12 Ways to Sleep Better With Low Back Pain

by Martin Reed Patient Advocate

If you regularly experience low back pain, your sleep is likely to suffer. A study published in The Clinical Journal of Pain in 2016 found that poor sleep was found to be a significant problem for those with acute and persistent back pain. Overall, two-thirds of those with low back pain reported sleep disturbances.

Man's back pain worsened by lack of sleep.

The relationship between pain and sleep

Research has shown not only that pain disturbs sleep, but that poor sleep also makes you more vulnerable to pain. In other words, if you experience back pain you will likely find sleep to be more difficult and if you don’t get enough sleep, your pain might feel worse. So, what can you do to break this vicious cycle in order to improve your sleep and reduce your low back pain?

Heating pad on a bed.

Tip #1: Know when to heat and when to cool

Ice packs can help reduce the initial inflammation and reduce nerve activity while heat packs can help increase blood flow, soften the muscles, and increase flexibility. In an email to HealthCentral, Richard Honaker, M.D., the chief medical officer at Your Doctors Online, suggested alternating hot and cold packs for 15 minutes each during the two hours prior to bedtime.

Ibuprofen and advil packaging.

Tip #2: Talk to your doctor about pain relief

When we experience low back pain it’s likely that we reach for over-the-counter pain medications such as aspirin or ibuprofen (Advil). Unfortunately, both of these medications may disrupt sleep. Acetaminophen (Tylenol) might be a better choice, although research suggests that this medication may not be effective at treating low back pain.

Friends laughing together.

Tip #3: Stay social

A study published in the journal Rheumatology in 2015 found that although pain increased the risk of insomnia, this association was largely explained by a combination of physical limitation and reduced social participation. This suggests that staying social and taking steps to improve physical function may help alleviate pain and improve sleep.

Woman swimming to improve back pain and sleep.

Tip #4: Exercise wisely

The American College of Physicians (ACP) recommends exercise as an initial treatment for chronic low back pain and determined that stretching and strength training were most effective at reducing pain and improving function. Pilates can also help improve sleep, while aerobic exercise performed two to three times per week may help prevent low back pain and improve sleep quality. Dr. Honaker recommends swimming as a good form of exercise for both back pain and sleep.

Woman receiving an acupuncture to combat back pain and insomnia.

Tip #5: Give acupuncture a try

The ACP also determined that acupuncture could reduce pain intensity and improve function — so booking an appointment with a licensed acupuncturist may help reduce pain (and research has found the acupuncture can improve sleep, too).

Woman practicing mindfulness to relieve back pain.

Tip #6: Experiment with mindfulness-based stress reduction (MBSR)

The ACP found that MBSR also helped improve low back pain and function, and identified one study that found it to be just as effective as cognitive behavioral therapy. Even better news for those with sleep issues is that MBSR and CBT for insomnia can both help improve sleep.

Man practicing meditation to ease stress.

Tip #7: Take steps to ease your stress

Stress and worry can make back pain worse due to the associated muscle tenseness, so it makes sense to consider that stress-management techniques such as progressive muscle relaxation, breathing exercises, and guided visualization might help ease muscle pain. “A five-minute meditation can help reduce muscle tension and force the relaxation response — perfect for before you go to sleep,” said Sandip Sekhon, founder of Pathways Pain Relief, in an email interview with HealthCentral.

Man doing tai chi on a beach.

Tip #8: Get into the martial arts!

The Chinese martial art and system of calisthenics known as Tai Chi can be more helpful when it comes to decreasing chronic back pain intensity than jogging, according to the ACP (although swimming was found to be even more effective). A modified form of Tai Chi known as T'ai Chi Chih may also help improve insomnia symptoms.

Woman shopping for a back-friendly mattress.

Tip #9: Sleep on the right mattress

The huge number of choices can make it a challenge to choose the right mattress and bedding. Although a firm or “orthopedic” mattress is often thought to be best for low back pain, there is a lack of scientific evidence to support this claim —you should be guided by whatever feels most comfortable. A study published in the Journal of Chiropractic Medicine in 2017 suggested that a latex mattress may be better than a polyurethane mattress at evenly distributing pressure across the body.

Man sleeping soundly on his side.

Tip #10: Get into position

Since it’s normal to move around while you sleep, “there is no perfect sleeping position for individuals with lower back pain,” according to Mackenzie Chrisco, a physical therapist at FX Physical Therapy, via email to HealthCentral. Alex Tauberg, a board-certified sports chiropractor, agreed — but told HealthCentral that side sleepers may want to put a pillow between bent knees to reduce body twisting and back sleepers can try putting a pillow under the legs to provide some low back pain relief.

Woman shopping for a new pillow.

Tip #11: Choose the right pillow

Jason Hare is a chiropractor at Pure Chiropractic. Although Hare recommends the side sleep position, he told us that the key is to keep the spine in a neutral position — and the right pillow can help. “If someone is broad shouldered they will need a bigger pillow. Narrow shouldered people should choose a smaller pillow”, Hare told HealthCentral. Pillow material doesn’t really matter as long as it holds the head in the right position, according to Hare.

Woman stretching in bed.

Tip #12: Get stretching

In an email to HealthCentral, Jason Piken, a New York City chiropractor, noted that since the last few hours of the day tend to be lazy hours followed by lying in bed without moving much for another six to eight hours, some gentle stretches before bed can help you feel better. According to Piken, the Sun Salutation yoga sequence is particularly beneficial when it comes to alleviating back pain and improving sleep.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.