Do's and Don'ts for Back Pain Prevention While Sleeping

Atlantic Spine Center

Spine Health Blog

Back PainPrevention

Dr. Kaliq Chang offers tips on how mattresses, pillows and sleep positions impact back pain.

Sleep is supposed to be a respite from our troubles, but sometimes the way we sleep – and the mattress and pillows we surround ourselves with – can actually contribute to troubling back pain, according to interventional pain management specialist Dr. Kaliq Chang of Atlantic Spine Center.

Back pain and sleep problems can be a chicken-egg situation, Dr. Chang says, since existing back pain can make it harder to sleep and certain sleep positions and products can ease back pain or make it worse. A 2014 study in the Asian Spine Journal indicated that nearly one-third of people with low back pain dealt with disturbed sleep from their pain. Researchers also found the worst time for back pain was between 7 pm and midnight, with heightened pain affecting sleep even more.

"But if your aching back is keeping you up at night, it might have less to do with your activities during the day than with how you're positioning yourself during sleep, or what you're sleeping on," explains Dr. Chang. "Back pain can make it tough to get a decent night of shuteye, but a few simple changes can help take the stress off your back and make refreshing sleep more likely."

Sleep positions that help and hinder back pain prevention

Some sleep positions place extra pressure on your neck, shoulders, hips and lower back – all of which can lead to an aching back, Dr. Chang notes. But what's the position most likely to cause back pain? Sleeping on the stomach, which flattens the natural curve of the spine and requires neck rotation that can trigger pain between the shoulders.

On the other hand, modifying your favorite sleep position can help take the strain off your back, he says.

  • Back sleepers can place a pillow under the knees to promote their spine's natural curve;
  • Stomach sleepers can place a pillow under the lower abdomen to ease back strain; and
  • Side sleepers can pull their legs up slightly toward the chest and sleep with a pillow between the knees.

Changing your sleep position during the night is probably a good thing as far as your back is concerned, Dr. Chang says.

"It's normal for us to move around a bit while we sleep, and shifting position helps ease pressure on the back," he adds. "When you do turn over, try not to twist or bend at the waist, but to move your body as one unit. This can prevent further back strain."

Choose mattresses and pillows to promote pain-free sleep

Too many people buy mattresses and pillows – the "tools" of good sleep – without even trying them out, Dr. Chang says. But much more consideration should be given to these highly important choices.

Mattresses come in so many forms these days – hard or soft, memory foam or pillow top, and countless choices in between – that it's impossible to point to one type and say it's best for back health, Dr. Chang says. "When shopping for a new one, really spend some time lying on different mattresses in the store and don't hurry the process," he suggests. "Choose one that feels not only comfortable, but provides support for the natural curves of your spine."

Pillow choice should be given just as much consideration, since ultimately pillows don't just affect your head and neck. Pick a pillow that supports the natural curve of your neck, without being too high or low, Dr. Chang advises. "Depending on your sleep position, adding or subtracting a pillow can help keep your spine in the proper position," he adds.

The proof is found in how you feel when you rise each morning. "Waking up with achy, tense muscles is a clear sign your mattress, pillow or sleep position is off," Dr. Chang says. "Since we spend nearly one-third of our lives sleeping – or trying to – spending some time optimizing your sleeping position and products such as mattresses and pillows is a worthwhile pursuit."