What Is The Best Position For Sleeping With Back Pain?

Getting Good Sleep Is Essential For Pain Relief - FACT. But How?

In This Article –

– How to Get a Good Nights Sleep

– Sleeping Positions

– The Pain of Restlessness

The ‘Sleeping With Pain’ Conundrum –

It is widely accepted that good sleep is essential for reducing your overall back pain. But for many of us – therein lies the problem. If I cant sleep, I will be tired, most likely grumpy and feel my pain more.

But then my increased pain means I cant sleep – at least without sedating myself to the point that I still feel sick the following morning.

We all have a favourite sleeping position (even if we don’t know it). Today we analyse all the basic angles what is the best position for sleeping with back pain?

How To Get A Good Nights Sleep

There are 3 basic considerations here – the position you sleep in, the type of mattress you sleep on and the type/ style of pillow you use. In this article, I am using the results of a number of face to face pain management meetings on exactly this subject as well as further research to answer the complex question – what is the best position for sleeping with back pain?

The main objective when you are asleep is to ensure your spine is as straight and supported as possible. Mattresses that are too soft or cushions that are too large will push your spine out of it’s natural alignment and result in increased back pain, especially when you first try to get out of bed in the morning.

There are four basic positions that most people sleep in – flat on your back, flat on your front, flat on your side (either side) or reclined on your back. I will deal with each below.

Sleeping on your back.

This is universally accepted as the best position to adopt if you suffer with back pain. The main reason is the weight distribution around your body is at its most even. A small pillow should be used under your head to align it with the centre of your shoulders and, if it helps, a small cushion can often provide additional support and stop the spine from over-stretching. Please see the picture below for the correct position –

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Sleeping in the fetal position.

For people like myself who may be carrying a bit more around the tummy than the stickman (woman) would recommend, sleeping on your back may not be the most comfortable position. Indeed, for those who would be classified as morbidly obese it is not recommended at all as the tummy fat would put extra pressure on your spine and may even make breathing difficult, leading to sleep apnea as well as agonising back pain.

For us, sleeping on our side, but in the ‘fetal position’ may be the best option. The fetal position (as pictured below) is literally lying on your side but pulling your knees up to your waist. The benefit of this is your legs help to support your upper body and spread your weight across a wider area and stop sharp ‘dips’ occurring in the mattress. These ‘dips’ then lead to your spine bending as you body bends in to the sunken mattress. Again, a pillow can be added between the knees to stop the spine pulling down, providing it feels comfortable enough to sleep with.

Sleeping on your side (not in the fetal position).

Again, this is a perfectly good option if managed carefully. A good mattress is essential here, as if you’re not lifting you legs up in to the fetal position, then you run the risk of your straightened legs pulling your spine/ hips out of line. It is therefore really important if you already suffer with back pain that you consider the extra cushion under your knees to keep both of your legs aligned to your spine.

Another tip from one of members, David Stallin, was to use a cushion under your side as well – between your hips and your ribs as it took the ‘sag’ out of his mattress and really helped with his lower back pain.

Creating better support for your spine and enjoying better sleep is not rocket science – it just takes a few tweaks and a full night of rest could at last be yours!

Sleeping On Your Front.

This really is for those that have grown up sleeping on their front and find it unnatural to sleep in any other position.

Sleeping on your front is generally accepted as the worst position possible for lower back pain. This is principally for two reasons – firstly your weight works against you pulling your spine forward in the middle and secondly most people then put there head on a cushion and turn sideways. This then pushes your shoulders/ neck back and can cause terrible back/ neck problems.

If you are going to sleep like this, then the best way to minimise any potential back pain is by placing a small cushion under your mid-section to provide extra support. You should also consider using a U-shaped wrapped towel or travel-style cushion for your head, so that you can sleep face down with your mouth/ nose clear.

This should allow a sufficient air gap for you to breath normally without having to twist your neck to the side.

Sleeping In A Reclined Position.

Sleeping in a reclined position is often adopted by morbidly obese people, because it helps them to breathe easier.

However, those with back pain or isthmic spondylolisthesis may also benefit from it’s use. The chair itself still needs to be firm and supportive of the spine, but with a cushion under your head if needed, this position can prove vital to those that couldn’t be pain free when lying flat.

It is therefore definitely worth trying if the other positions above did not work.

The Pain of Restlessness.

This warning comes with a very personal touch – as the author of a number of the articles on this site, and the organiser of a lot of pain management meetings, this would be one of my very best tips (and warnings).

I toss and turn at night. I know a lot of people do. However, I bought a new memory foam mattress – one that ‘moulds’ around your body. I thought this would be supportive of my spine, but my back pain in the mornings went from a 6 out of 10 to a 12 out of 10 and some days I could barely get out of bed in the first place.

It took a bit of research to work out what had changed but my partner got it spot on – every night I would still toss and turn by effectively throwing my shoulders over to turn my body in the night.

I would do it completely unconsciously, but every time the memory foam ‘hugged’ my body I would literally twist my back to turn over. I tended to turn quickly in my sleep so I was literally ‘wrenching’ my back every time I turned in bend.

After we filmed ourselves asleep one night I could see exactly what the problem was. Why I would go to sleep at night feeling fine and wake up in crippling pain.

Rolling over in bed, especially if you already suffer with back pain, can be a massive problem. In the end I broke the habit by sleeping downstairs in a chair on my own. After about six weeks, I returned to bed to a new mattress and with a second duvet rolled up tightly (and taped to make it firm).

I slept with my back against the ‘divider’ and had largely broken my habit of tossing and turning at night. And surprise, surprise – my back pain in the mornings was greatly improved again.

The Final Word –

What is the best position for sleeping with back pain? Well, it depends a bit on your body size and a lot on your personal preference. The ‘textbooks’ will always say sleep on your back, but in the world of real people, the best position is whichever you feel most comfortable with.

The most important factor in determining whether you get a pain-reduced night full of sleep and can actually get our of bed in the morning, is how supported your spine.

And this can be done with the right type of cushions in the right positions on the right mattress. If you can avoid tossing and turning in your sleep, then most common sleeping positions can be made supportive – and ultimately that is all you need…..and a partner that doesn’t snore, but that’s a different story altogether!

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