Sleeping Positions to Reduce Back Pain

Introduction:

Sleep plays a crucial role in the physical and mental recovery of humans. While some individuals experience relief from pain after a night’s rest, others wake with unexpected spinal symptoms or find their existing spinal issues aggravated. Spinal problems, predominantly in the cervical and lumbar regions, are common, and their prevalence has significantly risen in the past few years. Symptoms, such as stiffness and discomfort, are significant to patients with back pain. There is a hypothesis that poor sleep posture during the night may contribute to waking up with cervical and lumbar symptoms. Anecdotal and theoretical evidence suggests that specific sleep postures, like sleeping on the stomach, may subject the spine to mechanical stress that could trigger spinal pain.

Furthermore, sleep posture has been connected to sleep quality, subjectively assessed through criteria like delayed sleep onset, increased awakenings after sleep onset, and disrupted sleep continuity. Sleep postures that induce spinal pain may contribute to prolonged wakefulness, potentially affecting sleep quality. Poor sleep quality substantially impacts adult health and predicts musculoskeletal pain in various age groups.

How Do Poor Sleeping Positions Cause Back Pain?

Poor sleeping positions can lead to back pain by the following mechanisms:

1. Incorrect sleeping positions can disrupt the spine's natural alignment, for example. Sleeping in a position that causes the spine to be overly curved or twisted can pressure spinal discs, nerves, and muscles, leading to discomfort or pain.

2. Poor sleeping postures can cause specific muscles to remain tense or contracted for extended periods, leading to muscle fatigue and discomfort, especially in the neck, shoulders, and lower back.

3. Inadequate support from the mattress or pillows can create pressure points on the body, causing reduced blood flow to particular areas and resulting in pain and discomfort.

4. Sleep in positions not supporting the spine's natural curvature can stress intervertebral discs, contributing to disc degeneration and associated back pain.

5. Reduced or restricted blood flow in some sleeping postures can cause numbness, tingling, or discomfort, especially in cases where the nerves and blood vessels get compressed.

6. Sleeping with the head at an abnormal angle or without good neck support can strain the muscles and ligaments, leading to pain and stiffness.

7. In certain sleeping positions, especially when lying flat on the back, the tongue and soft palate can fall to the back of the throat, resulting in snoring or sleep apnea. This can also contribute to back pain due to disrupted sleep patterns and discomfort.

8. Using a mattress and pillows that cannot provide proper support can lead to back pain. For example, a mattress that is too soft may not support the spine’s natural curvature, while an overly thick or thin pillow can strain the neck.

How Is Sleep Related to Back Pain?

The most common sleeping positions include side lying, supine, and prone sleeping. The anatomical variations between the cervical and lumbar spine recommend that sleep postures may impact these regions differently. Studies indicated that supine sleeping was associated with lumbar and not cervical symptoms.

Considering the temporal relationship between sleep posture and spinal symptoms, only half of the studies examined waking symptoms. This knowledge gap may be due to variations in an individual’s sleep posture routines. Spinal pain is a significant global health issue, with an increasing disability rate. While biomedical approaches have historically focused on pathoanatomy as the cause of spinal pain, modified sleep positions can reduce the risk of back pain. Clinical recommendations on considering sleep posture in managing waking spinal symptoms and educating individuals to change symptomatic sleep posture are needed.

What Are the Sleeping Positions That Can Help Reduce Back Pain?

Some sleeping positions that can help reduce back pain include:

1. Supine Position:

   • Place a small pillow or rolled-up towel under the knee to maintain the natural curve of the spine or lower back.

   • Use a pillow that supports the neck curve without tilting the head too far forward or backward.

2. Lateral Position:

   • Sleep on the side with knees slightly bent.

   • Place a pillow between the knees to keep the hips and spine aligned.

   • Ensure the pillow supports the head and neck to maintain a neutral spine position.

3. Fetal Position or Curls up on the Side:

   • Curl up on the side with the knees bent towards the chest,

   • Consider placing a pillow between the knees for added support.

   • Avoid curling up too tightly to prevent strain on the back.

4. Semi-fetal or Modified Side Sleeping:

   • Instead of curling up tightly, maintain a more open, less curved position.

   • Use a pillow to support the head, keeping the spine aligned.

5. Using Adjustable Beds or Recliners:

   • Elevating the upper body and knees slightly can relieve pressure on the lower back.

   • Adjustable beds or sleeping in a recliner can help you sleep in this position.

How to Sleep With Back Pain?

Sleeping with back pain can be difficult, but these strategies and positions can help alleviate discomfort and pain and improve sleep quality. These include:

1. Choose the Right Mattress and Pillow: Invest in a mattress that provides adequate support for the back. The ideal firmness level can vary from person to person. Choose a pillow that maintains the natural neck and spine curve in the proper alignment.

2. Modifying Sleep Positions: Modifying sleep postures, such as back sleeping with a pillow under the knees or side sleeping with the pillow between the knees, can help alleviate back pain. One must avoid sleeping on one's stomach as it can strain the neck and spine.

3. Use Extra Support: Using body pillows or wedges for additional support can help maintain proper spinal alignment and reduce pressure points.

4. Heat or Cold Therapy: Applying a hot or cold pack to the painful area before bedtime can relax tense muscles and reduce inflammation, providing more relief.

5. Medications or Topical Treatments: Consulting a doctor and taking OTC (over-the-counter) or prescription medicines before sleeping can also help manage pain. Topical creams or patches can also help.

6. Stretch and Relaxation Exercises: Practice gentle stretching before bed to loosen tight muscles and improve flexibility. Yoga or other relaxation exercises can be beneficial.

7. Maintain a Consistent Sleep Schedule: Sleep and wake up simultaneously every day. A regular sleep schedule helps regulate the biological clock.

8. Stay Active During the Day: Regular physical activity strengthens the back and core muscles. However, avoid strenuous activities before bedtime.

9. Consult a Healthcare Provider: If the back pain persists or worsens, consult a healthcare provider or orthopedic specialist for a thorough physical evaluation and get personalized treatment options.

Conclusion:

Managing back pain during sleep is crucial to avoid back pain and improve sleep quality. Choosing the proper sleep position is vital for alleviating back pain. Side and back sleeping with appropriate support can aid spinal alignment and relieve discomfort, while stomach sleeping is generally not recommended. Personal comfort also plays a role, so experimenting with different positions and supportive pillows is essential.