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A Doctor’s Advice for Sleeping Better With Back Pain

Even on the most comfortable mattress, any number of issues—stress, aches, pains, the hormonal swings of pregnancy or menopause—can keep you awake. For a lot of people, the culprit is back pain. In fact, more than 50% of individuals suffering from back pain also report insomnia. To make matters worse, lack of sleep can increase discomfort from back pain during the day, leading to a vicious cycle of pain and sleeplessness.

What are the most common signs of back pain?

Most of us have had back pain at some point or another—the American Chiropractic Association estimates that about 31 million Americans experience lower back pain at any given time. The most common symptoms of back pain include the following:

  • Persistent stiffness or aches along your spine—from the base of your neck down to your tail bone
  • Sharp, localized pain in your neck, upper back, or lower back—particularly after any sort of strenuous activity or lifting of heavy objects
  • Chronic aching in your middle or lower back—particularly after sitting or standing for long periods
  • Pain that radiates down from your lower back to your butt, as well as down the back of your thigh and even into your calf and toes
  • Difficulty standing up straight without pain or spasms in your lower back

Diagnosing and treating back pain is no simple task since it has so many potential causes, from acute injury to chronic conditions like arthritis and osteoporosis. But whether your back pain is temporary or ongoing, there are things you can do to sleep better.

How do you sleep better with back pain?

There are a few easy things you can do to get better sleep when you have back pain. Here, medical experts share their best advice for getting quality shut-eye when you suffer from back pain.

Consider a new mattress

If it’s been a while since you purchased a new bed, start there. Over time, mattresses can lose their give and begin to sag, creating a surface that bends your body instead of bending with it.

“Having a quality mattress is necessary for relieving some back problems,” says Lina Valikova, MD, sleep expert with DisturbMeNot. “People sometimes think that hard mattresses are best for back pain. However, this isn’t entirely true. You need to have a mattress that will support all of your body curves and allow for some degree of movement. For this reason, medium-hard mattresses are the best choice for people with back pain.”

Often, the best mattress is going to be what’s most comfortable for you. So, if you’re unsure, choose a mattress with a home trial of at least 90 days—that way you can sleep on it for a while and see if your back feels better. (Not sure which mattress material is right for you? Here’s how innerspring, memory foam, and latex mattresses relieve back pain.)

For some people, an adjustable base may help alleviate some pain. Others may find relief with a firmer mattress. Each body is different, so back-pain solutions aren’t one-size-fits-all.

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Rethink your pillows

The mattress isn’t the only part of your bedding you need to think about. The type and quality of pillows you sleep with can have a major effect on your back as well. To find the right pillow, make sure you look for one that will work with your usual sleeping position instead of against it.

Gregory Funk, chiropractor and owner of Ideal Health Chiropractic in Denver, has some advice on choosing a pillow that’s right for you:

  • If you’re a back sleeper, choose a pillow with medium firmness and medium thickness to keep your head, neck, and spine properly aligned. “This will alleviate the strain on your neck and allow your back muscles to relax,” Funk says. Placing a small pillow under your knees as well will reduce pressure on your lower back.
  • Side sleepers should choose thick, firm pillows. “It needs to be able to bridge the gap between your shoulder and ear while on your side, which will retain the neutral alignment of the spine,” says Funk. Adding another pillow between your knees takes you a step further in maintaining that spinal alignment.
  • Stomach sleepers should look for thin, soft pillows, which will reduce the strain on your neck. “Since this position offers the least amount of support for your lower back, you want to reduce the strain on your neck as much as possible,” says Funk. “You may even be able to sleep without a pillow at all.”

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Change your sleep position

While pillows can alleviate some discomfort, you may want to consider changing your sleep position altogether if you have persistent back pain.

“The best sleep position for low back pain is on your back, sleeping face-up,” says Thanu Jey, chiropractor and clinic director at Yorkville Sports Medicine Clinic. “This is the most ideal sleep position, but if you feel some discomfort, you can try placing a pillow under your knees to take some pressure off your back.”

Lying on your side is the next best position, while stomach sleeping is the worst position for back pain because it compresses your lumbar spine, Jey says.

Make lifestyle changes

What if you’re already sleeping on your back and you have a comfortable mattress and you’ve chosen supportive pillows? The next thing you should look at is what you do when you aren’t sleeping.

If you work at a desk all day, you may need to adjust your posture. Getting an ergonomic chair and keyboard will help, but nothing beats being mindful of how you’re sitting. Make sitting up straight a habit, and your back health will improve.

You should also make sure you’re getting enough exercise. Excess body weight and lack of flexibility contribute to pain that may keep you awake at night.

Always talk to your doctor before you make any drastic changes. Your back pain may be coming from a surprising health concern. So, after you rule out the easy fixes, your doctor will run some tests to get to the root of your problem and determine the right treatment plan for you.

For more advice on dealing with back pain, read these articles: