Sleeping Advice for Those With Lower Back Pain

By Kealia Reynolds

For those that experience lower back pain, getting a good night’s sleep can be a recurring challenge. On one end of the spectrum, there are people who go to bed with back pain and have a difficult time falling and staying asleep. On the other end, there are people who experience poor sleep and wake up with lower back pain.

Doctor Patricia Carter, PhD, RN, CNS, member of the American Academy of Sleep Medicine and the Sleep Research Society and associate professor at the University of Texas at Austin School of Nursing, recommends asking yourself two questions when looking for ways to remedy back pain and improve sleep quality.

  1. Are you going to bed with back pain that disrupts your sleep or is poor sleep leading to your back pain?
  2. Is the pain acute (something new) or chronic (something you have been dealing with for awhile)?

“The recommendations (in general) for people who are waking up with back pain is to look at their sleep surface and determine if it’s providing enough support to keep their spine in alignment (normal curve),” Dr. Carter says.

For most people who are experiencing this issue, a medium-firm surface is recommended. Medium-firm mattresses will have more resistance and response than soft mattresses and tend to be better for stomach and back sleepers. “Too hard (e.g. an uncarpeted floor) or too soft (e.g. a hammock) would cause the spine to be out of alignment and put strain on the back muscles which leads to back pain,” says Dr. Carter. “Second, the sleeping position is important, essentially for the same reason (spinal alignment). If you sleep on your stomach or back, it causes the back to arch too severely and again pulls on the muscles causing pain.”

View our guide to choosing a mattress: How to Choose a Mattress: The Ultimate Guide in 6 Steps

According to Dr. Carter, “The best sleeping position to maintain alignment is on the side with knees pulled slightly up [with] a pillow between the knees (e.g. fetal position). This keeps the spine in alignment and decreases pull or stress on the muscles in the back.”

For those who are going to bed with back pain, Dr. Carter recommends following the advice above, but going a step further since this group may be experiencing chronic pain, which can complicate things.

“They [should] discover the source of the pain (e.g. fibromyalgia, osteoarthritis, etc.) and work with their healthcare provider to work out a plan to treat the pain so that it will be less likely to disrupt their sleep,” says Dr. Carter. “This treatment plan does not have to be (nor should it be in most opinions) limited to medications. More effective treatment of chronic pain is achieved with a combination of therapies (e.g. medication, physical therapy, relaxation).”

Above all, Dr. Carter stresses that treating the pain prior to hitting the sack will help promote quality sleep. “Not treating the pain will most certainly lead to decreased sleep quality and will actually (studies have shown) increase the intensity of the pain felt the next day.”

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