Tips to reduce sleep-related back pain

Back pain is one of the most common types of pain reported in the United States. Most people — up to eight out of 10 — will have at least one episode of back pain during their lives. While various factors contribute to back pain, how you sleep — from your sleep position to the pillow or mattress you choose — can be a cause.

Pain and sleep are interconnected. Back pain can make it harder to get a good night’s sleep, while some research shows that insufficient sleep can exacerbate pain in addition to causing other health problems, from impaired focus to increased risk of cardiovascular disease.

The COVID-19 pandemic has only made matters worse. Disrupted daily routines and anxiety about the pandemic have fueled insomnia, while working from home without proper office equipment has caused more people to experience back and neck aches and pains.

Health Matters spoke to Dr. Clark Smith, a neck and back pain medicine specialist with NewYork-Presbyterian Och Spine, and Dr. Kelly Grimes, a physical therapist with Columbia University Irving Medical Center, about what causes sleep-related back pain and what you can do to prevent it.

Everyone has unique, individual variations in terms of the shapes of our spines and individual flexibilities. This is called “body anthropometrics,” says Dr. Grimes, so what’s most important is to find a sleep position that balances support for your spine with comfort and allows you to get a good night’s sleep.

Whatever position a person chooses, having a neutral spine is important, says Dr. Smith. This means there is no major bend in your neck or back.

When you lie down, your back either flexes a little bit or extends, meaning it leans forward or leans back, depending on your position. For a lot of people, the easiest way to achieve a neutral spine is to lie on your side with a pillow, either between your knees or a pillow that you’re hugging, and not have your neck or spine contorted in any way, says Dr. Smith. However, people with some conditions, including hip conditions, shoulder bursitis, or hip bursitis, can have trouble with side sleeping. While there’s no one best position for everyone, lying on the side is usually going to be the healthiest thing in terms of spine care for most people.

Some people prefer a firmer mattress, while others prefer something with more moldability, like a foam mattress, but generally, you want a mattress that’s in good condition, says Dr. Grimes. If you’re sleeping on a sagging mattress and you’re starting to have problems sleeping, rotating the mattress or getting a mattress topper could help.

Your body will react to mattresses in different ways. If you’re lying flat on a hard mattress, your spine may be neutral, with no bending or twisting. This may be beneficial for someone who needs extra support. But if you’re lying flat on your back on a soft mattress, your lumbar spine might bend forward like you’re looking down, which is called “flexion,” says Dr. Smith. This compresses the discs, and that can make disc pain worse. If you’re lying on your stomach in a soft bed, that could extend your back. This position might feel good for the low back in people whose spines bend forward, but it could cause discomfort for others.

Pillows should also help you achieve a neutral spine, adds Dr. Smith. Stomach sleepers usually prefer a thin pillow so their neck isn’t contorted, while back and side sleepers can tolerate a thicker pillow as long as their spine stays neutral.

If you’re sleeping on your back and that’s not working out, try sleeping on your side, says Dr. Smith. You could even place a pillow next to your back so if you move from your side to your back in the middle of the night, you’d have a gentle reminder to stay on your side, adds Dr. Grimes. If you’re a stomach sleeper and you have neck pain, try using a skinnier pillow so your neck is not turned back as much, or if you’re using two pillows, use only one.

Props like a pillow or rolled-up towel can also be helpful, says Dr. Grimes. If you sleep on your back, you might get an arch in your back in that position. If that’s causing pain, place a pillow or two underneath the knees, which helps with low back pressure, and/or place a little towel roll underneath the arch of the low back to support that gap.

Similarly, stomach sleepers can put a small pillow under their stomach to help create a neutral spine. These fixes mean a person can still sleep in their preferred position, but they’re not putting as much stress on the tissues in their spine throughout the night.

An expert can help determine the cause of your pain, says Dr. Grimes, though she adds that it might take a bit of detective work. They might ask questions about your sleep positions and if you feel any similar pain connected to sitting or standing, which can help them narrow down the cause of your pain.

It is also important to investigate whether other medical issues are interfering with sleep. If somebody is waking up frequently because of sleep apnea, their back pain might be getting worse because they’re not getting restorative sleep. For some people, immobility while they sleep rather than a particular sleep position could cause pain, says Dr. Smith. With osteoarthritic conditions, for example, joints may swell a little bit when they’re not mobile. So getting those joints moving again can be painful when you go to the bathroom at night and get up in the morning. Some people may report similar discomfort if they go to a movie, so that pain may not be related to your sleep position.

Today, there’s a lack of separation between work and home for many due to COVID-19, so it’s easy for people to go right from the computer to bed. This is why it’s important to build in behaviors and habits, like a gentle mobility routine, into an intentional nighttime wind-down routine, says Dr. Grimes. The “motion is lotion” concept means you’re bringing nutrition and blood flow to the tissues in your spine when you move. Here are simple stretches and exercises that you can do before bed to loosen up your back.

