How to relieve back pain at night

Douglas deHoll, MD

Spine Surgery

Most of us will experience back pain at some point in our lives, making it difficult to get a good night’s sleep. Douglas deHoll, MD, offered some advice on what you can do to ease your pain and get some rest. Although the causes of back pain are varied, the symptoms are often the same, including: 

• Aching or stiffness along the spine, from the bottom of the neck to the tail bone
• Sharp pain around all areas of the neck and back, especially after lifting heavy objects
• Long periods of aching in the middle or lower back, especially after sitting or standing for extended periods
• Back pain that radiates into the thigh, calf, and toes
• Muscle spasms in the lower back

While these symptoms are problematic during the day, they are often even more unpleasant to deal with at nighttime. Here are a few methods to help ease your pain and prepare you for more enjoyable sleep.

1. Sleep on your side with a pillow between your knees.

If lying on your back is a trigger for your pain, try this: 

• Lie starting with your right or left shoulder touching the mattress, followed by the rest of that side of your body.
• Place a pillow between your knees. 
• If you notice a space between your midsection and the bed, you might like using a small pillow there for extra support.

Simply sleeping on your side won’t alleviate back pain on its own, but the additional pillow will help by aligning your hips, pelvis and spine. Make sure you switch which side you sleep on every now and then in order to avoid muscle imbalances. 

2. Sleep on your back with a pillow under your knees.

While some people experience back pain when lying on their backs, others find that sleeping this way is the best position to relieve their pain. If you do, try this:

• Lie directly on your back.
• Place a pillow behind your knees while keeping your back flat. By placing the pillow here, your body will preserve the curve in your lower back.
• You can also try adding a small, rolled up towel under the small of your back for additional support.

When you sleep on your back, your weight is fully and evenly distributed across the widest spot of your body, meaning there is less impact on your pressure points. This position also allows your spine to be properly aligned. 

3. Pick the right mattress.

If your hips are wider than your waist, a soft mattress can be good since it will help keep your spine straight as you sleep. If your hips and waistline are straight, a hard mattress might feel better since it offers more support. You can try adding a sheet of plywood between your mattress and box spring to mimic a harder mattress. While doctors used to always suggest firm mattresses to patients with back pain, recent research has shown that those with low back pain actually sleep worse on hard mattresses. However, too soft of a mattress can cause issues such as twisting joints or allowing your body to sink too deeply. Try testing different styles of mattresses at hotels or relatives’ homes to see what works best for your body.