Back pain during sleep


Reducing Back Pain While Sleeping: Causes & the Right Sleep Positions for Treatment

See how sleep positions and mattress choices can influence and improve nighttime back pain, and why managing pain is important for healthy rest.

If you experience frequent back pain, you aren’t alone. The American Chiropractic Association estimates that 31 million Americans are experiencing back pain at any one time, and that up to 80% of us will endure back pain at some point in our lives.

With the intersection of so many muscles, joints, bones and ligaments, back pain is a diverse condition with many different causes. From poor posture to tense muscles, genetic disc issues to arthritis, overdoing it at the gym to obesity, and even pregnancy to psychological stress, the reasons people experience back pain prove quite varied.

But, while it’s a common condition, that doesn’t mean it’s an insignificant one. Back pain can have enormous individual costs, affecting productivity, mood, enjoyment of life and more.

One area of life where back pain can have a significant effect is sleep. Pain can make it difficult to relax and get comfortable at night. This often translates to less overall rest and poorer quality sleep, which can actually further exacerbate this pain.

In this article, we’re going to be taking an in-depth look at the impact of back pain and how to minimize its effects on sleep and waking life.

The Basics of Back Pain

From temporary, acute pain to debilitating chronic conditions, the term “back pain” can be quite broad. It can be attributed to many different causes and can vary in intensity, but the scope and effect of back pain can be quite significant when it strikes. Before we get into the specifics of sleep and pain, here’s a look at where back pain comes from and how it can affect life for those who have it.

Who Gets Back Pain?

Back pain can affect pretty much anyone at anytime. However, a few traits are linked with higher risk. Older adults (over 30 years) and women are more likely to experience back pain. People who are overweight or obese, and people with a sedentary lifestyle and poor fitness levels have higher rates of back pain.

Physically strenuous work that involves a lot of lifting, pushing or pulling creates greater risk of injury or strain. Other occupational risks include extending sitting (such as at a desk or driving) with poor posture, and even mentally stressful work.

Factors that increase risk of back pain:

  • Age: most common between 35 and 55
  • Gender: more common in women
  • Smoking
  • Being overweight
  • Sedentary lifestyles
  • Stress
  • Anxiety and depression
  • Pregnancy

Smoking is another potential risk that might not be so obvious. Data suggests smokers are more prone to back pain for a couple reasons – nutrients may not be able to reach the back where they’re needed, coughing can cause strain, and smokers are slower to heal from injury.

Other factors also increase the odds of back pain, such as pregnancy, strenuous exercise, anxiety and depression, and certain hereditary conditions.

Where Does it Come From?

Back pain, of course, originates in the back. There are a wide variety of potential causes from temporary muscle strain to spinal abnormalities. Medical News Today explains causes of back pain can stem from different types of strain, structural problems, internal infections and cancer, as well as sleep and mattress issues. The more common causes of back pain are:

  • Strain: Strained muscles or ligaments due to improper or too heavy lifting, awkward movements
  • Skeletal problems: Ruptured or bulging discs, sciatica, scoliosis, arthritis, osteoporosis
  • Infections: of the spine, pelvis, or nerves
  • Sleep disorders: people with sleep disorders are more likely to have back pain
  • Bad mattress: poor support can cause or worsen pain
  • Lifestyle: poor posture, standing, hunching and bending for long periods and extended driving


Strain is the most common reason for back pain, affecting muscles and ligaments. Improperly lifting or pulling things and lifting or carrying heavy objects are common ways muscles become strained. Sudden movements, such as getting out of bed or cars awkwardly or falling, can trigger pain. Bending, standing, hunching over a desk or driving for extended periods of time also causes muscle tension and strain.

Structural Problems

Structural problems relate to the spine and joints, accounting for many cases of back pain. Discs that sit between and cushion spinal vertebrae can rupture or bulge, placing pressure on nerves and causing things like sciatica. Scoliosis and other conditions that cause the spine to have abnormal curvature can make pain more likely. Arthritis and osteoporosis may also affect the spine and result in back pain.

Other Causes

Internally, certain conditions can cause back pain as a symptom. Spinal infections create pain along the spinal nerve, and shingles can also cause nerve pain. Infections in the kidneys, bladder and pelvic organs, and tumors on or near the spine are other possible internal causes.

