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Lower back pain is one of the most common health issues people have to deal with.
In fact, an average of 18.6% of people experience lower back pain at some point each year (1). And let’s not forget about those who have to live with chronic pain.
Naturally, back-related issues can interfere with different aspects of our lives, including one of the most important ones – sleep. Because sleep quality is tightly linked to our overall well-being, it’s vital to learn how to catch your Zzz’s when dealing with lower back pain. And that’s what we are going to do today.
What Causes Lower Back Pain
Before we learn how to sleep with lower back pain, it wouldn’t hurt to consider the potential causes of this unpleasant issue. After all, when you know the core of the problem, you can find possible solutions and potentially, get rid of the issue.
So, here are the most common reasons why you are suffering from lower back pain (and, consequently, poor sleep):
- Bad posture. If you tend to slouch over your computer, sit for long periods, or simply don’t maintain a relatively straight back during the day, you can experience pressure build-up in certain parts of your spine (2). Often, the lower back takes the hit and experiences too much tension, which can lead to acute or even chronic pain.
- Pulled or overworked muscles. If your daily activities involve frequent awkward bending or heavy lifting, you can easily pull your back muscles (2). While it can be difficult to change one’s occupation, you may at least give your lower back some extra support to prevent pulled muscles. For example, wearing a back support belt might come in handy during work (and exercising).
- Sprains and strains. These might also be a result of overworking your back. Strains and sprains include injuries to back ligaments, muscles, or tendons. Typically, healing from sprains and strains takes up to a few weeks. You might want to stay active but avoid exercises that put too much pressure on your back (3).
- An overly soft, unsupportive mattress. When a mattress can’t support your weight properly, it allows for excessive sinkage and causes the spine to fall into misalignment (often leading to pain). You see, a good firm mattress will keep your body “on top”, so to say, without making your spine curve. However, an overly firm mattress might also cause misalignment if you sleep on your side or back, so it may be a better idea to get something with a bit more padding.
If you require some cushioning and want to avoid developing tender pressure points, a quality hybrid mattress might do the trick. Such mattresses typically combine a sturdy, supportive base with cradling comfort layers to achieve a very balanced feel.
- Age-related changes. As we get older, our cartilage becomes thinner and weaker. As a result, spinal discs and joints begin to develop wear and tear, which often leads to disc degeneration and lower back pain (4).
- Spinal curvatures. Such conditions as scoliosis or kyphosis are quite common and often cause lower back pain (5). It happens because spinal curvatures can put too much pressure on certain parts of the back due to constant misalignment. This leads to tension build-up and, of course, pain.
- Certain medical conditions. They may include arthritis, spinal stenosis, fibromyalgia, and more (6). These disorders can come with a bunch of other symptoms, so it can sometimes be hard to realize that lower back pain is also related to them. Talking to a professional is always a good idea in this case, as your doctor can find the source of the problem and help you deal with it once and for all (or at least alleviate some of the symptoms to help you sleep better).
The Best (and Worst) Sleeping Positions For Lower Back Pain
To sleep with lower back pain and to get enough rest, you might have to try various methods. But changing the sleeping position is often the most effective one. So, here are the best sleep positions for lower back pain:
- On your back with a pillow under the knees. When sleeping on your back, the weight is evenly distributed, which means fewer chances of experiencing tension build-up in certain areas (including the spine). Back sleeping also creates optimal conditions for proper spinal alignment. And by elevating your legs a little, you will reduce pressure from the lower back.
- On your side with a pillow between the knees. By placing a pillow between the knees, you allow your hips and pelvis to remain in a proper alignment, which reduces pressure from the lower back and can help relieve the pain.
- In a reclined position. Lying on your back and elevating the upper body slightly is beneficial when you need to put less pressure on your spine. This sleeping position creates an angle between the thighs and the torso, which allows the lower back to stay a bit more relaxed.
- On the back with a small pillow under your back. You can add a small pillow (or a rolled towel) to fill in that curve above your lower back. This little trick will provide extra support for the spine, allowing it to relax a bit more during sleep.
- Fetal position. Lying curled on your side with the knees pulled up closer to your head can help create more space between vertebrae in your spine. As a result, you may alleviate the pain caused by a pinched nerve. This sleeping position also reduces stress from the spine.
A quick note: if you suffer from lower back pain, try to avoid sleeping on your stomach. This position is not optimal for a proper, healthy spinal alignment. It also often creates a curve in one’s neck that can lead to additional pain. Moreover, if your mattress is not suited for this sleeping position, you may experience sinkage in the hip area. As a result, your spine will curve, putting pressure on the lower back and potentially aggravating the pain.
How to Sleep Like a Baby Despite Lower Back Pain: Tips and Tricks
Back pain should not be your “lifetime sentence”.
After all, there are numerous things you can do to sleep with lower back pain like a baby (almost). Here are a few examples of what you can try:
- Upgrade your mattress. If your current bed is overly plush or too stiff for your sleeping position and body type, getting a new comfortable mattress could potentially rid you of lower back pain. Make sure you get the appropriate firmness level for your preferred sleep position. For example, side sleepers typically enjoy using softer mattresses, back sleepers –medium to medium-firm, and stomach sleepers – firm (or even extra-firm if you weigh more than 230 pounds).
