Achieving Better Sleep With Chronic Back Pain

Achieving better sleep with back pain through strategies that will address the pain. The spine is an amazing but highly complicated structure. It is made up of:

• Bones
• Joints
• Ligaments
• Muscles

All support the body’s weight, protect vital organs and nerve structures while maintaining flexibility. When the spine gets:

• Injured
• Strained
• Sprained

This can make standing up, lying down, and sleeping a consistently painful experience.  

Achieving Sleep Solutions

The connection between sleep disturbance in individuals who suffer from acute or chronic back pain is high. Fortunately, back pain does not have to ruin the sleep experience. There are strategies to achieve better sleep. These include:

• Adjusting sleep positions
• Improving sleep hygiene
• Better understanding the source of pain

Sleep Positions

When back pain presents, finding a comfortable position leads to endless tossing and turning. But sleeping in the wrong position can worsen chronic/acute back pain, or create new injury and pain. Here are some options for alleviating pain:  

Back sleeping

Sleeping on the back is the best position anatomically, especially for back pain. It evenly distributes the body’s weight putting less strain on the back. For optimal results, use a soft pillow with minimal height to keep the spine aligned with the neck through the low back. Placing a pillow under the legs can also reduce stress on the low back. Back sleeping is also not recommended for pregnant women in their second or third trimester. This is because the weight can press against the spine causing strain. It can also press on the main vein that carries blood back to the heart from the lower extremities. This can interfere with circulation causing dizziness. For this stage sleeping on the side is recommended.

Side sleeping

Sleeping on the side is considered a safe position for those with back pain. However, this is only if the mattress has proper support. Side sleepers need a mattress that maintains spinal alignment. Any strain while sleeping translates into backaches. Side sleepers should also utilize a pillow with enough height to hold their heads so that the spine stays aligned. To keep the mid-spine from sinking into the mattress, place a pillow in the waist area below the ribcage above the pelvis. This will maintain a neutral position. Using a pillow between the legs and slightly with the knees up toward the torso in a relaxed position along with a body pillow for extra comfort and support.

Stomach sleeping

Stomach sleeping is strongly discouraged by a majority of medical professionals, including the American Chiropractic Association. This is because this flattens the natural curve of the spine, straining the low back placing unnecessary pressure on the neck from twisting the head for prolonged periods. If stomach sleeping is a must use a pillow with a very little height so that the neck stays aligned with the backbone. Also, place a thin pillow under the pelvis, this gives the lower back more support.  

Achieving Pain-Free Sleep

Here are some other strategies for achieving pain-free sleep.

Mattress quality

Mattress quality affects healthy sleep, especially when it comes to back pain. Older, sagging mattresses lose performance factors needed to support the lower back, relieve pressure points, and maintain spinal alignment. Newer mattresses with memory foam, latex, or a hybrid with a core of innerspring, have been proven to help back pain and achieve better sleep.

Getting in and out of bed

Getting into and out of bed can be a challenge. There are techniques that limit movement and put minimal pressure on the back, reducing back pain. One technique works by sitting on the edge of the bed and then leaning to the right or left making sure to keep the spine aligned and ease down onto the mattress. Bring the knees up so the body is entirely on its side. Then, in one smooth movement, gently roll onto the back. To get out of bed do the same steps reversed. Because getting into and out of bed requires sitting or lying on the edge of the mattress, make sure the mattress has enough edge support so it won’t sag when sitting.

Healthy sleep habits

Adopting healthy sleep habits ensures proper sleep. Establish a consistent sleep schedule going to bed and waking up at around the same time every day, including weekends. Schedule at least 7-9 hours of sleep every night. Establish a relaxing nighttime routine around half an hour to an hour before sleep to help release any tension.

• Take a warm bath
• Practice yoga or meditation
• Listen to gentle music
• Read a little
• Avoid electronic devices
• Don’t drink caffeinated drinks from mid-afternoon on
• Drink warm caffeine-free tea to help the body calm down before sleep
• Sleep in an environment that is cool, dark, and comfortable

Back Pain Types

Pain can be severe or persistent. Understanding the source is one of the first steps toward knowing how to treat and manage it.

Posture

The bones and muscles can slip out of alignment with poor posture and not switching positions to allow the muscles, and bones to relax and recover. This can lead to:

• Muscle tightness
• Headaches
• Back pain upper to lower
• Muscle fatigue
• Tingling
• Numbness

Muscle Strain

Muscle strains happen when the muscles or attaching tendons get damaged. This can happen when lifting something heavy or working out too hard. However, it can also happen during regular activities if the muscles are not warmed up. Muscle strain can cause swelling, bruising/redness, and pain in the muscle/s even when resting.

Nerve Pain

Nerve pain can is unpredictable. Nerve-related back pain usually involves the sciatic nerve. When the sciatic nerve becomes irritated, inflamed, pinched, or compressed, the pain can be felt in the low back and radiate down the leg to the foot.

Fractures and Bone Spurs

Bone pain is usually caused by a fracture or bone spur. Fractures cause a deep ache. Bone spurs, or bony growths that appear on the edge of a bone, often along the spine. If bone spurs press on the nerves, it can cause:

• Weakness
• Numbness
• Tingling in the arms or legs
• Muscle spasms and cramps

The main cause of bone spurs is joint damage.

Medical Emergency

Sometimes back pain requires a visit to a medical professional to rule out more serious causes, like fractures, tumors, or infections of the spine. Symptoms to look out for include:

• Fever could indicate an infection
• Trauma, like a fall, could indicate a fracture
• A diagnosis of osteoporosis could mean a fracture has occurred
• Numbness or tingling could indicate nerve irritation/inflammation damage
• History of cancer
• Foot drop condition and needing to lift the foot higher to prevent dragging, which could be a sign of a nerve or a muscle condition
• Pain that presents only at night when sleeping
• Unexplained weight loss can accompany infection or tumors
• Advanced age increases the risk for infections, tumors, and abdominal issues

Better Sleep

Around 80% of the world’s population will experience backache, and back pain at some point. When the spine’s bones, joints, ligaments, and muscles become injured, strained, or sprained, it can interfere with sleep. Try some of these strategies to help reduce the pain so sleeping well and waking up refreshed can be achieved.

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Body Composition

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Increase Movement with Exercise

One reason the body could be holding on to extra weight could be from high cortisol levels. Cortisol increases when stressed. Stress can derail exercise routine, diet, and sleep, increasing the chances of becoming overweight/obese. With exercise, the body releases endorphins or hormones that help reduce pain and stress. Exercise does not mean intense gym workouts. It can be as simple as taking small parts of the day, moving around to get the blood flowing, and muscles, tendons, ligaments stretched out. For example, if an individual uses the elevator or escalator regularly, take the stairs instead. Or take a short walk. All it takes is small and consistent adjustments to achieve health.

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Cochrane Database of Systematic Reviews. (2010.) “Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica.” pubmed.ncbi.nlm.nih.gov/20556780/ National Library of Medicine. MedlinePlus. (Updated April 30, 2020.) “Back Pain.” medlineplus.gov/backpain.html