There are many reasons why you may toss and turn at night, but one of the most annoying is back pain. When your back is painful or tingling, it may be difficult for you to fall asleep. Back pain can also wake you up late at night, especially when you tend to lie on your back.
First thing to do: It helps to find out the reason behind back pain, especially when you often experience back pain. “Common causes of back pain may include disc problems, nerve stimulation and muscle strain,” physical therapist Dr. Jasmine Marcus, PT, DPT, CSCS told Bustle. Sitting for long periods of time or lying at the desk all day can also cause annoying tension. These are the culprits and can usually be resolved with subtle lifestyle changes during the day.
Nonetheless, any type of pain can disrupt peaceful sleep. The night is when you are most likely to notice the pain that lurks throughout the day. “We naturally move around during sleep, and the bouts of back pain can make you uncomfortable and wake you up,” Dr. Thanu Jey, a chiropractor and clinical director of the Yorkville Sports Medicine Clinic, told Bustle. Your sleeping position can help or aggravate back pain. “Lying on your back with your legs straight is actually not neutral to the spine,” said Dr. Theresa Marko, a physical therapist and board-certified orthopedic clinical expert. She explained that it will stretch your back, which can cause pain and squeezing.
Although it is difficult to find the perfect combination for relieving back pain at night, one of these professional techniques may be helpful.
1. Put a pillow under your knees
If you are lying on your back, try putting a pillow under your knees. “This tilts your pelvis forward, which helps prevent overextension or backward bending of the spine,” Jay said. Once you put on a pillow to raise your knees and support your back, you will feel your muscles relax. If you are a side sleeper, a pillow between your knees in a curled position may help. Jey says you can also hug the pillow to make sure your spine is aligned correctly. If your neck is the source of pain, he recommends that you roll up a towel or blanket and place it at the bottom of the pillowcase. “This will support your neck curve and help relieve pain,” he said.
2. A soft foam top hat for your bed
Marko says that sleeping on a mattress that is too soft or too hard can make back pain worse, which is why back pain may tempt you to buy a brand new bed. Before you put down your money, try to use a bubble top hat to see if it helps. “The foam gel top of the mattress will help your back sink into the mattress,” she told Bustle. If you are a side sleeper, Marko says that the soft foam will give your pelvis room to settle on your bed and relieve pain points.
3. Try different sleeping positions
According to Marcus, back pain is often beneficial to certain postures. “For example, someone may have pain when standing, and relieved when sitting, or vice versa,” she explained. “If you have pain while sitting, you may also have pain in a curled up position, while people who are in pain while standing may have pain when lying down.”
If you are a big fan of side sleeping, the idea of turning to your belly or back may not be attractive. But Marcus said it was definitely worth trying. “You may need to adjust the number of pillows you use, or you can try to use a body pillow or a pillow between your knees,” she said. “There is no perfect way to sleep, so you have to find a way that suits you.”
4. Try guided meditation
You may not meditate in the throes of back pain, but it may help. “Listening to meditation is actually very effective, especially when you have difficulty relaxing due to pain,” said Dr. Alyssa Kuhn, a physical therapist. Look for an app that can guide you through the visualization, or just close your eyes and try to let your thoughts drift by. “It can help you divert your attention from pain and help you find time to relax so you can doze off,” she said.
5. Tuck your knees
Still can’t sleep? Try to pull one or both knees to your chest and swing side to side. As Kuhn said, “A lot of times exercise can help your muscles relax and reduce pain.” So this stretch may work.
DPT physiotherapist Dr. Whitney Fitzpatrick PT said that the cat and cow yoga stretching exercises are also very helpful. Therefore, if you cannot fall asleep, jump to the floor and try to tie a knot. Fitzpatrick told Bustle: “Stretching should relieve some painful areas caused by pressure and improve flexibility.”
She said that for extra relief, you can follow up the stretch by placing a heating pad or ice pack on your back, depending on which feels better.
6. Be active during the day
Stiff back is usually caused by sitting in the same position all day. To help prevent cramps and tension, try to get up more often and do some exercise. Physiotherapist Noah Arenson said that whether it is walking, jogging or doing yoga, exercise can help keep your back relaxed and flexible.
You can even do some small exercises in the duvet. “It may be lying on the bed, doing gentle movements with the hips, or arching the back before lying down,” Aronson said. “If your back is more flexible, you are less likely to be stimulated in the middle of the night when you switch positions.”
7. Do something to reduce stress
If you have been under a lot of stress, if you can find a way to cope, you may sleep better. “When the sympathetic nervous system is activated during a fight or flight, the large superficial muscles of the neck along the spine and waist respond and tighten,” said physical therapist Dr. Stephanie Carter Kelley. “When these muscles remain open, you will feel tight, and eventually you will feel pain.”
Consider adding a cold night routine. Kelley said the goal is to calm your nervous system before going to bed, because if your body relaxes, it will be easier to get a good restorative sleep. “If you can’t turn off your brain, please write a diary before going to bed,” she suggested. “Just write down whatever you think of, and then tear the paper into pieces. The idea is to make the contemplation in your mind appear on the paper.”
It may also be helpful to follow the same procedure every night, so that once you take a bath or pour a cup of tea at night, your body will know it is time to relax and get ready to fall asleep. Kelly said that a calm routine is usually the most effective thing, especially when you feel that you have tried all the methods to relieve back pain and fall asleep.
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Merkle, S. (2020). The interaction of pain and movement. J hand there. doi: 10.1016/j.jht.2018.05.001
Schell, E. (2008). Association of stress biomarkers with neck, shoulder, and back pain in health media workers: a 12-month prospective follow-up. European Spine Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270377/
Physiotherapist Dr. Theresa Marko
Physiotherapist Dr. Thanu Jey
Dr. Jasmine Marcus, PT, DPT, CSCS, physiotherapist
Dr. Alyssa Kuhn, Physiotherapist
Dr. Whitney Fitzpatrick PT, DPT, CIDN, ITPT, physiotherapist
Noah Arenson, PT, MPT, ATC, physiotherapist
Stephanie Carter Kelley, PT, PhD, OCS, physiotherapist