width apart, so the spine stays straight from neck to tailbone.
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On your side with a pillow between your knees, or on your back with a pillow under your knees. Both keep the spine in a neutral line and take pressure off the lower back.
Yes, for many people, as long as a pillow under the knees keeps the lower spine from arching. Without that support, back sleeping can strain the lumbar area.
Research has found medium-firm mattresses often relieve back pain better than very firm ones. Too soft lets the hips sink and twist the spine.