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We are not powerless against back pain. It can be alleviated or even prevented with one simple thing: how we sleep. Unfortunately, the reverse is also true. Some aches can be aggravated or even caused by how we position our bodies during slumber. How and on what we sleep can go a long way toward preventing or eliminating back pain completely.
Back pain is one of the most common complaints that people bring to their doctors. About 80 percent of adults report experiencing low back pain at some point in their lives. According to National Institute of Neurological Disorders and Stroke, a 1990 study ranked low back pain as sixth among the causes contributing to poor health and mortality. Two decades later, it moved to third place.
Studies point to a relationship between back pain and sleep. The Sleep in America poll — a national, random-sample survey of 1029 noninstitutionalized adults weighted to be nationally representative that was conducted by the National Sleep Foundation—found that 21 percent of Americans experience chronic pain and that 36 percent report having had acute pain in the week preceding the poll. Of those experiencing chronic back pain, 23 percent report having been diagnosed with a sleep disorder by a doctor, while 6 percent of all others have been.
Health specialists sometimes have a hard time figuring out why our backs hurt. A lot depends on where and when it hurts. There is no one single uniform category of back pain. Instead, there are many different types of back aches.
There are three main types of spine curvature disorders:
There are five regions to your spine, and all five need to be supported to ensure a restful and restorative night’s sleep, especially if you suffer from one of the above spinal curvature abnormalities The regions of the spine consist of five areas: the cervical, thoracic, lumbar, sacral, and the tailbone.
Stress and anxiety become a part of a vicious cycle. Back pain, often worsening quality of sleep, can in turn aggravate stress and anxiety. And, in turn, worry can lead to physical pain. According to The Anxiety and Depression Association of America, back pain is more prevalent in people with anxiety and mood disorders than those without them. The management of stress and anxiety involves proper diet, sleep, and exercise as well as cultivating social ties. Medication and talk therapy have also proven beneficial in some cases.
Pulled or even torn muscles, which commonly cause pain in the lumbar region of the spine, can be the consequence of improper use of the muscles during heavy lifting or exercise.
Poor quality of sleep and not getting enough of it are common complaints. According to the Centers for Disease Control and Prevention, sleep disorders chronically afflict 50 to 70 million Americans. A 2012 survey found that 6 in 10 Americans crave sleep more than sex. According to Thomas Roth, director of the Sleep Disorders Center at Henry Ford Hospital in Detroit, data suggest that “disturbed sleep can worsen your pain.” The reverse is also true. One of the studies conducted by the team Roth oversaw found that sleeping longer decreases sensitivity to pain. Sleep loss and pain increase inflammation, he said, “but getting more sleep may help decrease it.”
A healthy spine serves three main functions:
An unhealthy spine means an unhealthy body and mind. The spinal column needs proper support at night. A well-chosen mattress can help in the maintenance of proper posture.
The Mayo Clinic advises that “there doesn’t doesn’t appear to be one type of mattress that’s best for people with back pain.” Instead, a helpful mattress is “a matter of what feels most comfortable to you.” According to a report by the National Institutes of Health, “having a comfortable mattress and pillow can help promote a good night’s sleep.”
In the 2015 Sleep in America poll by the National Sleep Foundation, people with acute and chronic pain reported that environmental factors often disturbed their sleep. The environmental factors that affect quality of sleep included noise, light, temperature, and, indeed, an uncomfortable mattress.
While no one type of mattress is a fix for all, in general, a firmer mattress—one that supports the spine at all points throughout its natural curve—is preferred by back sufferers. According to Spine-health.com, an independent, peer-reviewed website whose contributors are medical doctors and doctoral degree holders, a firm mattress can work, but it some mattresses can be too hard. In those cases, “it can cause aches and pains in pressure points such as the hips.”
The caution about a mattress that’s too firm was confirmed by a peer-reviewed study published by the medical journal The Lancet. Researchers tested 313 adults with chronic, nonspecific low-back pain and who complained about back ache when sleeping and upon rising found that after 90 days. Some of them were randomly assigned firm mattresses and others medium-firm mattresses. Mattresses of medium firmness improved pain and disability among patients with chronic nonspecific lower back pain. Doctors and manufacturers agree that if a mattress helps you sleep well and wake up rested, regardless of its firmness and composition, it’s a good mattress for your specific back pain.
Buying a mattress is a significant and consequential expense, so it is best to try out a mattress before committing to it. Does this mean that a mattress from a box is out of the question? Not at all, if the manufacturer offers the standard 100-day money-back guarantee. A hundred days is a much more thorough inspection period than whatever customers can find out during the time they spend trying out mattresses at a store.
There are four key factors to consider when buying a mattress:
In addition to mattress type, another factor to which back pain sufferers need to pay attention is the frequency of replacing the mattress. Watch for signs of age such as sagging and how long, it takes for the mattress to recover from body impressions. The conventional advice is to replace the mattress every eight years. However, chronic back pain sufferers might realize that the best mattress for lower back pain requires to replacement more frequently.
Once you’ve decided on a mattress type, there are just a few more things for you to consider.
You know the saying, it takes two to tango? Both your mattress and your pillow(s) play a role in reducing back pain.
You’ll want to choose a different pillow based on your sleeping position to reduce stress on your spine and keep your neck properly aligned:
Back sleepers should tuck a small pillow underneath their knees to allow the lower back to curve naturally and comfortably. For the head, choose a pillow of medium height and firmness to keep your neck and spine aligned. If snoring is an issue, prop your torso up using a few firm pillows.
Side sleepers should tuck a pillow between their knees to relieve stress on their hips. For the head, opt for a firm or extra firm pillow around 4 inches in height to keep your spine straight from neck to hips.
Stomach sleepers should tuck a small, flat pillow beneath their stomach and pelvic area to prevent the spine from sinking. For the head, a thin pillow is best because it keeps your neck flat and in alignment with the rest of your body.
If lying in a recliner feels more restful than lying straight on your back, you may want to consider an adjustable bed.
Adjustable beds let you lie at a 30-45 degree incline, making them a good fit for back sleepers recovering from back surgery or living with degenerative spondylolisthesis, osteoarthritis, or spinal stenosis. These beds can be adjusted by remote control, often have timers or massages built in, and come in multiple sizes.
However, they can be quite expensive and many couples find the design to be awkward.
Mattresses vary widely in price. Depending on the type of mattress, the quality, where you bought it from, and whether you added any customizations, you can expect to pay somewhere between a few hundred to several thousand dollars.
We recommend planning to spend between $800-$1,000 on a mattress you plan on using full-time.
Recognize that the five minutes you spend in the store isn’t really a great proxy for how the mattress will feel to sleep on for several hours each night.
Fortunately, a good return policy and long trial period can help make up for that. Look for a trial period of at least 30 days (online mattress retailers often offer up to 100 days) and make sure you understand the fine print. It typically takes 30 days for your body to fully adjust to the mattress, so use the trial period for all it’s worth
“Can Switching Your Sleep Position Ease Back Pain?” by Everyday Health
Henry Ford Macomb Spine Center
John’s Hopkins Medicine Health Library: Low Back Pain
Low Back Pain Fact Sheet by the National Institute of Neurological Disorders and Stroke
Mayo Clinic’s Website: Back Pain
The 2015 Sleep in America poll by The National Sleep Foundation
“The Structure and Function of a Healthy Spine” by the Cleveland Clinic
“Research on the Alexander Technique for chronic and recurring back pain” by The BMJ