Nearly 80% of Americans will suffer with back pain at some point in their life. For many, an injury is triggered by strenuous activity. Others simply bend over to pick something up and their back gives out.
Some people have more difficulty sleeping if they’re suffering from back pain: the pain can be so distracting that it prevents you from a good night’s rest. Luckily, there are a few tips you can use to sleep better. We reached out to these experts, who will explain their tips below.
Back pain can be caused by a lot of things: poor posture, wrong sleeping positions, stress, injury, and trauma.
One of the best ways to get rid of back pain is by correcting your own sleeping position. Sleeping on your back is the best position for people suffering from back pain as it keeps the spine in neutral alignment. Neutral spine is the natural position of the spine when all 3 curves of the spine—cervical (neck), thoracic (middle) and lumbar (lower)—are present and in good alignment. This is the strongest position for the spine when we are standing or sitting, and the one that we are made to move from. However, this might not be the easiest position for snorers and pregnant women. If you fall into either of those categories, it’s best to go with sleeping on your side with your legs straight. This will keep your airways open, which is great for snorers and people suffering from sleep apnea too. Simply following these sleep positions removes the risks of back pain.
Liz Brown is a certified sleep science coach and founder of SleepingLucid, a company that aims to raise sleep problem awareness by creating informative sleep product reviews and other helpful sleep-related content.
Not only is the amount of rest you get important, so too is the position you get it in.
If you are healthy, without any pain and sleep the wrong way, you can wake up with back pain or sciatica. The main culprits for bringing this on are tossing and turning in your sleep and the quality of your mattress. In general, if you have lower back pain and sciatica, avoid sleeping on your stomach at night. Laying face down puts your lumbar spine in compression, which can lead to pain and stiffness when you wake up.
“Stretching before going to bed can help prevent back pain when you sleep” states Dr. Allen Conrad, BS, DC, CSCS of Montgomery County Chiropractic Center in North Wales, PA. When your muscles contract or spasm, you are more likely to get back pain when you sleep. Anything you can do to keep your spine in proper alignment will help, and regular stretching before you sleep is a good start. The muscles of your back and neck attach to your spine, so if they are stiff or sore, they will pull on your spinal column and cause back pain.
Dr. Allen Conrad, BS, DC, CSCS, is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA) as well as the Team Chiropractor for the Blackthorn Rugby Team. He is also the owner of the Montgomery County Chiropractic Center. He has worked with patients on therapeutic exercise and low back stretching for over 19 years.
People do better with a mattress that does not overly support the shoulders and hips. A mattress that allows the hips and shoulders to sink in such as a foam mattress will be better tolerated.
Also, side sleeping in a fetal position is most comfortable.
Willam Charschan DC, CCSP, ICCSP is the “The Body Mechanic”. His clinic, Charschan Chiropractic and Sports Injury Associates, can be found at two locations:
490 Georges Rd. No Brunswick, NJ 08902 (732) 846-6400
1281 Raritan Rd. Scotch Plains, NJ 07076 (732) 829-0009
Finding the right pillow can be vital towards getting a good night’s sleep. This is especially true if you are someone who suffers from neck and back pain. In some cases, it’s as simple as switching pillows. Because our spine is naturally curved, the pillow provides the support needed. Sleeping without adequate support can result in stiffness and back pain. Variance in the firmness of the pillow is mostly a personal choice. As long as the pillow provides you some support for your head. Sometimes the best way to find the right pillow for you is through trial and error.
In general, for side sleepers, the best type of pillow will be one that is about the same height as the space between the middle line of your neck and your shoulder. This allows for your head to sink slightly into the pillow, but should keep your neck in a fairly straight position. When your neck is laterally flexed too much one way or the other, you are most likely to experience pain. Side sleepers should try to use pillows between their elbows and knees to support the middle and lower back.
For someone who is a back sleeper, the best pillow is likely to be slimmer. The pillow should be thick enough to support the head so that the neck is not kept in extension all night. If the pillow is too thick then this will cause the neck to stay in flexion all night which can put a lot of strain on the neck. Ideally, you want a pillow that will keep your neck in a neutral position where your head is likely to be just a few inches off of the mattress.
Mattress quality is very important if you want to achieve an optimal night’s sleep. Having a mattress that does not provide the proper support for your body can cause you to toss and turn throughout the night, leaving you less rested and potentially in more pain when you wake up. Furthermore, when a mattress does not provide enough support, it doesn’t allow your muscles to completely relax. If your muscles are kept active all night and don’t get the proper rest, this can potentially lead to pain and injury.
A high-quality mattress is more likely to support the natural curvature of your body. This allows for your muscles to relax and does not put the body in a compromised position. The better support the mattress provides, the easier it is for someone to sleep in a more optimal position. The best advice I can give is to try the mattress out to some extent before committing to the purchase and make sure they have a generous return policy.
