While sleeping you have no conscious control over your body which may result in tucking in your pelvic bone or twisting up the spine. When such pain and discomfort get aggravated it may lead to restless nights of sleep.
It is necessary to maintain the natural curve of the spine while lying in bed which can be done by keeping the shoulders, hips, and head in proper alignment. Using specific sleep postures can prevent the stress on your spine and relaxing your back, thereby creating a healing environment.
Following certain sleep techniques and positions can help you to reduce your back pain. So, you need to find the position that is most comfortable for you.
Below are a few guidelines for proper sleeping positions to reduce back pain
Elevating the knees while sleeping on the back
Lying on the back is considered as the best sleeping posture as it helps in evenly distributing the entire weight of the body. it also ensures proper alignment of the neck, spine, and head, thereby minimizing the pressure points.
If you are a back sleeper, place a pillow beneath the knees to raise it slightly. This will help to maintain the natural curve of the spine and reduce stress on your lower back. Alongside, use a head pillow for proper neck and head support and maintain the alignment of the spine.
To properly follow this sleeping position you must:
- Lie flat on your bed facing the ceiling without turning the head sideways.
- Position the pillow to properly support the neck and head.
- Place a small pillow under your knees for properly elevating them.
- For filling up any other gap between the mattress and the body place more pillows, especially at the lower back.
Keeping the hips stacked while sleeping on the sides
Lying on the side is the most common sleeping position but it can often pull the spine out of its position causing strain on the lower back. For side sleepers, placing a flat, firm pillow between the knees can prove to be effective. The pillow will help to align the hips with your lower spine and prevent the leg on the top to exert pressure on your pelvis or lower back. The support also helps in creating room for the spinal nerves and relieves stress from the lower spine. Also, make sure to use a head pillow to align your head with the shoulders.
- To adopt this side sleeping position:
- After lying on your bed, slowly roll on to your preferred side.
- Place a pillow to support the neck and head.
- Slightly pull up the knees and place a pillow between them.
- For added support, you can place more pillows at the waist to fill any gap between the mattress and the body.
Stomach sleeping by arching the spine
Although stomach sleeping might not be a good posture for those with neck pain it can be therapeutic for people with low back pain, degenerative disc disease, or herniated disc disease. Lying on the stomach extends the lower back and arches the spine. This is why people with low back pain are advised low back extension exercise. However, if you are a stomach sleeper and you have back pain, place a pillow underneath the waistline and hips to open up more space for the spinal nerves.
To properly adapt this technique:
- Go to bed and roll on to your front.
- Place a thin pillow underneath the hips and abdomen to raise the mid-section.
- For placing your head, either use a flat pillow or sleep without one.
Sleeping in the fetal position
People with a herniated disc may get relief by adopting the curled-up fetal position. Lying with the knees tucked into the chest helps to bend the spine and opens up the joints.
For adopting this sleeping posture you should:
- Get into bed and roll on to one side.
- Position the pillow for properly supporting the neck and head
- Pull the knees up to your chest until the back gets stretched out and straight.
Sleeping in a reclined position on your back
People with isthmic spondylolisthesis can benefit a lot with their lower back pain by sleeping in a recline position. You may also get relief from resting in a reclined chair. When the body is in a reclined position there is a natural space created between the thighs and trunks. This posture exerts minimal pressure and strain on the spine.
You can also think of investing in an adjustable bed that can be positioned to a reclined chair.
Sleeping on the front with your face down
Sleeping with the head down is often considered bad as the head remains turned to one side. This puts additional stress on the shoulders, back, and neck and twists the spine from its usual position. While some sleep experts recommend placing a towel or firm pillow on the forehead to sleep with the face down it is not so practical. To sleep in this posture an additional pillow needs to be placed under the stomach.
- Get into bed and roll on to your front.
- For raising the mid-section place a slim pillow underneath the hips and abdomen.
- Position a rolled-up towel or firm pillow up the forehead to provide adequate room for breathing between the mattress and the mouth.
Expert Advice from Dr. Stuart M. McGill
Dr. Stuart M. McGill is a professor emeritus, University of Waterloo, where he was a professor for 30 years. His laboratory and experimental research clinic investigated issues related to the causal mechanisms of back pain, how to rehabilitate back-pained people, and enhance both injury resilience and performance. His advice is often sought by governments, corporations, legal experts, medical groups, and elite athletes and teams from around the world. He continues as the Chief Scientific Officer for Backfitpro Inc. Difficult back cases are regularly referred to him for consultation.
On sleeping and back pain
Back pain when lying in bed or when getting up the next morning is not normal. All back pain has a cause. The key to successful management of back pain is to understand the cause and remove it. Then the task is to restore a robust back that thrives on a variety of activity. Here are some thoughts that are founded in science and clinically proven.