Psychological factors are believed to play a role in certain cases of back pain. There are genetic differences in pain sensitivity and attention that can make pain feel more intense. Low mood, stress and catastrophizing can also alter pain tolerance. It’s believed that long-term pain may affect the central nervous system pathways, contributing to chronic pain conditions.

External conditions are another potential back pain trigger. Chairs and workstations that don’t support good posture can increase pain via slouching and hunching. Mattresses that lack adequate support to keep the spine straight may also result in strain and tension.

More Than a Minor Inconvenience

Seeking relief, Americans spend over $50 billion (with healthcare costs estimated over $190 billion) each year just on lower back pain. It’s the second most common reason people miss work, third most common reason for surgeries, and fifth most common cause of hospitalization, and it’s responsible for 20% of doctor visits as well. Two 2014 studies suggest back pain is the leading cause of disability worldwide.

Pain can also affect sleep. A 2014 Korean study of people with chronic lower back pain found that 32% of respondents experienced sleep disturbances due to pain, with those experiencing more pain reporting a higher amount of disturbances. A previous Australian study looking at both acute and chronic back pain found that 58% of people reported disturbed sleep due to pain.

The ongoing impact of back pain in America:

  • Over $50 billion in treatment costs
  • 15-20% have long-term back pain
  • 3-4% temporarily disabled due to back pain
  • 1% of workforce disabled permanently
  • 2nd most common cause of missed work
  • 3rd leading reason for surgery
  • Among leading reason for hospital and doctor visits

In a study of back pain triage in the UK, 44% of people that came to a clinic reported pain at night. Of that group, 42% experience back pain every night. Their research identified that people experiencing nighttime back pain averaged less than five hours of sleep, awoke multiple times during the night, and reported their pain scores higher than people without nighttime pain.

Other research also finds that missing out on sleep can worsen pain — meaning not only does back pain make it harder to get rest, but not getting enough sleep can make pain feel worse. Offering potential insight, one recently published study from the journal PAIN showed that missing out on rest may increase perception of pain by decreasing pain tolerance.

The 2015 Sleep in America poll looked at the connections between sleep, stress and pain. Over 1000 adults were surveyed, and the results found:

  • People who experienced more pain reported less overall sleep and poorer quality sleep.
  • People with pain were more susceptible to disturbances like light, noise and mattress comfort.
  • People with chronic pain were more likely to say sleep difficulties interfered with work, mood, activities, relationships and life enjoyment.
  • People with pain who said they made getting sleep a priority did in fact get more sleep than less motivated peers.

Missing out on sleep can have wide ranging effects when it happens often. Chronic partial sleep deprivation is associated with cognitive impairments and worse moods, more anxiety and depression, more dangerous driving, as well as greater risk of diseases like obesity, heart disease, Type 2 diabetes, Alzheimer’s disease and more.

All things considered, back pain is no small problem either for individuals who suffer from it or on a societal level. It can affect a person’s performance at work and their earning potential. It can affect relationships with family members and friends. It can affect life enjoyment in the short and long term, and create a costly healthcare burden.

While managing back pain can prove complicated, there are a few lifestyle factors that can prevent or help reduce pain, such as being mindful of how you move during the day and how you sleep at night. If pain is significantly affecting your daily life, if you’ve experienced an injury or fall, if you have numbness or tingling, or if you begin having bladder or bowel control trouble it’s important to consult with your doctor.

Minimizing Back Pain During Sleep

While back pain has a multitude of causes, there are certain things that can be done to help minimize the effects at night. Ensuring your sleep position is properly supporting your back, choosing a good mattress, and engaging in healthy lifestyle habits all play a role.

Be Careful Getting In and Out of Bed

Many back injuries are attributed to making awkward movements when doing routine things. One of the easier ways to prevent new injuries or exacerbating old ones is to be conscious of your movements. Here are a few pointers from WebMD experts on protecting your back when getting in and out of bed:

  • Don’t twist your back or make rapid jerking motions.
  • Get in bed by sitting on the edge the mattress. Supporting yourself with your hands, bend your knees and lay on your side. Then adjust your position as needed.
  • Get out of bed by rolling on your side (facing the edge of the mattress) and bend in your knees. Supporting yourself with your hands, carefully swing your legs to the floor and stand up straight. Get up from the seated position.

