Many who experience back pain may also often have difficulty falling or staying asleep.

Poor sleep may contribute to problems over time, potentially leading to:

  • difficulty with multi-tasking and increased stress, anxiety, frustration, and depression, all of which may contribute to an increased sensitivity to pain
  • daytime fatigue, which may affect one’s ability to use proper ergonomics while working or exercising
  • negative effects on the cardiovascular and neurologic systems that may affect your body’s ability to heal

A specialist can provide options to help you manage your back pain, such as medications, physical therapy, and other conservative treatments. Unfortunately, there is no one-size-fits-all when it comes to recommendations for how to improve sleep when you suffer from back pain. It depends on what is right for each individual.

Sleep positions and back pain

In general, if you are experiencing back pain, it’s best to avoid lying on your stomach. But most individuals have a preferred sleep position and trying to sleep in another position may only increase the sleep problems.

No matter what your preferred sleep position, there are some recommendations and adjustments that can help with back pain and hopefully improve your sleep.

  • Stomach sleepers. Generally, it is recommended that patients with back pain avoid lying on their stomach as this position alters the normal alignment of the spine. If you really prefer lying to sleep on your stomach, it is important to only use a thin pillow under your head and place a more supportive pillow under the hips and abdomen. This will help to prevent the back from sinking into the mattress, which may pull the spine out of alignment.>
  • Back sleepers. If you prefer to sleep on your back, it may be helpful to use a pillow roll under the neck and knees to maintain normal spinal curvatures and to reduces stress on the spine.
  • Side sleepers. If sleeping on your side is your preference, it is helpful to use a pillow under your head and a firm pillow between your knees. You might also consider placing a pillow under your waist for additional support. Pillows will help maintain normal alignment of your spine, prevent the leg on top from increasing pressure and relieve stress on the back and pelvis. When pain is on only one side of the back, avoid lying on the more painful side. Also, be sure to limit time in the fetal position.

A good mattress

Many patients with back pain ask for advice on which mattress to choose. Because mattresses are not cheap, picking the right mattress will not only save money but will help to reduce pain over time.

Here are some general tips for mattresses:

  • Maintaining proper alignment in your spine requires a mattress that is in good condition and does not sag in the middle excessively. If your mattress is sagging, it may be time to consider a new one.
  • It’s critical that any mattress have a good foundation of support.
  • When it comes to firmness level, research shows that a medium to firm mattress will provide an even surface to maintain normal spine postures. However, the most appropriate firmness may vary based upon a person’s weight, height, favored sleep position, body shape, and other individual preferences.
  • Some mattress companies now allow you to try a mattress out for a certain amount of time with the option to return it if you don’t like it. For those with back pain, this may be something to consider.
  • Adjustable beds are becoming more common. If you prefer an adjustable mattress, raise the upper part of the bed to decrease tension in the lower back.

Tips for a good night of sleep

With or without back pain, there are things you can do to improve your sleep.

  • Stick to a routine by going to bed and getting up at the same time every day.
  • Avoid screens for an hour before bed.
  • Your bedroom should be dark and cool.
  • Reduce your caffeine intake.
  • Get regular exercise.

Back pain treatment near you

If your back pain is keeping you up at night, we can help. Learn more about back pain treatment and our back specialists at the Norman Prince Spine Institute with locations in Providence and Newport, Rhode Island.

Alexios G. Carayannopoulos, DO, MPH, DABPMR, FAAOE, FFSMB

Alexios G. Carayannopoulos, DO, MPH, DABPMR, FAAOE, FFSMB

Alexios G. Carayannopoulos, DO, MPH, FAAPMR, FAAOE, FFSMB is chief of the departments of physical medicine and rehabilitation at Rhode Island Hospital and Newport Hospital, and chief of the division of physical medicine and rehabilitation of Lifespan Physician Group. He is also a physician at the Norman Prince Spine Institute.