There are no hard and fast rules when it comes to back pain and sleeping positions, making trial and error the usual process to figure out what works for each individual. As we spend a third or so of each day sleeping, it is essential not to overlook the importance of having a healthy sleep system, or so-called ‘sleep hygiene’, especially when it comes to maintaining good back health or relieving existing back pain.
Certain basic principles are helpful to remember, such as not sleeping in a cold and draughty room and not falling asleep slumped over a desk. Specific back problems, such as pain from spinal stenosis, can be partially relieved by adopting a different sleeping position for some sufferers, as can problems with degenerative disc disease, cervicalgia, hip pain, and even osteoarthritis. A firm mattress can help support the back but if it is too firm then a lack of comfortable sleep is likely to do more harm than good; common sense should prevail. Many people find most relief when sleeping on their back with a small pillow just raising the knees slightly so as to take pressure off the spine and prevent a ‘hollow’ back curve occurring during the night. This is a helpful sleeping position for those who have just undergone back surgery in many cases and also for those with lower back pain.
Back Pain Relieved by Sleeping on Your Side
Plenty of people like to sleep on their side however, and this can be particularly helpful for those with osteoarthritis especially if the knees are curled up to the chest a little. This position helps to decompress the facet joints and can effectively relieve pressure on the spinal nerve roots for those with spinal stenosis. To add extra comfort, and keep stress off the hips and lower spine, it also helps to place a pillow between the knees when sleeping on your side. Stress on the spine can be lowered by sleeping in a reclining chair or in an adjustable bed where both the head and the knees can be raised.
Where degenerative disc disease is causing spinal stenosis some back pain sufferers find that sleeping on their stomach can lower spinal stress and pain when trying to sleep. To avoid problems sleeping in this position however, it helps to place a small flat pillow under the hips and stomach to prevent the lower back becoming compressed and to maintain a healthy spinal curve during the night. A relatively firm mattress is usually preferable in such cases in order to keep the back supported. If a patient has bursitis however then a firm mattress can prove painful and so a combination could be attempted by using a mattress pad to soften the surface whilst maintaining good underlying support. Prodigious use of pillows can also help to cushion particularly painful parts of the body whilst keeping the spine supported and specific neck pain pillows may be helpful for patients with cervical spinal stenosis.
Sciatica Sleeping Positions
Paracentral disc herniation (to one side of the vertebral canal), is usually less painful when sleeping face down, whereas back pain from a foraminal disc herniation can be more effectively relieved by sleeping on your side. In cases of sciatica, where nerve compression from lumbar spinal stenosis may be responsible, it is likely that sleeping in a reclining chair or on your back will be most helpful in relieving sciatic nerve pain. Sleeping on the stomach is likely to exacerbate sciatica as the lumbar spine may become further compressed, although placing a pillow beneath the hips/stomach can help in such cases.
Sleeping Positions for Neck Pain Sufferers
Where cervical spinal stenosis is a problem it is important not to twist the neck too much or bend it by sleeping on too many pillows or too firm a pillow. Sleeping on one side with a low pillow supporting the head at the same angle as when standing up straight can effectively reduce neck pain. Sleeping face down with the head forced back, or face up with the head forced forwards can cause disc compression and further nerve pain leading to cervicalgia and should be avoided.
Finding a comfortable position in which to sleep can make a huge difference to our experience of pain as fatigue and tiredness makes us more sensitive to pain signals and less able to heal any trauma or injury. Where there are significant sleeping problems it is important to discuss these with a physician and possibly to attend a sleep clinic. Taking sleeping pills that simply knock you out will not help reduce back pain or neck pain, especially if you sleep in an awkward position for hours without moving. Whilst a new sleeping position might feel odd at first it should not take long to get used to and after a few nights it will usually become second nature. It may even be that, for some patients, back pain and sleeping positions that compress the spine are irrevocably linked, with a new sleep posture effectively relieving chronic unexplained back pain and spinal stenosis symptoms.