Choose Sleep Positions that Support Pain Relief

How you sleep plays an important role in managing back pain, as certain positions place more strain on the back than others. Generally, back sleeping and supported side sleeping are regarded as most ergonomic, while stomach sleeping tends to be most associated with pain. Whichever position you prefer, here are tips for staying comfortable.

Side Sleepers

Side sleeping is the most common position, especially among women. While it can place some strain on the body, ensuring your hips and shoulders are supported can make it comfortable.

Ideally, side sleepers should bend both knees in slightly and place a small pillow between their legs to prevent hips from twisting and placing stress on the back. If your legs are too straight, this can exaggerate the curve of your lower back, but if your legs are drawn in too tightly, your back may round — and both can cause pain.

Your neck pillow should be the right height to keep your neck and spine straight and even, generally higher than pillows needed for back sleepers. Your chin shouldn’t be drawn in to your chest or leaned too far back. Think natural standing position.

Conditions that may see more relief from proper side sleeping include osteoarthritis, spinal stenosis and foraminal herniated disc, as the position can reduce pressure on spinal joints.

Back Sleepers

Back sleeping is typically what you’ll see recommended as the ideal position for back health. It’s the second most common sleep position, and with a good mattress, sleeping on your back supports a neutral neck and spine position.

To optimize comfort and support, there are a couple modifications you can make. Placing a small pillow or towel beneath your knees reduces strain and tension on the lower back and hips by creating a more natural spinal curve. Legs should ideally be positioned straight out (not kicked off to the side or spread too wide, which can strain the pelvis and hip joints).

Other people may feel a small pillow under the lumbar region lends additional helpful support. Bed pillows should support the natural angle of the neck, not push your chin to your chest or allow your head to fall back too far.

The semi-fowler position, in which the head and foot are both elevated, is often recommended for lower back pain, especially the type that feels worse when you stand up straight. A reclining chair or adjustable bed can allow you to achieve this position.

Stomach Sleepers

Sleeping on your stomach is considered least ideal for pain relief, since the lumbar region is left unsupported, placing strain on your spine and lower back muscles. This position can also place strain on your neck and shoulders.

“Sleeping on your stomach is the absolute worst sleep posture, placing enormous stress on the lower back causing the spinal joints to compress,” said Dr. Scott Duke, an NYC based Chiropractic Sports Physician and the author of Back in Action. Use props to to support the spine, whether on your back or side, he added.

To better support your body, place a pillow under your pelvis and lumbar region. At your head, use a flat pillow or no pillow so as not to strain your lower back.

There are two situations where stomach sleeping is actually recommended, though. People with degenerative disc disease and paracentral disc herniation may feel more relief laying on their stomachs since it can reduce disc pressure compared to other positions. A firm mattress with a pillow beneath the abdomen is considered best.

The Role of Your Mattress

We spend one-third of each day in bed, meaning your mattress and how you sleep is just as important as focusing on posture in the daytime hours. Since sleep is a time for healing and renewal, it may arguably be even more important.

So, what is the best mattress for back pain?

It’s an important, often-asked question. But, there is no single right answer. When it comes to picking a bed, there are no hard and fast rules that will apply for every person, every time. Essentially, the best mattress is the one that you feel gives you good, refreshing sleep with minimal pain and stiffness.

While we all have different preferences and needs that are important to consider, research and studies can shed some insight on different mattress traits and how they may interact with back pain.

The Two Basics of Beds

At their most basic, beds do two things: provide support and comfort.

Support comes from the core of the mattress, typically a sturdy foam layer or innersprings depending on the type of bed. A supportive mattress will have enough firmness to keep your spine aligned, meaning your heavier areas like hips and shoulders won’t sink too far into the bed. On the other hand, it shouldn’t be so firm that it forces hips and shoulders up at an awkward angle either.

Comfort speaks more to a bed’s ability to prevent pressure points and pain. Although preferences for the firmness and thickness of padding layers will vary, a good mattress for back pain will also adequately cushion areas like hips, shoulders, elbows and heels from pain in your preferred sleep position — without compromising the support of the mattress.

Now, comfort is pretty easy to identify, but how do you know if a mattress is providing adequate support? Essentially, your spine should maintain an even, natural posture (similar to good standing posture), with whichever sleep position you prefer.