Historically, clinicians were taught that back pain during the night is a marker for a more sinister cause of back pain such as infection or a tumor. While this remains a possibility, these mechanisms are actually quite rare. New studies and evidence show that pain at night, and after first rising from bed, is more often a mechanical cause. The most common cause of pain involves the spinal discs between the vertebra. Here, excessive forward bending when combined with forces from lifting objects leads to pain sensitivity in the posterior parts of the disks. The pain is made worse when the curve in the low back flattens or bends forward. Even when laying in bed people with sensitized discs can trigger pain when the spine is out of neutral alignment. For example, when lying on the back simply place your hands palms down under your low back and if this is more comfortable and reduces pain, you fall into this category of pain mechanism. If pain is caused by side lying then place a folded towel under the waist area between the rib cage and the hips. If this removes pain and discomfort then once again you fall into this postural category of pain. Changing postures migrates stress from one part of your spine to another. Our family of back supports creates a posture that moves the posture away from the offensive stress and pain. Trials with patients have proven the effectiveness of this approach.
The second common mechanism for night pain is from spinal joints that have experienced a loss of height. The height loss (often mistakenly called degenerative discs) allows micro-movements to occur between vertebra as you roll over or change position. Specifically the height loss reduces the structural stability of the joint allowing sharp pain triggers with each joint micro movement. For those who have sharp pain when rolling over will benefit from stabilization exercises performed during the day together with sitting with a lumbar back support.
The solution to reducing night pain and morning stiffness and pain involves three components, all of which are equally important. The first step is to stop the cause of pain. Pain is not random or non-specific. Back pain is very specific. A major flaw in the traditional medical system is that thorough assessments of back pain generally do not exist. This is why we began to train Master Clinicians to conduct thorough assessments of back-pained people to create a precise understand of their pain pathway. Then the most appropriate intervention can be matched specifically to the mechanism. Due to the inability of many people to see one of these Master Clinicians, I wrote a book titled, Back Mechanic, to guide the lay public with back pain through nine self-administered tests to determine the cause of pain with more precision. The book then shows ways to move to accomplish daily tasks without triggering pain. These “movement hacks” are known as “spine hygiene”. There are many people who report that they never had another acute attack of back pain after following the principles of spine hygiene. For those with night back discomfort, supporting postures that remain in the pain-free range are part of spine hygiene.
The second part of the solution is to create an exercise program that encourages the body to adapt to handle the specific stressors of a person’s life in a pain-free way. The skeleton is really a linkage formed by links with joints. This linkage functions best when some joints have appropriate mobility and other joints have appropriate stiffness and stability. These specific exercises create movement patterns to optimize both stability and mobility. Then the exercises are programmed to encode these pain free patterns into the person’s muscle memory to make them their movement habits.
The third part to the solution involves using the low back supports to position the spine in a way that avoids stressful positions. But each person has a different shape of their spine and a different body type therefore the supports need to be highly adjustable. All of the supports incorporate a pneumatic bladder that inflates to the right level and position. The specific support recommended for sleeping is called the PropAIR. The support is worn with the Teflon outer cover to allows sliding on bed sheets with a quality velour material against the body.
The PropAIR will help most people with night pain but not all. To see if the PropAIR is for you repeat the test described above – briefly, lay on your back and place your hands palms down under the low back. Start with your hands at the top of your butt crack Adjust your hands up and down. If this increases comfort and reduces pain the PropAIR will help you. Some women in particular are quite curvy in that when they lay on their side their waist area is not supported by the bed. This area sags and triggers pain. However, placing the PropAIR under the waist to align the spine allows many to wake up with much less pain and some to be completely pain-free.
Do these supports really work?
Our science has shown the mechanisms of posture and influence on back pain, and how to find the best posture to remove their back pain. The key is to migrate stress away from the pain sensitised parts. Of all of the patients who saw us at the experimental university clinic and who were told that they had tried everything and surgery was their last option, we were successful in allowing 95% of them to avoid surgery. In follow-up after one-year, they reported they were glad for their decision. Our program involved the three-part solution outlined here and which included the back supports for sitting and lying. My book, Back Mechanic together with the supports are available on backfitpro.com.
A Final Word of Advice
Although lower back pain is not a malignant condition it can often disrupt your normal sleep quality. It can either wake you up in the middle of your sleep or cause discomfort and pain after waking up. In all the above recommended sleeping positions it is seen that spinal alignment is thoroughly stressed on. This indicates that most problems associated with back pain are due to aggravation of the spine.
Besides, following a specific sleeping posture it is also necessary to consider other associated factors like using ergonomic pillows and mattresses, doing regular back exercises, and consulting a healthcare expert in case of discomfort and pain. You can also follow the expert advice of Dr. Stuart M. McGill on sleeping and back pain.