- Update your mattress (with a topper). If you aren’t ready for a big investment, you can also change the feel of your mattress using a topper. There are plenty of great mattress toppers for lower back pain that can offer some extra support for your spine. However, keep in mind that in most cases, a topper is just a temporary solution. Additionally, it might not work if your mattress is too old or saggy.
- Change your sleeping position. You already know that the best sleep positions for lower back pain include the fetal position, lying on your back (with a pillow under your knees), reclined, and so on. If your lower back pain is not letting you sleep, try to shift in bed and use extra pillows to your advantage. Chances are, once you change the way you sleep, the pain will dissipate.
- Upgrade your pillow. Often, sleeping on the wrong pillow can cause back pain too. You see, if the pillow is too tall (or way too thin) for your sleeping position, it can cause your spine to fall into misalignment. Naturally, some of its parts will experience more compression or tension than others, which may lead to back pain. If you are a back sleeper, make sure that your pillow is tall and can deliver firm support (to fill in the space between the neck and the mattress). Back sleepers can use softer, thinner pillows (an elevated cervical section would come in handy for proper neck support). Stomach sleepers are advised to choose flatter pillows or can even sleep without one.
- Stretch before bed. Sometimes all you have to do is release tension to help your spine relax (and alleviate back pain). Not only can gentle stretching (7) or light yoga (8) soothe your pain, but also they may help you relax and wind down before bed (which may lead to more restful sleep).
- Consider light exercise. Strengthening your core and back muscles can provide more support for the spine (which is a good way to reduce tension and pain). You don’t have to work too hard. On the contrary, being careful is crucial in this situation. But make sure that you keep moving and do that regularly.
- Talk to your physician. Depending on the source of your back pain, a professional can help you find a proper treatment. Perhaps some light pain medications or physical therapy would help, and you will start sleeping normally again. And if the matter would require a more serious treatment type, the sooner you get diagnosed, the better. So never hesitate to talk to a professional concerning any of your back issues.
What is the best sleep position for lower back pain?
The best sleeping positions for lower back pain include lying on one’s back with a pillow (or a rolled towel) under the knees, sleeping reclined, lying on one side with a pillow between the knees, fetal position (curled up on one side), etc.
When should I be worried about lower back pain?
If your pain lingers for more than a couple of months, you should consult your physician. Additionally, if the pain is the result of an injury, you might also want to get checked. Generally, older patients (over 55) and younger individuals (under 20) are advised to talk to their doctor when they experience lower back pain as it is less typical for the latter and can be more dangerous for the former.
Why does my lower back pain get worse at night?
If your back pain worsens at night, it might be a sign that you are sleeping on the wrong mattress (or have an unsuitable pillow). It could also be a symptom of certain medical conditions, so don’t hesitate to consult your doctor.
Naturally, lower back pain can be a huge inconvenience (especially for your healthy sleep).
But the thing is, there are ways to fix this situation. To start sleeping better with back pain, you can experiment with different sleeping positions, upgrade your mattress, use pillows as helpful props, work on your back and keep it strong, and so on. Chances are, you will forget about pain at all. But if you don’t, it’s always better to talk to your doctor (just to be on the safe side).
Have you ever tried any of the previously mentioned tricks to sleep better with back pain? And for how long have you been dealing with it? Share your thoughts in the comments below!
- Cassidy, J David DC, PhD, DrMed; Côté, Pierre DC, PhD; Carroll, Linda J. PhD; Kristman, Vicki MSc (December 15, 2005). Incidence and Course of Low Back Pain Episodes in the General Population. Retrieved from https://journals.lww.com/spinejournal/Abstract/2005/12150/Incidence_and_Course_of_Low_Back_Pain_Episodes_in.21.aspx
- WebMD (December 08, 2019). Slideshow: A Visual Guide to Low Back Pain. Retrieved from https://www.webmd.com/back-pain/ss/slideshow-low-back-pain-overview
- Harvard Medical School (June 2014). What's causing your lower back pain? Retrieved from https://www.health.harvard.edu/pain/whats-causing-your-lower-back-pain
- William C. Shiel Jr. (February 10, 2021). Low Back Pain (Lumbar Spine Pain). Retrieved from https://www.medicinenet.com/low_back_pain/article.htm
- Medline Plus (n.d.). Low back pain – acute. Retrieved from https://medlineplus.gov/ency/article/007425.htm
- Janelle Martel (August 01, 2019). What You Should Know About Low Back Pain. Retrieved from https://www.healthline.com/health/low-back-pain-acute
- Emily Cronkleton (February 12, 2019). 7 Lower Back Stretches to Reduce Pain and Build Strength. Retrieved from https://www.healthline.com/health/lower-back-stretches
- Harvard Medical School (June 2018). The safe way to do yoga for back pain. Retrieved from https://www.health.harvard.edu/staying-healthy/the-safe-way-to-do-yoga-for-back-pain