Sleep Resources

Sleep and Back Pain

Do you find yourself waking up from chronic aches and pains? Learn how changing your mattress may be contributing to your low back pain and why an upgrade might solve your issues.

By Noelle Chandler

It probably comes as no surprise that pain can make it difficult to fall asleep. The National Sleep Foundation found that people with pain sleep less and have worse sleep quality. For those who suffer from chronic back pain, finding a comfortable sleeping position may seem like an impossible task. And since poor sleep quality can intensify pain, it is especially important for those who suffer from chronic pain conditions to get a good night of rest.

Senior Woman Suffering From Backache Getting Out Of Bed

Causes of Low Back Pain

The American Chiropractic Association reports that back pain is the number one cause of disability worldwide. The back is a complex area with numerous ligaments, muscles, joints, and discs all working together to support the rest of your body. As a result, there are many possible causes of back pain, such as sprained ligaments, strained muscles, arthritis and joint irritation, poor posture, injury, and obesity. 

Many other chronic pain conditions such as fibromyalgia, multiple sclerosis, nerve damage, and others may also cause back pain. Sleep disorders can also cause pain. Your body needs sleep to heal and recover from the day’s wear and tear. Therefore, if you don’t get enough rest, you may wake up sore. That, in turn, can make it difficult to fall asleep the next night, quickly turning into a vicious cycle. The good news is a doctor, particularly a good chiropractor, should be able to narrow down the list of potential causes, even if the root cause isn’t always clear. One of the more common causes (and one of the easiest to fix), may actually be your mattress.  

How Your Mattress Impacts Pain

While chronic back pain may have numerous causes, your mattress may be one of them. Even if your pain does come from a different source, the right mattress may make a surprising difference in pain levels. Since sleep is so important for overall health, in addition to pain management, finding the right mattress is critical. Believe it or not, mattresses are not “one size fits all.” There are several factors to consider:

  • Firmness. Doctors tend to recommend medium-firm mattresses, but it’s also important to try out a variety and find a mattress that is comfortable for you.
  • Body Type. When it comes to mattress type, weight matters. People who weigh more than 200 lbs are more likely to sink into a mattress, so they will need a different level of firmness than someone lighter.
  • Mattress Material. Weight is also important as you consider mattress material. Heavier individuals should look for mattresses made of higher density material to get the best support. Mattress material can also help with those who tend to be hot at night. Some materials are more breathable than others.
  • Mattress Age. Even an expensive mattress will eventually wear out. Doctors recommend that you replace your mattress at least every 5-7 years, if you’re buying on the high end, and every 1-3 years if you’re going with a budget option.

How Your Sleep Position Impacts Back Pain

You probably already know that posture is important. But what you may not know, is your sleeping posture is just as important as your posture when you are awake. The difference? You don’t have control over sleeping posture because you lose all musculoskeletal function during sleep. As a result, you are left to the mercy of your mattress to maintain a healthy sleep posture.

Depending on your preferred sleep position, you’ll need to find a mattress that gives the right amount of support. Keep in mind, a firm mattress isn’t always better! Despite firmness, the right mattress will keep your spine in proper alignment as you sleep. Ideally, you want your spine to be in a straight line from your tailbone all the way to the base of the neck, no matter how you’re lying in bed. A mattress that sags in the middle can cause pinching in the lower back. This often causes pain in the hips and legs, but it may also cause pain in the upper back, shoulders, and neck.

Even if your mattress provides good support, your sleep position may throw your back out of alignment. If you tend to sleep on your back, you’re lucky–this is the number one sleep position, according to doctors, because it naturally keeps your body in alignment. For back sleepers, a medium-firm mattress is highly recommended. If you’re sleeping on your back and experiencing pain, doctors suggest you put a pillow on both sides of your hips. This helps keep you in a straight position throughout the night. You can also put a small pillow or rolled up towel under your knees to ease tension in the legs, which pulls on the back muscles.

However, we don’t always get a choice when it comes to sleep position. While you’re unconscious, you can’t choose to stay on your back. If you find that you’re frequently sleeping on your side, this position is second best, and it’s actually the most common sleep position. Sleeping on your side rotates the hips and places more pressure on the lower back, shoulders, and chest. Fear not! Memory foam mattresses are often recommended for side sleepers, as they give a good mix of support and cushion to adjust to the natural curve of your spine. As for firmness, try something in the medium or medium-soft range to start. If you’re experiencing pain while lying on your side, doctors suggest placing a pillow between your knees. This can help correct that hip rotation, keeping your hips square and ease pressure on the lower back. You can also hug a pillow to your chest, which keeps shoulders from hunching and eases pressure on the neck and shoulders.

Sleeping on your stomach is, according to doctors, the worst sleeping position. It’s also the least common. This is because stomach sleeping places extra stress on your back and neck. For stomach sleepers, a medium-firm mattress with multiple layers of memory foam may be the way to go. If you’re still experiencing pain, you can try placing a pillow beneath your pelvis to keep pressure off your spine. And, use a thinner pillow to minimize the angle of your neck. 

Bigger Implications: How Pain Impacts Sleep

More than half of people with chronic pain report that sleeping issues cause problems with work, relationships, mood, and more. You probably already know that when you’re sick or injured, the number one recommendation is always rest. Sleep is when your body does most of its healing from everyday wear and tear, in addition to larger injuries. Sleep also plays an important role in immune support. If you’re not getting enough sleep, chances are higher that you’ll catch that cold going around the office. 

But when you’re in pain, getting the rest you need isn’t easy. It’s not only harder to fall asleep, but when you do finally doze, nighttime rolling and shifting can irritate the pain. You might wake up more frequently throughout the night, or get poorer quality sleep, as you don’t get a chance to enter the deepest sleep phases before the pain jolts you awake. The first step, of course, should be a trip to your doctor. But a new mattress, or some adjustment to sleep position may be all you need to ease the pain.


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