    • For side sleepers, your spine should be straight from your neck to your tailbone, and parallel with the floor. If your hips and shoulders tilt upwards (think smiley face), the mattress is likely too firm or lacks an adequate comfort layer. If your hips and shoulders sink downward (think frown face), your mattress is not supportive enough, or perhaps the comfort layers are too soft.
    • For back sleepers, your back should maintain a neutral curve that mimics standing. Ideally, your neck should rest at a neutral angle to your shoulders, and your shoulders, hips and heels should feel pretty straightly aligned. Your lumbar region should feel supported. If you notice a large gap beneath your back and your bed and feel pressure on your upper back and hips, the bed is likely too firm. If you feel like your hips and chest sink below your legs and arms or feel heel pressure, your mattress may be lacking support.
    • For stomach sleepers, you also want to maintain a neutral curve similar to good upright posture (likely requiring use of a pillow below the hips). The mattress shouldn’t allow your torso to sink in too far, which could exaggerate your lower back curve and place stress on your hips. While firm support is good, a mattress without an adequate comfort layer could be painful for shoulders and sensitive areas.

The Best Mattress Firmness

Mattress firmness is another area to consider. Generally, most experts recommend beds in the medium to firm spectrum for back pain. The American Chiropractic Association says medium is best, and studies have shown best back pain results with people sleeping on medium to medium-firm mattresses.

It’s thought that beds in the medium/medium-firm range have enough support for the back while also providing enough cushion to minimize pressure points. But, it’s important to listen to what your body likes and prioritize that over general guidelines.

Side sleepers, especially people with larger frames, may prefer beds closer to the medium or medium-soft range, or those that have thicker comfort layers, since more of the body sinks into the bed in the side position. On the other hand, beds on the firmer end of medium will typically feel more comfortable and supportive for back and side sleepers.

Your personal comfort preference and health will also play a role. For example, beds in the firm to medium-firm range can be painful for people with conditions like bursitis or fibromyalgia, as they can lead to more pressure points. Think about the surfaces that you tend to get the best sleep on — do you prefer the cushy couch or recliner, the floor, a certain bed you’ve tried, or somewhere in between?

And while firmness is often correlated with support, it’s important to note that firm beds can still be unsupportive in terms of alignment. Don’t forget to consider the quality of mattress materials, as this factors into a bed’s ability to provide long-term support and comfort as well.

Mattress Materials and Fabrics

There are a fairly wide variety of mattress types on the market, but scientific studies on mattress types and back pain prove quite limited. One of the few to compare types found that memory foam and waterbeds resulted in better sleep and less pain than firm futon-style mattresses. Since clinical data isn’t widely available, mattress reviews are one way to compare comfort and potential for back pain relief.

Mattress review organization Sleep Like The Dead finds that the best memory foam mattresses and latex mattresses earn above-average reviews for pain relief due to the combination of support and conformability, with less risk of sagging.

More common innerspring mattresses tend to be below average on pain relief due to potential durability issues. These are averages however; within the categories there can be quite a bit of variation, and the best one for you will depend on individual preferences.

When it comes to mattress types and back pain, the key thing to consider is the bed’s ability to provide long-term support and comfort for your needs. Always check into things like foam density or coil count/gauge, as these specifications will give you insight into how durable the bed will be — typically more so than price and warranties.

Researching and comparing beds can take a little time, but the sooner a mattress starts sagging and losing support, the sooner it will stop feeling comfortable. Fabrics on the surface of the mattress can also play a role in overall comfort. The majority of beds use polyester blends, but some may use natural fabrics like cotton and wool.

Cotton’s key benefit is excellent breathability, which keeps you cool. Wool is a natural thermoregulator, meaning it helps balance body temperature and may promote circulation, which can in turn reduce pain.

Newer generations of “smart fabrics” are taking benefits even further. One clinical trial showed that mattress covers with Celliant®, a type of textile technology that converts body heat into infrared energy, may help reduce pain at night.

Participants also spent less time awake in bed (18.3 minutes), improved sleep efficiency by 2.6% and several reported subjective improvements in sleep quality. Celliant has also been shown to improve tissue oxygen levels by 10% to 24%, which may help speed recovery and reduce fatigue and swelling.

Mattress Age and Pain

The age of your mattress can play a surprising role in how it feels. As time wears on, even the best mattress will eventually begin to lose comfort and support.

Estimates vary quite a bit, but a quality mattress is generally expected to last about eight to ten years. Beds made with lower quality materials or that receive heavier wear may need to be replaced as soon as five years.

