Follow These Tips to Reduce Back Pain when Sleeping

By Sherwin Nicholson | SN Health Resources

moderate to firm mattresses for lower back pain

When you have lower back pain, sleeping becomes particularly challenging.  It is common to wake up often with many episodes of pain.  Chronic pain affects your quality of sleep by limiting your ability to enter the deeper state of sleep.  Without deep sleep, your body won’t repair and heal efficiently, slowing down the healing process for your back.

Pain symptoms can range from a dull, deep sensation in the lower back, a very tight & stiff feeling involving both the back and hips, to a sharp, tingling sensation radiating down either leg.

These symptoms can include severe discs issues, facet joint irritation, nerve root impingement, and strained muscle imbalances.

When pain is compromising your sleep, there are some immediate steps to take to improve your opportunity for deeper sleep.  Below are some suggestions intended to optimize your sleeping conditions.

1.  Use a moderately soft to a moderately firm bed

A firm mattress is commonly what is recommended by back specialists.  However, this is to prevent lower back pain for those who are flexible and relaxed.  If you already have pain, a softer bed may help to cushion and absorb the stiffness that your body currently has.

Although a firm mattress is ideal, changing to one may or may not be suitable at the time.  If your pain is already affecting your sleep, a mattress change may be required.  If it is not convenient or affordable, there are other solutions listed below.

2.  Sleep on your side not on your front

It is never a good idea to sleep on your back unless your back is pain-free or if you have a medical condition that requires you to sleep on your back.

Sleeping on your back can cause an anterior pelvic tilt, that worsens disc and facet joint pain.  It also causes your tightened iliopsoas muscle to pull on your lumbar discs.  Sleeping on your stomach is the least comfortable choice for pain relief as it can cause facet joint pain.

3.  Add lumbar support


Use a small cushion to support a slight arch under your lumbar curve.

If you have pain, the chances are that you have an excessive lumbar arch when you stand.  But as you try to lie down, the arch becomes even tighter as your back tries to relax (straighten out) on the bed.

The cushion will help to ease any strong pull that your iliopsoas may have on your pelvis and cause your back to become tighter as you lay down.  It reduces any swelling from disc pain.

4.  Add knee support

Always place a cushion/pillow between your knees.  It keeps the knees apart and helps to relieve pressure off of the pelvis.  Using support underneath your knees is also advisable for those without pain.

5.  Keep your knees bent

If you must sleep on your back, use 1-2 pillows underneath your knees to keep them in a bent position.  Bending helps to tilt the pelvis towards posterior and reduce pressure due to anterior pelvic tilt.

6.  Sleep on the couch or against a wall


use a couch to sleep sideways

If you find that you are rolling from your side, then onto your back, you will need to have a back support.  Use the back of the couch or a wall to sleep against while sideways.  It will keep you from rolling onto your back so you can sleep uninterrupted.

7.  Keep your room warm

Don’t sleep with the temperature down.  It can make you feel too cold and reduce your circulation.  Sleeping when it is cold can make you stiff and uncomfortable at night.  It also makes you prone to back spasms due to your muscles tightening in response to the temperature change.

8.  Dress comfortably

Don’t underdress.  You will feel colder and may have more frequent spasms or even tightness.  Comfortable clothing will help you to feel warmer and will improve circulation to your back.

9.  Practice relaxation before bedtime

Do’s and don’ts:

  • Avoid strenuous workouts as they can tighten your back
  • Minimize chronic couch sitting as couches provide the least support
  • Stretch more to help reverse any overnight tightness that develops
  • Take a warm bath or shower to relax and boost circulation to your lower back muscles

Follow these recommendations before bed.  Your goal is to prepare your body for bed via relaxation and not from exhaustion.  For some, the lower back tends to feel better towards the night and worse in the morning.  There are some very useful tips for morning back pain.  By relaxing before bed, your chances of a full and restful sleep are better.

10.  And of course, exercise & stretching, but this way instead

The above 9 suggestions are merely part of the solution.  The Low Back Pain Program Site is designed to help those with chronic lower back pain build a greater awareness of many of the strategies required to help overcome their pain.

Optimal sleeping conditions are vital.  Retraining your muscles and joints to function more effectively is equally if not more.  If your lower back properly retrained and reconditioned through specific targeted exercises, then you will be able to sleep much better.  This is also an advantage where the sleeping conditions are less than optimal.

Back pain due to mechanical issues such as disc or vertebrae injury can worsen your body’s ability to regain balance.  Muscle balance is what is necessary to prevent disc failure and joint injury.  If it is not corrected properly, the imbalances will remain, making disc repair sub optimal.

To test whether or not muscle imbalances are a contributing factor in your lower back pain, it is helpful to try these 10 Exercises for Lower Back Pain.  Perform them as instructed slowly and carefully.  If you find some relief from them, then this is an indication of at least some part of your pain being as the result of poor muscle conditioning.  Most of us to some degree will have some form of poor muscle conditioning which in turn worsens a present spinal condition.

The Deep Squat Rest

An exercise for alleviating back pain while sleeping

This simple but challenging exercise will help alleviate issues of lower back pain

The Deep Squat Rest is one of the best methods to test if your muscles and joints are worsening your pain when trying to sleep.  It will test the degree to which your tightness and stiffness affect your hip and back flexibility.  If you are too tight to complete this movement then you will have issues with adequate sleep.  This is an important exercise to perform both prior to sleep and just after awakening as it helps to reduce the progressive tightening of your hips throughout the course of your day. Tight and immobile hips will compromise lumbar flexibility leading to chronic lower back pain.