Millions of people suffer from lower back pain as a result of factors such as work, exercise, excessive prolonged positioning, or chronic conditions. Your lower vertebrae, or lumbar region, is prone to pain and muscle exhaustion. One aspect of taking care of your spine is learning how to sleep properly. Some of these positions may take time for your body to get used to; however, changing your positioning and supporting your back will pay off in the long term. If you suffer from back pain, invest in a good mattress and pillows, learn a supportive sleeping posture and take some steps to ensure a good sleep every night. Sleep can help to relax muscles and reset pain receptors, so that you wake up in the morning feeling pain-free.
According to the APTA Move Forward survey, in which over 2600 respondents shared their experiences and habits regarding back pain, 39% of adults reported that LBP limited them from fully engaging in daily life tasks. Of this value, 37% of the respondents reported that the pain affects their sleep.
When it comes to having a good night’s sleep, a properly placed pillow can make all the difference between waking up restored and refreshed or waking up tired and in pain. Sleep is your body’s prime opportunity for recovery. It is a restorative time for our body to rest and heal itself, unfortunately, for individuals with back and neck pain, this restorative sleep does not occur.
In fact, sleeping at night can be one of the most dreaded times of the day. Every spinal condition is unique, so what might work for you, may not work for some. In other words, finding a proper sleeping position is not a one size fits all approach. Ultimately, it’s all about keeping the spine in proper alignment or in neutral-spine. A neutral position for the spine is described as, not arched a lot, but not flat either. The spine has natural curves that should be maintained at night and during the day. The goal is to achieve neutral spinal alignment that would reduce pressure off your spine and the muscles surrounding the spine.
Generally speaking, there are 3 positions that people typically sleep in. The best positions are sleeping on your back or side. Stomach sleeping is the least recommended position due to your neck being fully rotated all night, in addition to increased compression on the low back. Although for a small percentage of people stomach sleeping may help.
Back sleepers/Supine-lying: When sleeping on your back, you should comfortably place a pillow (1-3 standard pillows) under the knees depending on your body type (small, medium, large frame). This will improve your spinal alignment and decrease compression on the joints of your spine. Also, pay attention to the position the pillow places your head and neck in. If you are more rounded in your upper back (hunchback) or the head is more forward relative to your shoulders, you will need a thicker pillow or even two pillows. For someone with a straighter spine, one thin pillow may be sufficient. Remember neutral position.
Side sleepers: When sleeping on your side, bend both knees up toward your chest in the fetal position. Use a pillow between your knees and try to keep your knees together, not letting the top leg fall over top of the bottom leg. Using a full-length body pillow is another good idea to keep your spine in good alignment. Also, if you have a wide pelvis you want to make sure the pillow is thick enough and if not, you may want to use two pillows. Remember a neutral hip position would be shoulder width apart in standing, if you are a side-lying position try to simulate this position. , when lying on your side, pay attention to the position your head and neck is in. Ideally, the head is in a neutral position. Too many or too thick of a pillow may force your neck to be bent upward all night. Too small or no pillow will allow it to sag and not be supported properly.
Stomach sleepers/Prone-lying: As previously mentioned sleeping on your stomach is the least recommended position. However, a small percentage of people (such as disc herniation patients) may find prone-lying to be the most comfortable position. When sleeping on your stomach place a pillow under the pelvis or stomach. Prone-lying should be temporary. Once pain from a disc herniation settles down, then side or back lying is preferable.
Depending on your personal preference, you may chose to use or not to use a pillow under the head so as to not place the neck into an extended position and a small pillow under the ankles to better position the legs/feet. Many of the individuals who sleep on their stomachs tend to flex one knee, bringing it up towards the hip mimicking a crawling position. This crawling position is not recommended as it creates a torque on the spine. Any non-neutral position held for prolonged periods may create and/or cause pain.
Other things to consider when selecting the proper pillow are the size and firmness of the material used. For individuals experiencing neck pain, consider rolling up a small towel and putting it in the pillowcase at the bottom. This will provide support to your neck while you sleep. If you wish to purchase a contoured neck pillow, be sure that the rounded contoured portion fits the curve in your neck to allow for a neutral position.
Proper workplace ergonomics is key to protect your spine. If you are unable to have an ergonomic evaluation by a professional who can recommend a chair that would properly fit your needs, consider a pillow! The McKenzie roll (Original, D-Shaped or Super-roll) can help as long as you chose the correct size and position it correctly. With any pillow used to assist with posture of the lumbar spine be sure to position the pillow at just above waistband level when sitting to stimulate the user to maintain a better sitting posture. The roll is D shaped so the flat backside sits flush to the chair and the curved side mimics the contour of the lumbar spine. Held in place by an elastic strap the roll is easy and quick to fit to most chairs meaning it can by moved without difficulty from car to office to dining chair and so on. The Original Roll is cylindrical and the Super roll is less dense.
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