Your nighttime posture matters just as much as your daytime posture, and if your lower back pain is worse in the mornings, that might be because you’re unknowingly exacerbating your condition while you’re asleep.
You don’t need to twist yourself into a painful contortion to do ill for your spinal health. A handful of common positions are known to be some of the greatest offenders when it comes to lower back pain, including lying on your side with your knees together, and lying on your stomach with your head on a pillow.
Anything that places pressure on your vertebrae or shifts the alignment of your spine and hips in a negative fashion will have you feeling it the next day. However, it only takes a handful of simple adjustments to get a much more comfortable snooze.
What You Need to Know About Lower Back Pain
The spine is a curved column of bones and cartilage, with many nerves running through it. A lot of lower back pain comes from damaged cartilage or inflamed regions between the bony vertebrae, causing tissue and bone to push on these sensitive nerves and send constant pain signals throughout the body.
While there are number of medical interventions to deal with this issue, from surgery to injecting the area to numb the nerves and reduce swelling, taking pressure off the nerve through posture adjustments is one of the safest and most effective ways to immediately introduce relief, and reduce pain.
To do so, patients are taught to observe their posture, avoid specific movements, and sometimes, a patient may work with a physical therapist to strengthen muscles in the body that help prevent pressure from being further added onto the affected area. The result is condition that either stalls deterioration or deteriorates at a much slower rate, with less pain and higher overall quality of life. But when we sleep, certain positions undo our hard work.
Positions wherein the vertebrae are pushing onto each other and applying pressure to affected areas will produce pain, especially upon waking up. Healthy sleeping positions for lower back pain have to take into account the various conditions that can befall an individual with back pain (from herniated discs to spondylolisthesis). As such, your ideal sleeping position will depend on what you find most comfortable, where exactly your pain is originating, and why you’re experiencing said pain.
A good rule of thumb is that pressure on any given single spot on the spine is reduced when the body is in proper alignment. That entails that your ears, shoulders, and hips are all in a straight line. The spine curves naturally, but it’s a minor curve and it shouldn’t cause your hips to dip forward or backward (sometimes indicating weakness in the abdominal muscles or pelvic floor).
When sleeping, try to sleep in a way that keeps your torso and neck in a straight line, without straining to remain rigid. What you’ll find is that your body will have to sink in places due to gaps between you and the mattress. We’re not perfect rectangles, and the curvature of our body causes us to slump and bend in places when we’re lying on a flat surface. Use small pillows to fill the gaps, trying to keep in mind that your goal is to maintain an effortless alignment of the spine without straining anything. Here are a few good examples!
Sleep in the Fetal Position
Curling up in a fetal position with your knees tucked up close to your chest can help alleviate pressure on herniated discs in the lower back, provided you don’t try to forcefully bend the back in the other direction.
Rather than curling up into a ball, gently roll to your side with your head and neck on a pillow and bring both knees up and close to the chest, until you feel your back straighten out. Don’t go any further.
Sleep on Your Back With Knees Raised
If you’re a back sleeper, the easiest and quickest way to experience relief and take pressure off your vertebrae is to gently raise the knees with a small pillow placed under your kneecaps. This is also good for knee pain, as it prevents the ligaments from being stressed under accidental overextension in your sleep.
By using a pillow under the knees, you can keep your knees slightly bent and allow the lower back to completely relax onto the mattress, opening the joints up and preventing any curving or cramping in and around the spine.
Sleep in a Reclined Position
For people with isthmic spondylolisthesis, a reclining bed may be more comfortable than a regular bed. Reclining beds are commonly found in hospitals and are simply beds with a joint in the middle allowing for adjustments to be made, much like a reclining chair. If you feel less pressure on the back when lying back into a reclining chair, you may find that your back pain would be greatly reduced by switching to a reclining bed.
This isn’t always possible, however, especially for individuals who can’t afford to buy an adjustable bed frame. There are do-it-yourself ways to achieve the reclining effect in a normal bed, if a reclining bed frame is not an option, such as a bed wedge.
Sleep on Your Side With Knees Apart
If you prefer to sleep on your side, keeping your knees apart with a firm pillow is important. While it might not seem like much, without that space between your knees, your hips are likely to shift and cause a minor twist throughout the spine, placing additional pressure onto your back. An additional firm pillow under your waist can further help keep the hips, spine, and shoulders in alignment.
Don’t forget keeping a pillow under your head and neck, too. This might seem awkward at first, but it’s just three pillows, two of which are smaller than the other, which seems like a small price to pay. Finally, consider reminding yourself to switch sides every so often. Even though this position is meant to minimize back pain, you could still aggravate muscle imbalances by favoring one side too much. This, furthermore, makes itself felt in your lower back.
Regardless of how you choose to sleep, choosing when to sleep and what to sleep on matters as well. Be sure to pick the firmest mattress you can manage to sleep on without discomfort – the firmest mattress on the market is likely to leave you feeling miserable, so test a few before you find something you can comfortably live with. Softer mattresses might seem superficially more comfortable but do you no favors for your spinal alignment. Good pillow quality is important as well, and regardless of how often you wash your pillow covers, it’s a good rule to replace your pillows out every 1-2 years.
Through proper sleep hygiene and good posture and spinal health, you’ll wake up feeling refreshed and, hopefully, pain free. Consult your general physician, orthopedic doctor, pain management specialist, or chiropractor if you’re experiencing chronic back pain.