In one study, researchers found that simply switching from an old mattress to a new one (a generic medium-firm bed) improved people’s ratings of back pain.

People in the study were sleeping on a variety of beds at least five years old, and had an average mattress age of 9.5 years. Of those with back pain, 63% reported relief from the new mattress over four weeks. Improvements were also seen to sleep quality and efficiency.

Don’t Forget the Pillows

An important, and often overlooked, part of mattress comfort is the pillow. A poor fit can strain your neck and throw off alignment, contributing to back pain. Regardless of sleep position, a good pillow will conform to different movements and support a neutral spine, as described in the sleep positions section above.

Stomach sleepers should generally look for higher-fill pillows or neck/contour style pillows. The pillow should support your neck, keeping a natural angle. A pillow that is too shallow can cause your head to bend inward, and may place strain on your shoulder.

A pillow that is too high can cause tension in your neck. A body pillow is a favorite for many side sleepers, since it can be hugged to the chest to prevent shoulder pain caused by awkward arm positions, and placed between the knees to keep the spine straight.

Back sleepers should generally look for medium fill pillows. If you sit up straight, this is the same angle that your pillow should provide when lying down. If your chin angled towards your chest, it’s too high; if your head falls back, it’s too low.

Side sleepers should look for fairly thin pillows with just enough padding to cushion the face but not so thick that neck is forced backward.

Lifestyle Factors that Prevent Back Pain

Aside from being conscious of how you sleep and where you sleep, there are a few daytime habits that can help reduce back pain as well. Much of the recommended habits for prevention go hand-in-hand with leading a generally healthy lifestyle. The Mayo Clinic suggests the following for minimizing back pain risk:

  • Maintain a healthy weight.
  • Consider quitting cigarettes if you smoke.
  • Get regular low-impact aerobic exercise.
  • Practice core strengthening and flexibility exercises. Yoga poses like cat-cow, child’s pose, and pigeon pose can be helpful, as can other forms of deep stretching.
  • Warm up and stretch before exercise, and any other strenuous activity such as lifting, gardening or swimming.
  • If you must lift something heavy, use your legs. Bend at the knees, keep your back straight and core muscles tight, and keep the object close to your body.
  • Stand with good posture.
  • When standing for long periods of time, reduce low back pressure by placing alternate feet on a low step or stool.
  • Choose ergonomic seats that have good lumbar support (or use a cushion/towel), swivel motion and armrests. Keyboard height should keep elbows at a 90-degree angle.
  • When sitting, ensure knees and hips are level and switch positions often.
  • Work on managing stress in healthy ways. Stress can increase perception of pain and affect sleep as well; so taking a few minutes to relax in the evening can be helpful.
  • Try hot or cold packs for temporary relief (hot for muscle spasms, cold for swelling and deep pain).

Back pain is not a small or insignificant problem, but for many people the side effects and severity can be minimized with fairly simple changes to habits. Awareness of ideal sleep positions and the relationship between mattresses and backs are essential for keeping pain at bay during the night, and paying attention to posture and movements improves comfort throughout the day.

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What do you find helps reduce back pain most for you? Do you notice differences between sleep positions?

About the author

Rosie Osmun regularly contributes to the Amerisleep blog writing about topics including, reducing back pain while sleeping, the best dinners for better sleep, and improving productivity to make the most of your mornings. She finds the science of sleep fascinating and loves researching and writing about beds. Rosie is also passionate about traveling, languages, and history.

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Low Back Pain

There are several things you can do to prevent or avoid low back pain. These include learning correct posture and strengthening your muscles.

What’s the best way to sit?

Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop up your feet. To turn in your chair, move your whole body rather than twist at your waist.

When driving, sit straight and move the seat forward. This helps you not have to lean to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.

What’s the best position for standing?

Maintain good posture while you stand. Keep your ears, shoulders, and hips in a straight line, with your head up and your stomach pulled in. Try not to slouch or arch your back. These put added pressure on your lower back. Wear shoes that are comfortable and provide support. If you stand for long periods, rest 1 foot on a low stool to relieve pressure on your lower back. Every 5 to 15 minutes, switch the foot you’re resting on the stool.

What’s the best position for sleeping?

The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You also may put a pillow between your knees for added comfort. If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don’t sleep on your stomach unless you put a pillow under your hips.

