Does your back pain get worse over night while you sleep? Do you wake up in the middle of the night due to lower back pain? Are you tossing and turning because of night time back pain? Do you wake up in the morning with lower back pain? Does your lower back begin to feel better during the day after getting up and moving around?
If you answered YES, to those questions these tips below should help get you on track to feeling better and begin to get a sound sleep without lower back pain.
Whether you injured your lower back at a specific point in time, due to a sports injury, or your back pain just steadily began getting worse and worse over time at night these tips should help you get rid of your lower back pain.
Here are the things you can start doing right away to help get rid of night time lower back pain:
#1: Mattress Problem
There's a really good chance that your night time back pain is caused by a crappy mattress/box spring. Is your mattress old and worn out (for the record, 8+ years is old for a mattress). If your bed is old or is droopy in the middle, it's absolutely time to replace the mattress with a Memory Foam Mattress. If you have a mattress that is newer and is still flat, then it's time to get a 3" Memory Foam Topper with a 4lb density.
Here's my night time lower back pain story... I started getting noticeable night time lower back pain over the last few years. I chalked it up to working long days sitting in front of a computer, working out, hiking, and skiing hard.
At the time when I started getting more and more back pain I hadn't thought that my pillow top mattress might be wearing out even though it was at least 7+ years old and was starting to sag in the middle. The mattress always felt comfortable when I first went to sleep, but my night time back pain got progressively worse over the last few years.
In my quest to figure out what was wrong with my back, I proceeded to try all sorts of mattress topper combinations (and sleep positions), along with sleeping on a newer mattress that I had in my guest room that was flat and not sagging (fairly hard bed, non-pillow top). No matter what sleep combination I used, I was still waking up with noticeable lower back pain (my old saggy pillow top mattress made my night time lower back pain the worst, and started to get unbearable). For a number of months I was starting to dread going to sleep knowing that it was going to be a painful night of tossing and turning and waking up due to my lower back pain.
That all changed once I got this Memory Foam Solutions Topper from amazon and placed it on top of the newer guest bed. Within the first night of sleeping on the memory foam top I could tell the difference in how much better I slept. While I wasn't totally convinced after that first night, due to the fact that it didn't completely solve my back pain overnight (not that I was expecting it to after just one night). But after three consecutive nights of sleeping on the memory foam topper, not only was I sleeping way better, and 'not' waking up in the middle of the night because of severe lower back pain, but I was waking up in the morning with less and less pain.
After just a week of sleeping on the Memory Foam Topper, I concluded I was on my way to recovery and fully convinced that memory foam is the real deal Holyfield for sleeping well and resolving night time lower back pain. After a few weeks, all I can say is that the memory foam mattress top absolutely has had the biggest impact on resolving my lower back pain, more than anything else I tried. So if you have any type of lower back pain or just want a better night sleep you should be sleeping on Memory Foam ASAP!
One last thing I'll mention about the Memory Foam Topper, is that you're supposed to let it air out and expand for 3 days or so. I didn't want to wait that long and decided to sleep on it the same night I got it (8 hours after unpacking the memory foam from its vacuum sealed bag). Essentially, it pretty much expanded to the 3" height relatively quickly and the initial memory foam smell never bothered me.
#2 Sleep Position and Pillows
Once you're sure you have a comfortable mattress, you need to be really conscience of your sleeping position. Ultimately, you'll need to discover for yourself, if you sleep better and feel better in the morning while sleeping on your back or sleeping on your side. Avoid sleeping on your stomach.
Head & Neck
Make sure you have the right pillow / height for your head and neck. Pillows stacked too high or too low will negatively affect your neck and/ or back problem. I went from sleeping with two pillows years ago, to sleeping with one pillow. I then bought a Sleep Innovations Contour Memory Foam Pillow to help fix my back problem, which at first I didn't like very much and didn't see it helping cure my back pain. But over the last few months I've "broken" it in (or just gotten more used to it) and it's become my go to pillow. You can also get Classic Memory Foam style Pillows.
