Patients frequently ask what brand of bed is best to help reduce or eliminate back pain. Although the quality of your bed can certainly influence a good night’s sleep, sometimes changing the sleep position will lead to less painful sleep. Improper sleeping positions can also accelerate degenerative conditions in the spine that summate over a person’s life. Today’s article seeks to help educate on proper sleeping positions that can help reduce or eliminate back pain.

Let’s begin with an anatomy lesson. The spine is made of continuous interconnecting bones called vertebrae. These vertebrae form joints with one another to allow for movement called facets (/ˈfasət/). The facet joints can become irritated by continuous compression (facet jamming) that certain sleep positions promote. It is therefore worthwhile to discuss positions that promote compression and those positions that reduce compression.

There are 3 primary sleeping positions: stomach, side, or back. Let’s start with the position that promotes facet compression (bad). The worst sleeping position for the back is on the stomach. Don’t do it! This position results in the stomach depressing into the bed and increasing the low back forward curvature. This will promote facet jamming and irritate the nerve endings in the facet joints. Furthermore, a person must turn their head to one side or another to allow for breathing. This position promotes both a painful low back and a painful stiff neck when awaking in the morning.

The side lying position is probably the most common. If you snore, this position can reduce snoring while reducing other painful sleeping positions. However, it can also promote a painful neck due to insufficient neck support. The proper positioned spine is one that remains in a neutral position when viewed down the long axis, so using a proper thickness and supportive pillow will help achieve a straight spine. Another consequence of side lying is irritation to the sacroiliac joints in the lower back. There are two of these joints just off to the side of the lowest part of your back. The two dimples off to the side of the low back mark the start of the sacroiliac joints. When side lying, your legs will often cross over one another placing stress in the joints. Again, a neutral position is desirable, and one way to achieve a neutral position is by placing a full-length pillow between the lower legs (knees to ankles). This will place the legs parallel to one another and reduce stress through the sacroiliac joints.

The last position is that of lying on the back. This is the optimal position and can allow for a more properly aligned spine. However, a poor mattress can allow for the hips to sink into the mattress increase facet jamming once again. It is therefore necessary to have a mattress that is supportive of the back. An excellent idea is to place a pillow underneath the knees to bring the thighs into a bit of flexion. This will unload the facet joints and provide low back relief.

There are certain low back postural anomalies that can further complicate proper sleeping. A thorough evaluation of your spine with x-ray analysis can help correct these painful postural anomalies. Our clinicians are highly skilled at diagnosing the cause of spinal pain and correcting the postural and sleeping conditions that lead to low back pain. Give us a call for evaluation today!

-Dr. Ryan Roth