Use a firm mattress. If your mattress is too soft, put a 1/2-inch plywood board under the mattress to add support.

What exercises can I do to strengthen my back?

Always stretch your back and body before you exercise. For a gentle stretch, lay on your back with your knees bent. Slowly raise your left knee to your chest and press your lower back into the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg.

In addition to back exercises, it’s important to stay active in general. Swimming and walking are good exercises to improve your overall fitness.

Top Sleep Positions for Back Pain Relief

There’s no good time to have back pain, but there’s definitely a worst time to have it: when you’re trying to sleep. Living with back pain is rough, but when you finally get through a long day and are ready to curl up and sleep, almost nothing is more debilitating than being kept up by a bad back. It’s not only a physical feeling, it’s mental, taking a toll on your mental state, which in turn can have an even worse effect on your body. It’s a rough cycle that can be hell to break.

So what can you do? The first thing is to invest in a good mattress. Honestly, a mattress that supports you may make all the difference when dealing with chronic back pain. The second? Figure out a sleep position that alleviates your back pain naturally, that’s comfortable and will allow your body the gentle rest it deserves, free from back pain. With that in mind, we’re here to share which sleep positions are going to get you rested, refreshed, and ready for the day.

The Fetal Position (On Your Side and Curled Up)

There’s a reason that this position is so popular from the womb to the tomb. Sleeping curled up on your side could be a great way to relieve back pain, especially if you’re dealing with a herniated disk. Here’s why it works: Your disks are soft cushions in between your vertebrae. A herniated disk means that one of those cushions has been pushed out of its natural position and is pinched, causing nerve pain or even weakness in your extremities. When you curl into the fetal position, you’re opening up the space between the vertebrae and allowing your disks a chance to unfold back to their normal positions. This can help especially with the lower back.

On Your Side With a Pillow Between Your Legs

Similar to the fetal sleep position, this one may help with back pain by keeping a pillow between your legs while the rest of your body is in vertical alignment on its side. Start by lying down on your side, your spine basically straight, but with your knees pulled slightly up and together. Place a pillow between your thighs, and you may feel the pressure released and your back pain subside. Here’s why it works: the pillow is the key ingredient here. It keeps your spine, hips, pelvis in a good alignment that may become out of whack if your knees are pressed too close together.

On Your Stomach With a Pillow Placed Under Your… Stomach

Popular wisdom states that sleeping on your stomach is the worst sleep position for back pain. This is partly true, but there are ways to deal with the misalignment that may happen from sleeping in this position. One way to potentially relieve these pressures and give your spine it’s most natural positioning is to place a pillow under your stomach/abdomen. This works by allowing the spine to keep its general shape, not bending inward. If you’re a stomach sleeper who doesn’t want to give up this sleep position, give it a try and see if it helps your stiffness in the morning.

On Your Back With a Pillow Under Your Knees

When you sleep like this, you even your weight distribution to all parts of your body, which lessens the pressure on your spine. This could alleviate some back pain by allowing that area to rest if it has become inflamed.

If you’re wondering if you’re even getting enough sleep, here’s how to know how much sleep is enough sleep! It’s vitally important info for getting a complete picture of sleep health. So what’s your favorite sleeping position? No matter what you’re doing, we hope you’re doing it on a mattress that supports your back the way it’s meant to be supported — fully, consistently, and most important — comfortably.

Now that you’ve identified more sleep positions, sleep better.

Note: Nectar Sleep does not provide medical advice or consultations. Individuals should contact proper health care providers if experiencing conditions or pain.

Prevent Back Pain While You Sleep

If the first sound that you make in the morning is a groan instead of a yawn, it’s likely that you’re familiar with back pain. Back pain isn’t just an uncomfortable nuisance that you have to deal with during the day—it can also rob you of sleep. People with back pain report that the discomfort can wake them up as often as six times throughout the night. If you’re having trouble falling asleep or staying asleep due to a sore back, read on for four simple tweaks that can help break the “ow!” cycle.

Switch Positions.

Certain sleep positions can place extra pressure on the neck, hips, lower back, and more—all of which can cause back pain. Luckily, a pillow can fix this. If you sleep on your back, try placing a pillow under your knees while you snooze. This will allow for proper alignment of the spine. If you sleep on your stomach, a pillow under your lower abdomen can help, while those who sleep on their side should tuck the pillow between their knees.