For myself, I found out the hard way (after tearing my ACL, due in part to my back giving out on me while ski racing) that sleeping on my back with my legs raised on pillows is what works best for me. After having ACL knee surgery, I was basically forced to sleep laying on my back all night for weeks (without moving around much) with my knee in a post-op brace, propped up on a Conforma Memory Foam Pillow to help keep swelling in my knee down. However, for the first two days after surgery I didn't use a pillow underneath my good un-injured knee / leg, and woke up with back pain. So on the third night I decided to start using a knee support pillow under my un-injured knee and my lower back pain pretty much went completely away for the weeks following surgery. Essentially, sleeping on your back, with a pillow or knee wedge pillow under both legs/knees will help maintain the normal curve of your lower back.
UPDATE 11/10/2015: I've since realized one of the reasons I may have started getting nighttime / morning back pain. A few years ago, I went from using two pillows for my head when sleeping, which I had been using since childhood without issue, to only using one small pillow. It was only in the last couple years that I started getting more and more nighttime lower back pain.
Well in the last two weeks, I've finally dialed in the in the proper sleep position and pillows for me that leaves me waking up pain free. Essentially, I bought this Extra-Large Foam Wedge Bed Pillow, thinking I'd use it to keep my upper back / head elevated, but after using it for less than a night with a pillow on top for my head, I realized it was too high (7 inches) and uncomfortable for sleeping that way. So instead, I decided to use it under my legs / feet, and stuck it underneath my mattress (between the box spring), which has since worked well. Along with that and realizing that using only one pillow for my head was causing pressure on my lower back, I started using a three pillows to create a smaller "pillow" wedge for my head / back. So essentially, essentally I'm using two pillows to creat an angle, then using the Contour Memory Foam Pillow on top for my head / neck. The entire head and leg pillow setup is in the shape of a low angled "V" (or hammock), so my butt rests at the bottom of the "V". This sleep position essentially takes the pressure off my lower back, and allows me to wake up feeling better than I ever have in a long while. NOTE: I've also been taking a Magnesium Glycinate tablet just before going to sleep, as Magnesium has been shown to help with back pain and better sleep.
I've found that sleeping on my side seems to aggravate my nighttime lower back pain. With that said, many "experts" recommend that the best position for lower back pain relief is to sleep on your (left) side with a leg knee pillow placed between your thighs in order to align your knees. The trouble with sleeping on your side is that your back, legs, and neck tend to get all out of whack throughout the night, which can increase your lower back pain. These 3 key steps helped me to avoid lower back pain when sleeping on my side:
- You need a knee pillow that is thick enough in order to keep your thighs parallel to each other, and so your knees don't touch or collapse inward.
- You can then place a softer pillow between your feet for added support, as well as to help keep you legs completely aligned.
- You'll also want to keep your head and neck fairly straight and inline with your spine (avoid tucking chin down).
To help keep your spine straight while sleeping on your side, you may also need to place a small pillow or rolled up towel under your side torso (between your ribs and hip). For example, fold a bath towel lengthwise and place it under the waist. If you do find sleeping on your side works better for you, just make sure you do NOT sleep with your back twisted or with too much curve to your back (overly arched or overly curved), or with your legs uneven when sleeping on your side. Also avoid sleeping in the fetal position with your chin tilted down into your chest and knees drawn up to your stomach, as this can be one of the worst positions for your lower back and neck.
Also, don't let your cat or dog sleep on top of you or under your arm or legs. A family pet that curls up on your legs / feet, stomach or under your arm will restrict your movement. Staying restricted in one spot will not be good for your back. You need to be able to move and roll around fluidly throughout the night, otherwise your back will get stiff and you will wake up sore.
#3 Walk / Move / Correct Your Posture and Movement patterns
Get moving and walking for at least 30 minutes everyday (1 mile) and work up to walking up to one hour on days you have the time (or 3 miles). Don't walk too slow (slow mall walking is not good). You want to walk tall, with a good pace and with good posture (while walking, imagine there's a string holding up your head that keeps your spine inline, and keep your chin parrallel to the ground). Swing your arms back and forth while you walk (you will feel this in your mid-back muscles if they are weak), and engage your core. Don't use hand weights while walking, while your back is weak. The more you can get moving around throughout your day the better off you will be when you go to sleep.
You also need to be conscious throughout the day, how you are moving, bending over or squating down. If you have bad positions throughout the day, likely it will affect your back pain at night
I highly recommend you pick up a copy of Back Mechanic by world renouned spine expert, Dr. Stuart McGill. This book gives you the essential knowledge in an easy to follow guide on how to rehabilitate your back.
