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Back Pain

Updated 13 May 2019

This sleeping position could be making your backache worse

Chronic backache can be debilitating, and a poor sleeping position could make it even worse.

How many hours of sleep did you get last night? If you suffer from backache, chances are it wasn't enough. According to a recent study by the University of Stellenbosch Business School, South Africans are sleep-deprived and their lack of sleep is linked to seven of 15 leading causes of death. Backache further decreases one's chances of getting restorative sleep, leading to even greater ill health.

Backache is the most common cause of disability, and the main reason we suffer from backache is an evolutionary mismatch between our genetics and our environment, says chiropractor Dr Greg Venning. 

“Of the cultures that experience the least lower backache, one of the things they share in common is firm sleeping surfaces (usually the floor),” he explains, but says that because our bodies are compromised by sitting for long periods every day, lying on the floor has become a challenge. 

The worst sleeping position 

Experts agree that we should never sleep on our stomach. Sleeping on the front part of our body exacerbates lower back, mid-back and neck issues, explains Dr Venning and adds that because we need to breathe, lying tummy-down means our neck has to be turned to one side for prolonged periods of time. 

Cape Town physiotherapist Najmeera Parker adds that this sleeping style makes it difficult to maintain a neutral position and therefore ends up flattening the natural curve of your spine because of the strain on your joints and muscles. Not only will it exacerbate your backache, but it could also lead to bad circulation, problems with breathing and misalignment of your shoulders.

Rules for sleeping

“Bed companies sell us soft beds that seem more comfortable but actually increase the problem,” says Dr Venning.“The key is to have a good pillow and as firm a mattress as possible. You need to create a position that places your body (especially the spine) in the position of least stress, and greatest ease and comfort. Sleeping on your side and back are the best positions, especially important if you suffer from backache.”

In an interview with Tonic, physical therapist Hidde Hulshof explains the importance of finding a mattress that properly supports your body. A mattress that’s overly soft will cause the middle part of your body to sink into the mattress, he explains, thereby placing pressure on your pelvic joints. On the other hand, a mattress that's too hard won't properly support the hollow of your lower back. 

On your back

Sleeping on your back is usually considered the best position for spinal health as it reduces pressure on the discs, helping to prevent backache.  

“Sleeping on your back with a pillow positioned under the knees is mostly recommended because it helps to align the spine, hips and pelvis, and reduces tension in your tendons,” says Najmeera, but explains that because some people struggle to fall asleep this way and others are prone to snoring in this position, the second-best option is to sleep on your side.

On your side

Sleeping on your side can also ensure that your entire body is supported. If you suffer from backache, you need to maintain the natural curve of your spine, according to Najmeera.

It’s imperative that your body is in vertical alignment. This works if you place a thin pillow between your knees, which will help maintain a proper alignment of the lower back and keep your hips and neck in line.

Correct your pillow height

Having your bed and pillow set up correctly means you’ll fall asleep easily and will also help to de-stress your spine. Dr Venning advises using a stack of folded towels to support your head rather than a pillow, as towels do not form a dent as easily as pillows do and therefore provide more support.  

However, if this doesn't work for you, Najmeera suggests using a pillow that moulds itself perfectly to the shape of your head and neck and to replace all pillows as soon as they lose their firmness.

Choosing the right mattress

Your mattress affects both your sleep and health and can affect the alignment of your spine as mentioned above, so selecting the right one is vital. Dr Venning suggests the following:

  • Choose as firm a mattress as you can tolerate without feeling uncomfortable.
  • Always choose an innerspring mattress, i.e. not 100% foam, latex, or memory foam.
  • Avoid mattresses with a pillow top or a layer of latex or foam.
  • Choose a reputable brand. You get what you pay for with beds, so choose the best quality within your budget.

Take care of your mattress by doing the following:

  • Rotate your mattress every three months (and also swap the head and foot ends).
  • Replace your mattress every 8–10 years (both for support and hygiene reasons – you can perspire up to 1l every night).

Image credit: iStock