When you wake up in the morning, if you’re lying on your back, squeeze your abdomen down into the bed to engage those core muscles. This is called “abdominal bracing,” says Dr. Smith. Or bring your knees to your chest to loosen up your hips a little bit. If you can tolerate it, try some supine knee twists, where you lie on your back and turn your knees to one side. Like the Tin Man with no oil, the spine and other joints can feel stiff and creaky after a period of immobility when you get up, so just giving yourself a little bit of extra time in the morning can also help. Often symptoms will improve once you get moving.

Clark Smith, M.D., MPH, is an attending physiatrist at NewYork-Presbyterian/Columbia University Irving Medical Center and the John A. Downey Associate Professor of Rehabilitation and Regenerative Medicine at Columbia University Vagelos College of Physicians and Surgeons. A fellowship-trained physiatrist, Dr. Smith specializes in treating patients with acute and chronic sports and spine injuries. Dr. Smith is board certified in both physical medicine and rehabilitation and pain medicine.

Kelly Grimes, DPT, is a Doctor of Physical Therapy at Columbia University Irving Medical Center who specializes in musculoskeletal pain, with a particular interest and expertise in spine care and scoliosis management across the lifespan. Her practice focuses on individualized treatment plans built around each patient’s unique goals —relying on assessments grounded in movement analysis, and a collaborative, hands-on style that considers the whole patient rather than just a painful or troublesome body part.

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9 Sleep Tips for Back Pain

Written by WebMD Editorial Contributors

• 1. Find the right position.
• 2. Get a good mattress.
• 3. Get into and out of bed carefully.
• 4. Exercise your core.
• 5. Try gentle yoga stretches before bed.
• 6. Medication may help.
• 7. Establish a bedtime routine.
• 8. Cut down on stress.
• 9. Don’t give up.
• More

Back pain can make getting through the day hard, but it can make getting a good night’s sleep even harder. It can be tough to find a comfortable position so you can doze off. And you might not even be able to get in and out of bed without pain.

But good sleep is essential to your health, and an important part of your overall well-being. Studies have found that Americans who ranked their quality of life very good or excellent slept an average of 18 to 23 minutes longer than those who considered their health and quality of life poorer. But studies have shown that not getting enough sleep may actually make you more sensitive to pain.

If you’re having trouble getting enough shut-eye because of back pain, try these tips that can make sleeping a little easier.

Certain sleeping positions can help ease your back pain, so find one that is most comfortable for you. Try sleeping with a pillow between or underneath your legs for extra support.

If you sleep on your side, put the pillow between your knees and draw them up slightly toward your chest. If you like to sleep on your back, try the pillow under your knees, or roll up a small towel and place it under the small of your back.

Avoid sleeping on your stomach because it puts a lot of strain on your back. If it’s the only position you can fall asleep in, put a pillow under your stomach to take some of the pressure off your back. Or, to break the habit, wear a sleep shirt with a pocket in front and put a tennis ball in it.

The Sleep Foundation recommends that you evaluate your mattress about every 6 to 8 years. You may need a change for optimal comfort and support. In one study, nearly 63% of people reported significant improvements in low back pain after switching to a new sleep system.

If your budget allows for buying a new mattress, don’t be afraid to “test drive” a few options. When in the store, take off your shoes, lie down in your favorite sleeping position, and spend a few minutes resting. Make sure the mattress supports you well enough to maintain your spine in the position you have with good standing posture.

The type of mattress you need depends on your body type. A soft mattress can be good if your hips are wider than your waist because it will let your spine stay straight while you sleep. If your hips and waist already line up straight, a harder mattress might feel better because it will give you more support.

Doctors used to always recommend firm mattresses, but research has shown that people with low back pain actually sleep worse on very hard mattresses when compared to other kinds. But soft mattresses can cause problems, too. You may sink in too deep and your joints may twist and cause you more pain.

Try sleeping on different kinds of mattresses, either at friends’ houses, or in hotels, to see what feels best. If you think a harder mattress might help, put a sheet of plywood between your mattress and box spring, or try a few nights with your mattress on the floor to see if the extra support makes a difference in your pain.

It may sound obvious, but be extra careful when you get into and out of bed. Bending forward at your waist or making quick and jerking motions can cause you more back pain.

Take your time and roll over onto one side and use your arms to push your way up. You can then swing your legs out of bed to stand up slowly. Reverse the movements when it’s time to lie down at night.

Getting regular physical activity is a great way to improve the quality of your sleep. But doing targeted exercises to strengthen your core — the muscles in your abdomen, hips, lower back, and pelvis — can also help ease back pain.