#4 Self Muscle Massage / Soft Tissue Mobilization
THIS is SUPER important... You can do everything else right on this list, but if you don't do Soft Tissue work, you may continue to have lower back problems, especially if the cause of your lower back pain is due to muscle tightness. There's a few things you should definitely have at home to properly do self soft tissue work yourself: a Foam Roller, a Tennis ball and/ or a Lacrosse Ball.
A larger ball like a soft ball, Massage Ball or MobilityWOD Supernova 2.0 is also good to have. Lastly a MobilityWOD Gemini or a double lacrosse ball can also be really good for soft tissue work around the spine.
To see the techniques to get started on self muscle massage for the low back make sure you check out this really helpful post and video from Athletes Treating Athletes here: Self Muscle Massage pt 10- Low Back. Also to learn how to put everything together including mobility and strengthening see Treating Lumbar Strain from Athletes Treating Athletes.
Also definitely pick up a copy of Becoming a Supple Leopard 2nd Edition by Kelly Starlett, as there are tons of soft tissue mobilization exercises for all parts of the body and specific mobility / soft tissue work you can do for the lower back. It's a solid 480 page book, with tons of color pictures (on just about every page). It's a book that every household should own, especially those with lower back pain or other muscle ailments.
#5 Yoga / Stretch Lower Back
Keep in mind, yoga may not be right for everyone... so proceed carefully. If your new to Yoga, you can first start out with light stretching and simple yoga (Cat Cow, Cobra aka Up Dog, Half Sun Salutations into Swan Dive Down). A really good starting place is Yoga with Adriene - Yoga Camp Day 1. Once your back has healed more, you may start to do more advanced Yoga. Before going to bed, you can also perform simple stretches or yoga to help with night time back pain.
#6 Strengthen Core / Lower Back
Make sure you get your back pain under control before starting any in-depth strength routine. That way you can be sure you know exactly what is causing your back pain. But more than likely you have weak back and core muscles that need to be strengthened.
Keep in mind, strength training can and will aggravate your lower back if you're not careful and don't use the proper form while performing the exercises. So don't try to do too much too quickly (that's a sure fire way to reinjury your back). But with that said, daily exercise is crucial for overcoming long-term reocurring back pain issues because more than likely one of the main reasons you have lower back pain is because the muscles in your back are way too weak. Update: 3-20-16: I've since found that for me, doing 4 sets of regular Planks everyday and Chin-ups (palms facing you) have helped relieve my nighttime back pain the most. I've since stopped having to use the bed wedge underneath my legs at night. Planks happen to be one of the best core / back exercises and Chin-ups also happen to be one of the best compound body weight exercises that also target back muscles. Along with chin-ups, you can also just hanging from a pull-up bar (palms facing away) for 30 seconds to a 1 minute after a workout, which can really help decompress the spine.
Once you do get to the point where you are comfortable enough to start strengthening your back muscles (such as the quadratus lumborum or QL), make sure to start slowly before ramping up exercises too much. Also, it's also a good idea to always wait at least 1 hour in the morning (but ideally at least 3 hours and after 2 meals) before starting any strength training in order to give your back the time needed to limber up and get blood flowing throughout your body. Also make sure to warm up for 5 to 10 minutes before starting any strength training. When just starting out, stick to just body weight exercises. There's literally tons of core exercises out there, but here are a few tried and true exercises to help strengthen your core and lower back:
- Stuart McGill's Big Three Core Exercises: 1) the Curl UP, 2) the Side Plank, and 3) the Birddog
- Chin-ups (palms facing you)... only 5 reps at time (not to failure) 25 to 50 total reps. Eventually progess to Pull-ups (and do different chin-up variations, including weighted chin-ups using an Ironmind hip belt). If you can't do a chin-up, use assisted pull-up bands to help you.
- Plank (hold 10-30 sec, continue to increase to 2 min) Keep in mind, the Planking World Record is 8 hours.
