Don’t lose sleep over back pain 

Don’t lose sleep over back pain 

Leading osteopath provides top tips to stop back pain sabotaging your slumber and getting a good night’s sleep

A leading UK back specialist is urging those with back pain to adopt some simple ‘back hygiene’ measures to help ensure a good night’s sleep.  

The steps, which may come as a surprise to some people, include avoiding the ‘foetal position’, using a pillow between the legs to help align the spine, sleeping for no longer than nine hours, and ‘icing’ the lower back a couple of hours before bedtime. 

Mr Michael Fatica, from the Back in Shape program, says: “Sleep is massively important for recovery, regeneration and injury prevention, but for those living with back pain it can feel impossible to get the optimum eight hours per night. To make matters worse, back pain and sleep are interconnected, with researchi showing that insufficient sleep can exacerbate problems, so it can feel like an unwinnable battle for many sufferers.” 

Importantly, Michael warns against sedentary behaviour in the two hours preceding sleep: “For many of us, the last couple of hours leading up to bedtime are often spent sat in front of the TV or other electronic device, and often with poor posture. Gone are the days when advert breaks encouraged us up, for example, to make a hot drink and move around. We then go straight from sitting, which significantly compresses the discs in the vertebrae, to lying in bed for hours, and so naturally the back will suffer over such a long period of inactivity.”   

Michael recommends the following steps to help ensure a good night’s sleep: 

  • Fix your evening routine – If you’re sedentary, move more in the crucial ‘two hour’ window before bedtime – go for a walk, make a drink, perform some light stretches such as some simple hip flexor and hamstring stretches and, of course, the towel stretch. 
  • De-stress – Stress can significantly impact sleep patterns and is linked to back pain. So, establishing a relaxing bedtime routine will help your mind and body wind down. This could include reading a book, listening to calming music, or practicing meditation or deep breathing exercises. 
  • Contrast warm bathing with ‘icing’ – Bathing will help relax stiff muscles and joints by stimulating blood flow. It can also help reduce the likelihood of muscle spasms and encourage tissue healing in damaged muscles. Icing can significantly help reduce inflammation of the muscles. A combination of the two is recommended for optimum results, especially after sitting with your back ‘warming’ as it’s pressed against the back of a chair before bed. 
  • Sleep on your side with a neutral spine – Use pillows between your knees if needed for extra support for the body, legs and spine. This is the best possible position to sleep in, provided the spine is optimally aligned. 
  • Invest in a good mattress – There aren’t bad mattresses, just old mattresses. It’s also impossible to say whether a hard mattress is better than soft. Ultimately, it’s what best allows you to sleep with your spine in a neutral position – everybody is different.  
  • Grab an extra pillow – For optimal spine alignment and to help alleviate pain, simply placing a pillow between the knees can significantly help when sleeping on the side, it can also be used to make sure your neck is aligned properly if you have thinner pillows. 
  • Start a rehab program to rebuild your back – This should incorporate strength and resistance exercises and a high-protein diet to build-up back and core strength – vital for supporting the spine.  This will make day-to-day routines ‘safer’ and prevent the back from being strained so easily. 

Sleeping positions to avoid: 

  • The ‘foetal’ position: Neck muscles are stretched and become very tight 
  • Side lying where your spine is bent crooked: More common in women because of a wider pelvis compared to waist size. Side lying without support can lead to rapid aggravation of sciatica in particular. 
  • On your front: This is actually a rather good position for the lower back on a firm mattress as it supports a natural curve in the low back. However, it can be too much for some and it is terrible for your neck 

Michael urges people to be aware and recognise the differences between morning and night back pain as they can be symptomatic of different things. “Morning back pain is most often related to a case of ‘bad’ activities the day before, which have put too much pressure on the back. Inflammation builds up overnight at a faster rate as a result and then, without moving for 6-8 hours, inflammation ‘pools’ and results in pain.  

“In contrast, back pain at night can be a ‘red flag’, especially if there are no obvious aggravating mechanical factors, such as aggravating the back during the day. As a general rule, if there are no movements that can help make the pain better or worse, then I would recommend seeing a professional to double check there are no other underlying issues.” 

Back health is wholly reliant on a blend of flexibility and stability to ensure the spine remains pliable but not unstable. “The body is designed to move! It may seem obvious, but many people don’t do enough exercise to stimulate their muscles. As a result, back muscles become weak and more prone to stress. We forget how these muscles are needed to support us for 70+ years, so good sleep and a physically active lifestyle is vital if we are to maintain them and enjoy many pain-free years to come.” 

‘Back in Shape’ is an online, rehabilitation program for treating back pain. For more information, please visit

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