Building strength and flexibility in these muscles can lower the chances of you straining your back and experiencing muscle spasms during the night. Holding a plank position with your hands under your shoulders and your legs out straight can help tighten these muscles. Start by holding the pose for 15 to 30 seconds and try to maintain proper alignment, with your body in a straight line and your abdominal muscles engaged.

Research has shown that yoga or intensive stretching can help reduce low back pain. It can also help reduce your stress and make you sleep better.

Talk to your doctor about which poses are safe for you to practice and which ones won’t make your pain worse. It might be helpful to start off using yoga props like blocks and bolsters for added support so that you can hold poses comfortably. And taking a few yoga classes with an instructor to be sure you’re doing the poses and breathing correctly — which is key to relaxation — isn’t a bad idea either.

Some medications can help you get sleep while helping with back pain. They should be used as part of a complete treatment plan and only under the direction of your doctor. The goal of medication should be to help you develop a more normal sleep pattern.

Over-the-counter pain relievers, such as aspirin, Tylenol (acetaminophen) or Advil or Motrin (ibuprofen), can be effective for short-term use. These drugs are also available in a “PM” version that includes a medicine to help you sleep. Naproxen sodium (Aleve) is long-lasting and may offer pain relief throughout the night. It’s also available in a “PM” version. 

Sedatives like zolpidem (Ambien), suvorexant (Belsomra), eszopiclone (Lunesta), and zaleplon (Sonata) are prescription medicines that can help you sleep.

Prescription drugs for back pain include antidepressants, such as doxepin or duloxetine (Cymbalta), or a medicine that combines antidepressant and pain reliever effects, such as amitriptyline, or a muscle relaxant, such as cyclobenzaprine (Flexeril).

Try to go to bed at the same time each night. Follow a routine, such as setting the alarm, putting on your pajamas, and brushing your teeth. Do not read, work, or watch TV in bed.

Stress is the major cause of insomnia. It’s also linked with back pain. So look for ways to relax and better manage stress. Don’t self-medicate with alcohol, which also hurts your sleep.

Do some soothing exercises. Try relaxation techniques, and ask your health provider or physical therapist about exercises that you can do to help your back early in the day.

The best way to get a good night’s sleep is to get rid of back pain, but this isn’t always possible. Other things that affect sleep and pain, such as anxiety and depression, might also need attention and treatment. Many people put up with pain, but it often can be helped and treated. Don’t give up on finding a treatment that can work for you.

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After sleep, back pain in the lumbar region: causes, possible diagnoses

If in the morning you wake up with pain in the lumbar part of the back, this circumstance can not only darken the mood, but also significantly limit the possibilities. Modern medicine gives many explanations for why the lower back hurts in the morning after sleep.

Causes of back pain in the lumbar region after sleep

The reasons why the lower back hurts after sleeping in the morning are very diverse and ambiguous – from the most frivolous and easily eliminated to intractable pathologies. But sometimes it is enough to look at the external circumstances that provoke this painful symptom every morning.

Hard surface, awkward posture

Too hard or, on the contrary, soft bed makes you take an unhealthy and uncomfortable position in your sleep. As a result, the muscles that should rest at night are not able to relax – and now, after sleep, the back hurts in the lumbar region. At the same time, even owners of orthopedic mattresses are often tormented by this problem. A properly organized place will not relieve the painful inconvenience in the morning if a person sleeps in the wrong position. It is recommended to sleep in such a way that the muscles do not have to stretch or tighten, one of the proven options is on the back with legs elevated.

Overvoltage

Overstrain of the back muscles occurs in those who are engaged in heavy physical labor or, on the contrary, sit in one position for a long time. During sleep, the muscles do not have time to relax, which is why the lower back hurts after sleep. This condition is temporary and passes without the participation of a doctor, however, for its further prevention, it is recommended to do physical exercises.

Diseases of the spine

One of the common reasons why the back hurts in the lumbar region after sleep is various pathologies of the spine. Localization of pain in the lumbar region indicates that the source is located in the lumbar part of the spine. There are the following pathological conditions that provoke this unpleasant symptom:

Osteochondrosis

We are talking about lumbar osteochondrosis, when various tissues of the lumbar region are damaged. The pain is caused by the fact that the disease affects the nerve endings, which is why the lower back hurts during sleep, even on the back and after it. The only way to stop the pain is to actively treat the disease, since neglected osteochondrosis turns into even more serious complications and painful manifestations.

Spondylolisthesis

This is a vertebral pathology in which one of the vertebrae moves forward and backward. If the lumbar region hurts after sleep, it is in this part of the back that the structure of the spine has changed. Spondylolisthesis is rarely caused by traumatic lesions of the spine, more often it is a congenital anomaly or the result of neoplasms affecting the vertebrae.

Spondylosis

Consequence of untreated lumbar osteochondrosis. Hard bone tissue grows around the spine, forming spikes that periodically touch the soft tissues. This is what causes back pain in the lumbar region after sleep. Spondylosis often accompanies other chronic diseases of the spine. This condition is typical for older people.