- Side Planks
- Push-ups - (variations like Bosu ball push-ups)
- Pelvic Tilt progress (Pelvic Tilt, -> Pelvic Tilt w/ straight crunch -> Pelvic Tilt w/ oblique crunch)
- Double Straight Leg Raises (Back should be flat on the ground, if you can't do Double, then first do Single Straight Leg Raises)
- Air Squats (start with body weight only, with Arms fully extended in front of you, squat full range of motion or ATG), progress to Goblet Squats -> Dumbbell Front Squats -> (lastly High Bar Back Squats once you are in shape, and back is no longer weak and sore)
- Myotatic crunches with Bosu ball
- 10-Minute Squat Test
- Deadlifts (make sure to use proper form) Start with no weight -> progress to light weight Sumo dumbbell deadlifts -> barbell deadlifts
- Back Extensions (floor)
- Back Hyperextensions using a Roman Chair or an Exercise Ball.
Just remember that you need to perform the exercises with the proper form or else you risk doing more damage to your back. Here's a simple fitness core workout to try from Olympic Skier Body Miller core workout. Here's another core workout from 5 x Triathlon World Champion Craig 'Crowie' Alexander core workout.
#7 Avoid Sitting / Get Standing throughout the day
Avoid sitting for long periods of time. Sitting can wreak havoc on your health and especially your lower back. If you sit for long periods of time at work behind a desk, more than likely this is one of the main causes of a weak back and your lower back pain issues. If possible, transition away from a traditional desk and into using an electronic adjustable sit / stand office desk that can be moved up or down throughout the day. Or else create a seperate standing desk work area. This will allow you to stand up for periods of time throughout the day. Not only will standing help your back recover, but it can also keep you from feeling so lethargic due to sitting in a chair all day. Keep in mind, transition into standing slowly, don't try to stand all day right away.
If you have to sit for any length of time, make sure you get good chair that can be adjusted back to 135 degrees. Sitting at 135° puts less strain on your back than hunching forward or sitting up straight at 90°.
Drink lots of it.. Daily water intake should be at least 100oz. a day (or 1 gallon of water = 128oz. on workout days). If you're dehydrated you lose disk height in your back and and a dehydrated disc can begin to shift and eventually press down on the sciatic nerve. Drink a full glass of water upon waking up in the morning. Drink a glass of water before going to bed (don't go to sleep dehydrated). Get hydrated and stay hydrated throughout the day.
Stop consuming caffeine (coffee, soda, pre-workout caffeine drinks, etc.). Caffeine stresses out the adrenal glands, which in turn weakens the glands and the area around them which includes the lower back. Alternatively, if you need some energy take a Super B-Complex vitamin after eating breakfast.
I have a feeling caffeine played a role in contributing to my reoccurring lower back pain. While I'm not much of a coffee or soda drinker, over the last few years I had been regularly drinking a pre-workout drink that is loaded full of caffeine (and lots of other junk). About a week before getting the memory foam topper for my mattress I decided to stop drinking these pre-workout drinks and do think I'm better for it.
#9 Avoid Sugar / Eat Healthy
Avoid consuming sugar and start eating healthy (if you aren't already). Consider going Gluten free and switching to a Paleo Diet or Ketogenic Diet. You want to stay away from refined carbohydrates foods (bagels, pasta, pizza, white bread, muffins, etc.) because they can drive up inflammation and the body essentially processes them into sugar.
Here are some vitamins that may be beneficial to you (these are the vitamins that I'm currently taking): Multi-Vitamin, Vitamin D3 5000IU, Vitamin C, Super B-Complex, Glucosamine & Msm, Magnesium, Fish Oil
Make it early if you can... try to go to bed no later than 10:30 PM. Drink some water and stretch a little bit before hitting the hay. Don't sleep with a heating pad on under your back.
Hope these tips help you to improve and ultimately resolve your lower back pain for good. Keep in mind, I'm not a doctor or a "back expert", these are just the steps I have taken to help solve my lower back pain problem. It could take you a year or more to resolve your nighttime lower back pain, so just take it day by day.
If these tips don't help you resolve your back pain issue you may have a more serious medical issue. So if that's the case, then you may need to see a qualified Chiropractor or Orthopedic doctor at once, and also get a prescription from your doctor to see a Physical Therapist. All the best to healing up and getting healthy!
Here's a couple great books to check out to get yourself healthy and rehabilitate your lower back injuries:
If you have any other tips or suggestions, I'd love to hear them in the comment section below. Thanks!