Alex Tauberg is a Pittsburgh Chiropractor who is evidence-based, board-certified as a sports chiropractor, a certified strength and condition specialist, and a nationally registered emergency responder. He has also been certified as a Primary Spine Practitioner by the highly regarded University of Pittsburgh. Alex specializes in treating musculoskeletal conditions. He graduated with a Doctor of Chiropractic degree from the National University of Health Sciences, and with a B.A. in Psychology from Eckerd College. He’s also a team chiropractor for the Pittsburgh Vengeance.
The best way to sleep better with back pain is to do everything you can to rid yourself of back pain. However, there are a lot of things that you can do to sleep better if you are suffering from back pain such as finding a proper pillow for your neck and shoulders for the upper back pain sufferer. Different positions as well as a pillow between your knees for lower back pain sufferers. Another frequent cause of back pain when sleeping is that many people clench their teeth; solution can be inexpensive over the counter mouthguard. Lastly, the role of your diet and beverage choices can have on sleep and back pain.
Todd Sinett has authored 4 books on back pain. He practices in NYC.
Sleep is the time when our bodies recuperate and this is especially important if we are in pain so that we can minimize the episode and heal more quickly. If you’re struggling with back pain, you need a firm stable base of support as your sleep surface. People with pain don’t need to resort to sleeping on the floor, but they should sleep on a mattress with a firm foundation. The mattress can have a soft top as long as it does not dip in the center from the weight of the body.
Positioning is important. Sitting causes the disks in the spine to take on more of a load, so sleeping in a recliner or on an adjustable bed that is elevated is not ideal.
Sleeping on your back is best, with a substantial pillow under the knees and a soft towel under the small of the low back to encourage the natural curvature of the spine. In this position, the weight of the body is distributed evenly on both sides. This means the disks and nerves are less compressed by gravity, which can allow the muscles to relax.
From the back, pain can shoot into one or both buttocks, hips and legs. Side sleeping, with the knees drawn slightly toward the chest and the painful leg, hip or buttock upward, can help to reduce pressure on an already overstimulated nerve. I recommend a body pillow for side sleeping. When placed between the knees, it can help keep the spine level and inhibit movement during sleep.
If a recliner is the only place someone is able to sleep, it should be as reclined and horizontal as possible.
Sleep is important for healing, so going to bed an hour earlier and resting your body even if you are not able to fall asleep will be helpful.
Don’t sleep on your stomach. This causes the head to be turned to the side for hours and may create another spinal problem in addition to the back pain.
Many of my patients have found natural products, like CBD oil, can reduce pain and inflammation–including pain in the back–making it easier to fall asleep and stay asleep. Over the counter melatonin and herbal sleep teas can help you doze off when pain is keeping you awake.
Spinal disks are composed primarily of water, so it is extremely important to stay hydrated. Drinking up to half of your body weight in pounds, in ounces of water a day, will help disks to remain hydrated and function properly and may even prevent the pain from the beginning.
Persistent pain should not be worse at night or in a relaxed position. If pain continues, and is worse at rest, seek help from a qualified healthcare provider as this could indicate something more serious than a muscle or nerve problem.
Dr. Wendy Twohey, D.C. of Dr. Gil Center for Back, Neck, and Chronic Pain Relief
Your mattress should help you ‘unwind’ or better yet ‘straighten out’. The day’s activities or lack of can negatively affect your posture and your posture is another barometer for your overall health. Your mattress can help or perpetuate bad posture by either working to straighten you out or maintaining a negative position.
One way to make any mattress better is to lie on the hard floor, flat on your back for a couple of minutes immediately before you go to bed.
Now when you lie on your mattress, you’re more likely to hold that positive posture position while you sleep, waking with a body better equipped for the new day.
Dr. Joseph Iannelli provides wellness, massage therapy, natural health, holistic medicine, and treatment for back pain. He invented a pillow insert that helps ease back pain.
The most helpful tip that I’ve given people who suffer with back pain is finding a comfortable mattress (ex. firm, soft, etc) and a comfortable position (ex. side, back, stomach, pillow or not, or some combination) that works for you! Everybody is individual and what works for one might not work for the next. It takes a little bit of experimentation, but once you figure it out, you’ll be sleeping like a baby again! Two other quick tips I recommend are getting on a regular exercise routine (again whatever activity you enjoy!) and dealing with stressful events in your life. This will allow your mind to relax and you to have a more restful night's sleep!
