One of the most common complaints I hear from patients with back pain is they have a hard time getting out of bed in the mornings as their pain seems to be at its peak after a night’s sleep. I am often asked what they can do to improve their sleep and if their pillows, mattresses or sleep positions are to blame for their restless nights. So, I’m here to give my recommendations and strategies to help you get a better sleep and roll out of bed feeling a little more functional in the mornings.
Mattresses
When it comes to choosing a mattress, personal preference will certainly play a role. I always recommend a mattress that is supportive yet comfortable. This usually means a more firm mattress with a softer layer on top to provide comfort. There isn’t one type or brand that I recommend. It’s about finding one that will support your spine while also being comfortable enough that you will enjoy your sleep.
Pillows
I have numerous patients who own a dozen different kinds of pillows, always looking for the one that will cure their neck pain. My message is always the same. You want your pillow to support your neck so that it is in a neutral position while you sleep. This means the pillow supports the natural curves of your spine so that your neck is not tilted or twisted in any particular direction while sleeping.
Personal preference will always play a role in pillow selection. I usually suggest a pillow that is not too firm (such as hard foam) as it is less forgiving, and not too soft (like a feather pillow) as it is not very supportive for your spine. As long as your spinal curve is well supported, the type of pillow material is not important. I often suggest a contour pillow for my patients as its shape supports the neck and head very well in a variety of positions.
Sleep Positions
Stomach Sleeping: this is not recommended for a few reasons. It results in an exaggerated curve in the lower back and an exaggerated twist in the neck. This is often accompanied by a pillow that is too high due to an arm placed under the pillow or the bulk of the pillow itself being too large for a stomach sleeping position.
Back Sleeping: this position is good to achieve a neutral spinal position, but is improved with a small pillow or bolster placed behind the knees for a slightly flexed knee, taking strain away from the lower back. It is also important here that the pillow under the head and neck offer support mainly at the curve in the neck and not be too bulky as to push the head forward while sleeping.
Side Sleeping: this position is also good to achieve a neutral spinal position, however it requires a few supportive elements at the neck and between the knees. A contour pillow which supports the neck and cradles the head is ideal for side sleepers. A pillow placed between the knees will offer support to the lower back and pelvis and help prevent a twist at the pelvis while side lying.
Stretching
Regardless of which mattress, pillow and sleep positions you choose, it is common to feel stiff and sore in the mornings upon waking, even moreso for those experiencing an episode of back pain. The stiffness and soreness can be lessened with a few stretches that can be done before you even get out of bed. Remember to always work within your pain-free range of motion.
Supine Pelvic Tilt
Before sitting up in bed, while laying on your back, gently and slowly tilt the pelvis upward toward the ceiling, and then back down, gradually accentuating the movements to feel a stretch in the lower back and hip muscles. Each position should be held for 5 seconds and repeated 3 times.
https://www.healthline.com/health/fitness-exercise/anterior-pelvic-tilt-exercises#pelvic-tilt
Knee to Chest
While laying on your back, gently stretch the muscles of your lower back by slowly bringing one knee toward your chest with the assistance of your hands. The other leg should stay at rest on the bed. Hold the position for 30 seconds then release, always staying within a pain-free range of motion. Repeat on the other side and do 3 repetitions for each leg.
https://www.healthline.com/health/lower-back-stretches#knee-to-chest
Trunk Rotation
While laying on your back, bend your knees. While keeping the knees together, gently tilt them side to side in a slow and controlled movement while using the arms to stabilize your upper body. You should feel a stretch in your lower back and sides during this exercise and it is recommended to do 3 repetitions per side, holding each for 30 seconds.
https://www.healthline.com/health/si-joint-stretches#5.-Quad-stretch
Back pain can really get your day off to a rough start. I hope these tips will serve to improve your pain, your sleep and help you put your best foot forward for the day ahead.