The expert view: How to get a good night’s sleep when you suffer from back pain

back pain
This article on achieving a good night’s sleep was contributed by Chartered Physiotherapist, Matt Donnelly, and was first published by Beds Are Uzzz, Southbourne.

Did you know that over 80% of people experience back pain at some point in their life?

Back pain is very common and although in most cases it is nothing serious, some people find it persists for a long time and interferes with everyday life. If you have ever suffered from back pain and been to see a physiotherapist or chiropractor they would probably have asked you if your sleep is affected.

Waking at night due to pain or feeling sore and stiff first thing in the morning may be a sign that your mattress is not appropriate. Your mattress should provide support to your spine to keep it in a neutral position throughout the night, whilst allowing sufficient pressure-relief for bony points such as your hips and shoulders. It is also important to consider carefully your choice of pillow to minimise the chance of waking with a sore neck.


Should I replace my bed?

Deciding to replace your bed/mattress to help your back pain is certainly worth thinking about. Although you shouldn’t necessarily expect a ‘miracle cure’, changing to a more appropriate mattress can make a big difference.

Consider the age of your current mattress. Different quality mattresses have different expected lifetimes, but as a general guide The Sleep Council recommend changing your mattress every 7-8 years. However, even if your mattress is relatively new, if you aren’t sleeping well because it’s not right for you then it might be worth investing in something that you find comfortable and improves your sleep.

Choosing the right bed is an important step in reducing or preventing back pain. However, don’t forget that exercising, keeping a healthy weight and reducing stress are also known to help in the management of back pain. If your back remains painful for more than a few weeks, you could consider making an appointment to see your GP or a Physiotherapist/Chiropractor to discuss whether they can suggest anything else which might help.


Do I need an ‘Orthopaedic’ mattress?

In the past, people with back pain were always advised to sleep on a firm or ‘orthopaedic’ mattress. However, more recent research has found that the majority of people suffering with back pain were better suited to a medium tension mattress.

In reality, everyone is slightly different and therefore people will have different opinions on what they find comfortable.

That is the reason that there is so much choice when it comes to buying a new mattress – it’s not to try and confuse you, it’s genuinely because there is no such thing as the ‘perfect’ mattress that will result in a good night’s sleep for everyone.

When you are trying mattresses, a useful method to use to try to decide whether a mattress is supporting your spine is to lie on your back and slide your hand under the small of your back. Your hand should slide under with minimal resistance. If your hand slides in without any resistance, the mattress is possibly too firm for you. If it is very difficult to slide in, then the mattress is likely to be too soft. This method can be useful, but it is best used to help guide your choice. The overall feel and comfort of the mattress is paramount – remember, this a personal decision.

Try as many different mattresses as possible before making your decision. Although you may be limited to testing each mattress for a few minutes, remember that ‘first impressions’ are often very powerful, and the more you try, the more you will be able to get a sense of what feels right for you. Aim to lie down in the position you would normally sleep in and pay close attention to how your back feels.

An experienced salesperson will be able to help guide your choice; give them plenty of information and feedback whilst you are in the showroom to facilitate this. Ask about split tension mattresses or ‘zip & link’ sets if necessary. These allow two sleeping partners with slightly different needs to ensure their spines are supported appropriately.


Why is my pain worse at night?

A good night’s sleep is essential to our health. Yet there are several reasons that pain might wake you or seem worse at night. The first is simply that you aren’t doing much i.e. you don’t have many distractions to take your mind of the pain.

Muscular pain might seem worse in the evening or at night due to the buildup of fatigue throughout the course of the day; muscles become sore when they are tired.

Something else worth noting is that levels of inflammation in the body are higher at night, therefore if your back pain is inflammatory in nature then this is the reason you might notice it more whilst in bed.

A mattress which doesn’t support your spine effectively can also contribute to restless sleep, with the need to wake frequently to turn over or find a more comfortable position.

Remember, if you find that your back pain is constant throughout the night and your sleep is severely disturbed, you should speak to your GP to work out the best solution.


What is the best position to sleep in?

The answer is simple: whatever you find most comfortable and allows you to sleep best. Similar to there not being one best mattress to sleep on, there is no ‘ideal’ sleeping position either. Some people move in their sleep more than others, so you might find that the position you fall asleep in isn’t the same as when you wake up. The best advice is to keep trying until you get comfortable and drift off to sleep.

Having said this, depending on the cause of your back pain, you might find certain positions are better than others.

For example, for people with arthritis-type back pain, sleeping on your front is probably not advisable. Although it is certainly not harmful, you might find that you wake up to move after an hour or so. This is because time spent with your back in an ‘extended’ position usually irritates the joints in the spine where arthritis is present.

Another common type of back pain is acute or sudden onset back pain, such as an injury to one of the discs of the spine.

In the majority of cases, a disc injury (“slipped disc”) is not serious and will heal naturally. However, this process can take a long time (typically 6-8 weeks but sometimes longer). During this time, some people might find a ‘semi-foetal’ position most comfortable. This is because this puts the least pressure on the outer layer of the injured disc.


How much will improving your sleep help with your back pain?

Not only is feeling tired unpleasant, it is now known that fatigue makes all forms of pain worse. The experience of pain is very complicated, but modern understanding of the science behind pain acknowledges that fatigue and stress have a big impact on the amount of pain people suffer. Therefore, the combination of pain and sleep loss can easily become a ‘vicious circle’.

Making the right choice when buying a new mattress can go a long way towards helping break this cycle and improve not only your back pain, but also your general wellbeing and quality of life.


Mammoth would like to thank Beds Are Uzzz for providing this article on getting a good night’s sleep.