Try a New Mattress.

Your bed may be to blame for your aching back. In fact, 63 percent of people say that their back pain improved after switching to a new mattress. Look for a medium-firm or firm mattress (the super cushy ones may feel great at first, but they are not back-friendly). Many companies allow you to test drive a mattress for a few weeks before you’re obligated to keep it, which is a good method for finding one that works for you. If a new mattress isn’t in the cards, adding plywood supports under the mattress may help.

Move Carefully.

Paying attention to how you get in and out of bed may help ward off back pain. Avoid sudden, jerky movements and also try not to bend forward from the waist when getting out of bed, as this can hurt your back. Instead, roll over onto your side and push yourself up using your hands while swinging your legs over the side of the bed.

Hit the Gym.

Working out, in general, helps you sleep better. And a stronger, more flexible core can help reduce your risk of back strains and muscle spasms during the night. Add exercises that work your abs and back to your regular workout routine, like the following plank move. Start on your hands and knees, with your hands directly under your shoulders. Walk your legs back until your body is in a straight line from head to toe. Engage and tighten your abs (as if you’re about to be punched in the stomach) and hold the position for 15 to 30 seconds.

If you’re consistent about following this advice, your back pain will hopefully lessen, but see your doctor if these nighttime tweaks don’t lead to improvement, since chronic back pain could be linked to more serious conditions such as scoliosis, fractures, or spinal tumors.

How to Tell if Your Mattress is Causing You Back Pain

When back pain comes about suddenly, it can be both inconvenient and confusing. What is causing your back pain if you haven’t changed anything in your daily schedule? The answer may lie in your mattress.

How to Tell if Your Mattress is Giving You Back Pain

There are so many causes of back pain, so it can be hard to pinpoint where your aches are coming from. However, there are some clues to look out for to see if your mattress is to blame. The first clue is when your back pain occurs. If your back pain is there when you first wake up, but you can stretch to get rid of it within 15-30 minutes, then that is a major sign that your mattress is doing more harm than good. Also, if you find yourself waking up more frequently or are tossing and turning trying to get to sleep, then that should also be a sign. Even if you are not prone to back pain, you should ideally replace your mattress every eight years.

How to Pick a Good Mattress for Your Back

Every one has different sleep preferences, which can make it hard to find the perfect mattress. Look for one that is not too firm or too soft. If the mattress is too firm, it will push on your pressure points and cause misalignment. Similarly, if the bed is too soft, it will allow your body to sink into the bed causing bad posture while you sleep, which can then lead to pain. The right mattress should make you feel like you are floating on air.

Financial times might be tough at the moment, but one should consider in investing in a good mattress. Think about it, you should be spending 7-9 hours on your mattress each night, which makes it an important piece of furniture. You want to invest in something that will give you better sleep and less pain, instead of going frugal and buying a mattress that is not right for your body.

Should You Get an Adjustment?

It is a very wise idea to get a wellness adjustment from your chiropractor before you go mattress shopping. This can help relieve pain and help you have better posture and body support while you sleep. Ask your chiropractor for advice on sleeping positions, as well as recommendations for mattresses. Not only is your chiropractor a back expert, but he has probably heard a lot of recommendations from his patients who suffered from mattress-induced back pain.

What Else Can I Do For Back Pain?

Changing your mattress will most likely do wonders for your back pain, if that was the cause. You can also implement a short stretching routine into your day. Aim to do a few stretches before you go to bed and after you wake up to help with spine flexibility. Also, it is important to learn how to sleep in the best position possible. Many experts recommend sleeping on your side with a pillow between your legs to support the hips and lower back. Certain pillows can also help promote less neck and back pain while you sleep.

For sweeter dreams and less back pain in the morning, consider getting a new mattress. Your sleep is essential, so make sure you are getting a mattress that will improve your sleep, not make it worse. When mattress shopping, bring your own pillow and spend a good ten to fifteen minutes on each mattress. It may seem silly, but it is the best way to ensure you get the right mattress for you.

Remember to always consult your chiropractor before taking any health advice.

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Choosing the Best Mattress for Lower Back Pain

Sleeping on the wrong mattress can cause or worsen lower back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.

