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Back pain: Is your mattress to blame?

Back pain is all-too-common and unfortunately, pinpointing the exact cause can be a challenge. If you’re waking up with back pain every day, you may be wondering what’s happening during the night to cause it. Could it be that your mattress is too old, too firm or not firm enough? Or maybe it’s because you’re sleeping on the wrong side?

As a chiropractor, I frequently talk with my patients about how their back pain impacts their sleep, and vice versa. It’s a complicated relationship with many different factors. Here are a few things to know about back pain and your sleep.

Why your mattress quality matters

The majority of back pain is nonspecific, meaning we don’t actually know the cause in many instances, so it can be hard to pin it down to one single variable, like a mattress. Common pain generators include joints and muscles; less common causes include discs and nerves. 

Many other factors should be considered for people experiencing back pain and sleep difficulties. These include:

  • Use of electronics before bedtime
  • Irregular sleep patterns
  • Sleep apnea
  • Anxiety/stress levels
  • Lack of exercise

That said, your mattress plays a big role in how well your spine is able to rest while you sleep. Sleeping on the wrong mattress can certainly aggravate or even cause underlying back issues.

Lack of support from a mattress can reinforce poor posture, strain muscles and prevent neutral spine alignment. A mattress that provides comfort and support can help reduce back pain, allowing the spine to rest and recover during the night. 

Signs your mattress needs to be replaced

If an old mattress visibly sags in the middle or is no longer comfortable, it’s probably time to purchase a new one. If you are using a wooden board under a sagging mattress, this is only a short-term remedy, and you need to replace the mattress.

Some studies recommend replacing your mattress every 5-7 years. Research shows that switching from an old mattress to a new one reduces back pain and improves quality of sleep. If you have questions about what type of mattress would be best for you, consult a chiropractor.

Related: 5 myths people believe about lower back pain

Most comfortable sleeping positions for back pain

Specific underlying back conditions can be an important factor in influencing sleep position. These conditions are usually diagnosed by your medical provider. If you have one of the following conditions, here are general guidelines for what sleeping positions people tend to find helpful.

  • Osteoarthritis: You may find relief in the fetal position. This position opens up the arthritic facet joints in the spine and can relieve pressure. 
  • Degenerative disc: You may find sleeping on your stomach is preferred, as this position can relieve pressure on the disc space. You may also feel most comfortable using a relatively firm mattress while placing a flat pillow under the stomach and hips. 
  • Spinal stenosis: You may prefer to sleep on your side with your knees curled up in a fetal position. This helps relieve pressure on the nerve roots. 
  • Bursitis: This can be aggravated by pressure from a mattress that is too firm. Switching over to a pillow top can reduce pressure on the bursa of the hips. 
  • Disc herniation: Sleeping in a reclining chair or adjustable bed that allows the head and knees to remain elevated can help sciatic nerve pain from a disc herniation. A less expensive alternative to purchasing a recliner or adjustable bed is to sleep with a wedge cushion. This may be helpful for you if your pain is worse when standing straight and relieved when bending forward. If your pain is alleviated by standing or bending back but worse with sitting or bending forward, sleeping on your stomach may be palliative.

Which mattress firmness is best?

For chronic back pain, studies show that reduction in symptoms and improved quality of sleep can be achieved by sleeping on a medium-firm mattress. However, mattress firmness is largely a matter of personal preference. Whatever helps you achieve 6-8 hours of sleep each night is always preferred.

What to do if your back pain doesn’t go away

How do you know when to seek care for your back pain? Consult a medical professional if your back pain limits your function, adversely affects your quality of life or radiates into your legs.

Back pain that just won’t quit? Find a doctor near you today.

About the author

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Jesse Cooper, DC, is a chiropractor on staff at Baylor Scott & White Clinic – Round Rock 300 University. Dr. Cooper has an expertise in chronic pain, functional rehabilitation and interdisciplinary collaboration. He helped establish the Department of Chiropractic Medicine within Baylor Scott & White Health. He has a passion for research and continues to publish studies aimed at improving spine care and modernizing chiropractic education. He enjoys volunteering his time at Georgetown High School athletic events and the Wounded Warrior Project. When he is not busy caring for patients, Dr. Cooper loves hiking, fishing and spending time with his friends and family.

Back pain: Is your mattress to blame?