The lower back features an interwoven series of structures. It includes the five vertebrae of the lumbar spine, each of which is bolstered by shock-absorbing discs and held in place by ligaments. Surrounding muscles offer support and are connected to the spine by tendons. Nerves run through the spinal column to deliver signals throughout the body.
The lower back supports most of the body’s weight and is integral to all kinds of movements. Whether standing, sitting, walking, or lying down, the lower back plays a role in mobility and comfort.
Given the complexity of the lower back and how much we depend on it, it comes as no surprise that it is a leading hotspot for pain. Eight out of 10 people have back pain at some point during their life, and lower back pain is one of the top reasons why people see a doctor.
Back pain can range from mild to severe, and it may be short-lived or long-lasting. When serious, it can be debilitating and interfere with nearly all aspects of daily life, including sleep.
Pain and sleep have a complex relationship. Pain can disrupt sleep, and poor sleep can make it more likely that a person will experience pain. In addition, a sleeping position or mattress that doesn’t support the lumbar spine can induce or exacerbate lower back pain.
Understanding the links between sleep and lower back pain offers new approaches to finding relief. Quality sleep can help prevent or reduce back pain, and knowing how to sleep when you have back problems can help cope with pain and contribute to healing and recovery.
There are two primary types of lower back pain: acute and chronic.
Lower back pain that starts as acute may become chronic. It is estimated that around 20% of cases of acute low back pain persist and become chronic.
Researchers have long seen an association between lower back pain and sleeping problems, and growing evidence points a two-way relationship in which they can be mutually reinforcing.
Discomfort from pain can be a major barrier to sleep. Lower back pain makes it hard to get comfortable enough to fall asleep or may provoke nighttime awakenings when pain surges.
At the same time, people with sleep problems are more likely to start having pain or to have pain get worse. Experts aren’t certain why this happens, but there are several potential explanations. Sleep deprivation may impair healing, affect mood in a way that heightens pain sensitivity, or disrupt chemicals in the brain that are involved in how we experience pain.
Another link between sleep and lower back pain is tied to how sleeping position affects spinal alignment. Although posture is typically associated with sitting and standing, it’s also critical when lying down.
A sleeping position that involves twisting, contorting, or otherwise putting pressure on the lumbar spine can cause pain and stiffness. This pain is often worse in the morning but may persist throughout the day.
The best sleeping position for lower back pain is on your side with a partial bend in the knees. Keeping the knees bent helps balance the body and reduces pressure on the lumbar spine. Many people find it helpful to put a small pillow between their knees to make this position more comfortable.
Unfortunately, many back and stomach sleepers have a hard time changing their sleeping position. Even so, they can take steps to reduce strain on their lower back:
Some people with back pain use an adjustable bed that makes it easy to raise the upper or lower part of the mattress in a way that decreases tension in the lower back.
Because it is a principal means of supporting the body during sleep, a mattress can play an important role in preventing or reducing lower back pain.
Proper spinal alignment demands a mattress that is in good condition and doesn’t sag excessively. Research supports using a medium-firm mattress to combat lower back pain, although the most appropriate firmness can vary based on a person’s weight, body shape, sleeping position, and individual comfort preferences.
Getting quality sleep is an important part of recovering from lower back pain, but sleeping well may seem like a tall task when your back hurts. While there’s no guaranteed way to get better sleep, certain practical tips can help:
Focusing on sleep hygiene can improve your sleep habits so that you can sleep better both during and after episodes of lower back pain.
Back pain is common and often recedes quickly, but it’s important to talk with a doctor if:
A doctor can review your symptoms and determine the appropriate next steps for testing, diagnosis, and treatment.
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