Sleep comfort is also sacrificed if a mattress does not match one’s individual preferences. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

See Mattresses and Sleep Positions for Each Back Pain Diagnosis

With the vast variety of mattresses on the market, choosing the right mattress can be difficult. The following practical guidelines are designed to help patients with low back pain choose the best mattress for both back support and sleep comfort:

  1. Personal preference should ultimately determine what mattress is best. There is no single mattress style or type that works for all people with low back pain. Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. Patients with low back pain should choose the mattress that meets their standards for comfort and support and allows them to get a good night’s sleep.
  2. Read more: Chronic Pain and Insomnia: Breaking the Cycle


  1. Understand and inquire about the physical components of the mattress. The coils or inner springs of a mattress provide the support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress comes in many different thicknesses. Mattress depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by individual preferences.
  2. See Mattress Guidelines for Sleep Comfort

  3. Find a mattress with back support. A good mattress should provide support for the natural curves and alignment of the spine. The right amount of back support also helps the patient avoid muscle soreness in the morning. While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.
  4. Read more about Posture to Straighten Your Back

In This Article:

  • Choosing the Best Mattress for Lower Back Pain
  • Considerations When Buying a New Mattress
  • How to Evaluate a Mattress
  • Video: What is the Best Mattress for Back Pain?
  1. Achieve a balance between back support and comfort. Overall comfort while sleeping on the mattress is equally important as sufficient back support. Sleeping on a mattress that is too firm can cause aches and pains on pressure points. A medium-firm mattress may be more comfortable because it allows the shoulder and hips to sink in slightly. Patients who want a firmer mattress for back support can get one with thicker padding for greater comfort.
  2. Learn more about Pillow Support and Comfort


  1. Know when it’s time to get a new mattress. If an old mattress sags visibly in the middle or is no longer comfortable, it is probably time to purchase a new one. Putting boards under a sagging mattress to keep it from sagging in the middle is only a short-term fix for the sagging; a new mattress is still needed.

3 Tips for Sleeping Better With Lower Back Pain

Sleep should be a period of rest and rejuvenation. But for the 31 million Americans suffering from lower back pain, this is often far from the case.

Ongoing back pain can leave you awake and uncomfortable for much of the night. This is why individuals with chronic back pain get an average of 42 minutes less sleep per night than their peers.

Even when you do manage to drift off, your quality of sleep may not be adequate. Back pain can cause you to spend more time in lighter stages of sleep, and you may wake multiple times an hour without even realizing it. This reduces the quality of your sleep and it can leave you feeling unrested or uncomfortable in the morning.

Fortunately, these issues sometimes can be addressed with simple lifestyle changes. These three tips may help you sleep more deeply at night — and wake up with less back pain.

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1. Adjust your sleeping position

One way to relieve back pain at night is to make sure pressure is equally distributed along your spine. Sleeping on your back helps ensure your body weight is spread evenly. Placing a pillow under your knees also can help maintain the normal curve of your lower back as you sleep.

Side sleepers can adjust their position to evenly distribute pressure as well. Drawing your knees slightly toward your chest can help, as can placing a pillow between your legs. Alternating which side you sleep on is also a good idea.

Sleeping on your stomach places the most strain on your spine, so avoiding this if possible is recommended. However, if you find you cannot sleep any other way, try placing a pillow under your abdomen to relieve some of the tension in your neck and back.

2. Check your pillow

Maintaining the natural curve of the spine will help relieve tension during the night, and your pillow plays a big role in that process. Pillows that are too high or too stiff cause your neck to flex all night. This can lead to pain and stiffness in the morning.

To keep your spine in alignment, make sure your pillow is at a comfortable height. Place it beneath your head and neck, not your shoulders. A pillow that conforms to the contours of your head and neck — such as a feather pillow or one containing memory foam — can give you additional support.

3. Update your mattress

The age of your mattress can have an enormous impact on your spinal health. As a mattress wears out, it may start to sag or lose its springiness. Therefore, it may no longer keep your spine in alignment as well as it used to.

But when the time comes to replace your mattress, what type is best? More independent research is still needed to answer this question definitively. One study, however, suggests that medium-firm mattresses have the biggest impact on relieving back pain.

If your back pain is on the milder side, these tips may be enough to give you relief. On the other hand, if your symptoms need more direct treatment, we are here to help. The expert physicians at the USC Spine Center can evaluate your pain and offer appropriate spine care, in order to relieve pain and restore ease of mobility.

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