Herniated disc

It is characterized by rupture of the fibrous ring of the intervertebral disc and compression of the nerves. This causes back pain in the lumbar region after sleep, lasting all day. The spine in the lumbar region is most vulnerable to a pathological condition, since it bears the highest load.

Spondylarthrosis

This is a lesion of the intervertebral joints, which is often combined with osteochondrosis and spondylosis. The connections between the vertebrae are broken, resulting in pinched nerves and discs. Therefore, after sleep, back pain occurs in the lumbar region. Spondylarthrosis is often provoked by developing vertebral diseases, it occurs with beriberi.

Diseases and pathologies of internal organs

Many internal organs and vessels are adjacent to the lumbar region. Therefore, back pain in the lumbar region after sleep can appear in the absence of any problems with posture, as a result of damage to nearby organs. Pain can indicate the following diseases:

Pathologies of the pancreas

Girdle pain of a aching nature is characteristic of various problems with the pancreas. If your lower back hurts this way after sleeping, you should visit a doctor, as this is a common symptom of pancreatic pancreatitis.

Pyelonephritis

It is an acute inflammation of the kidneys. The kidneys are located close to the lower back, so back pain after sleep is localized in this area. The nature of the pain is dull aching. They may not stop all day.

Pelvioperitonitis

This gynecological disease is an inflammation of the uterus and ovaries, which makes itself felt primarily with pain in the lower abdomen. Sometimes after sleep with pelvioperitonitis, back pain occurs in the lumbar region. You also need to pay attention to the general condition: body temperature, the presence of nausea and vomiting. Additionally, other symptoms may accompany pelvioperitonitis – for example, amenorrhea (prolonged absence of menstruation).

Metastases and tumors

The back in the lumbar region can hurt after sleep due to neoplasms in the internal organs: pancreas, stomach, kidneys, etc. Quite often, this symptom manifests itself as urological diseases. This is a serious phenomenon that needs to be carefully investigated.

Kidney disease

Due to their proximity to the lumbar part of the back, the kidneys can make themselves felt with dull aching and intense pain in the lower back. Sometimes back pain after sleep appears during movements and blocks them, thereby limiting a person’s capabilities. The pain is usually localized in the lateral part of the lower back. Also, this symptom is accompanied by edema. Kidney disease requires accurate diagnosis.

Diseases of the heart and blood vessels

In rare cases, the back in the lumbar region hurts after sleep due to circulatory disorders and the work of the heart muscle. Night pains are characteristic, while their intensity is disproportionate to the severity of the problem. Therefore, people prone to cardiovascular disease should pay attention to this symptom.

How to relieve pain

Since the causes of lower back pain after sleep can be different, self-diagnosis and pain relief is strongly discouraged. Some external problems do not require the participation of a doctor, while serious internal disorders need proper treatment. Self-management of pain – an important symptom that will allow the doctor to determine the source of the problem – is not recommended until the examination by a specialist. How to relieve an attack of back pain in the lumbar region after sleep, only the attending physician will tell you. Medication may be prescribed to treat pain. You need to know that pain is a symptom, not the cause of the problem. Often, lower back pain disappears after the correct organization of the bed, debugging the diet, correcting posture and two to three weeks of physical therapy.

Which doctor to contact

If you have back pain in the lumbar region after sleeping, first of all, you need to contact the therapist . He will conduct a survey and examination, send you for a medical examination, and, if necessary, to a narrow specialist. This can be a massage therapist, chiropractor , neurologist , gastroenterologist , cardiologist or another specialist. Pain after sleep in the back – in the lumbar region – can be a sign of a serious illness, so you should consult a doctor immediately after they occur. This will prevent possible costs for serious treatment of complications of the disease and save your health.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

causes, treatment – how to get rid of back pain after sleep

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Rarely, when back pain after sleep occurs as a result of physiological causes, for example, when you stay in one body position for a long time. AT 9In 9% of cases, discomfort is disturbing due to a pathological change – which one, only a doctor can determine.

CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 25 years of experience

Publication date: September 22, 2021

Verification date: January 30, 2023

All facts have been verified by a physician.

Article content

Causes of back pain after sleep

Varieties of pain depending on diseases

First aid for back pain after sleep

Which doctor to contact

Diagnostic methods

How to treat back pain after sleep

Rehabilitation

Rehabilitation is the final stage after therapeutic treatment aimed at eliminating pain in the spine after sleep. The recovery individual program is compiled by experienced specialists of the rehabilitation center “Laboratory of Life”.

The course allows you to significantly reduce the recovery period, improve the quality of life.

These measures are especially effective in diseases of the spine, scapula and other structures of the musculoskeletal system.

Consequences

Prevention

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