Michael Hildebrand is a Doctor of Physical Therapy who started M3 Physio in August 2019. He graduated from the University of Louisiana at Monroe in 2010 and LSUHSC – New Orleans in 2014. He received his Certification in Orthopedic Manual Therapist (COMT) through OPTIM Manual Therapy in Dallas, TX in 2019.
Back pain is usually caused by poor mechanics and/or postural imbalances. The symptoms can be felt and even exaggerated while at rest overnight if adequate positioning is not emphasized. A mattress that is too firm or too soft can be problematic. The goal to help with and prevent back pain is to create a comfortable and supportive surface and sleep position.
First, notice if you have pain when you get out of bed and if you feel “soreness” that starts to improve with movement and/or a warm shower. Your body might be communicating to you that your bed is not “Goldilocks” enough- not too hard and not too soft. If you can’t change your mattress, then you can try a foam cover that helps to balance the existing state.
Next, notice how you sleep. If you sleep on your stomach, you might want to try lying on your side with a pillow between your knees to get the pelvis more neutral and take the pressure off your back.
Finally, consider lying on heat or a mat that looks like a torture device with little spikes. One such mat is called a Pranamat and it claims to help relieve back discomfort through a variety of acupressure points. I have tried it and love it.
As with all pains in the body, pay more attention to everything! How you move, sit, and sleep can contribute to your back pain and conversely, can help to remedy the pain.
Lara Heimann graduated from Duke University with a BS in Biological Anthropology and Anatomy and an MA in Physical Therapy.
The LYT™ method was developed by Lara Heimann, a world-renowned yoga instructor and certified physical therapist, who has spent the last 25 years refining her practice by merging her yogic and therapeutic backgrounds.
Stretch out before going to sleep to avoid waking up with extra-low back stiffness and pain. One great stretch is to lay on your back with knees bent and feet on the bed. Slowly rock your knees from side to side while keeping the shoulders flat on the bed. Rock side to side just as far as what’s comfortable. You will feel a gentle stretch at the lower back. This helps to keep the muscles at the lower back relaxed to avoid excess tension and pain overnight and upon waking.
Nina Geromel, PT, DPT, ATC
Owner, Doctor of Physical Therapy
If you have chronic low back pain that gets worse when you sleep and is especially bad when you get up in the morning, it may be coming from your mattress. While thigh pillows and good sleeping posture can definitely help, it will be hard for them to make up for a bad mattress. First, like anything, your mattress will wear out. A good rule of thumb is that you may need to replace your mattress after 7-10 years. If you are not sure if your mattress is worn out, try lying down backward on it, meaning put your head where your feet normally go. If you notice a difference, then your mattress may be worn out and need replacing. The best kind of mattress to get is one that is medium-firm, meaning that it’s not too hard, and not too soft. Medium-firm mattresses have been shown to have the greatest effect on low back pain. The key is having a mattress that supports your lumbar spine in its natural position, and research points to a mattress that is medium-firm.
Daniel Paull MD
Founder and CEO of Easy Orthopedics
There are various reasons that may contribute to back pain. The reasons include malposition of the structure within the spine, such as a herniated disc, deformed shape of the spine such as scoliosis, degenerative disease of the spinal disc, slipping of the vertebrae over the one above it and many more reasons that could add up to this list. The key to treating the back pain apart from medical treatment is to keep the posture right by getting it into correct alignment. Here are some tips for sleeping position based on each condition above.
As we all know, this condition is characterized by slipping of the disc, a soft cushion out of the actual position. This results in compression of the nerve that may lead to catastrophic complications including sudden sharp back pain, sudden paralysis or urinary incontinence. By curling your torso into a fetal position, this may help to open up the space between the vertebrae keeping the disc or allowing the disc to stay in the normal position.
This condition is a fancy term for slippage of vertebrae over the one above it. It can be very excruciating but treatable via a surgical or medical method. The symptoms can range from persistent back pain to stiffness of the back and legs. This condition is most beneficial from sleeping in a recliner sofa or adjustable bed. This position provides an angle that is pressure-relieving in a patient with spondylolisthesis.
Avoid sleeping on the same side throughout the night as this will exacerbate conditions such as scoliosis. Sleep on the side with bent knees and hips. Place a pillow in between the knees and fill any gap with a small pillow or towel to keep the spine, hips, and waists in better alignment.
In the past, it was best to sleep flat on a hard surface as it is the position that will keep the body in the most aligned position. However, in this modern era, various mattresses could help you achieve the right alignment and still enjoy the comfort of a warm surface and good sleep. Sleeping on the back with a pillow under the knees will help to evenly distribute body weight across the widest area. Thus, this position reduces strain on the pressure points. In addition to that, keeping a correct alignment is a great help to reduce stress and placing a pillow to fill the gaps will enhance the effects.
Dr Sashini Seeni