Back Pain While Sleeping

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Sleep and Back Pain

Published: 30 December 2015

On a day-to-day basis I engage with clients who have sleepless nights due to back and neck pain. Other common causes of sleepless or interrupted nights are leg pain, and or numbness - sometimes also with pins and needles.

I feel very much for my clients whose sleep is interrupted, and often prevented, through back pain. I know what they are going through, I had a bad accident many year’s ago, which led to a severe back injury and many sleepless nights, which occasionally occurs to this day. Thankfully, I have the knowledge of how to treat and manage it when it occurs.

Treat the cause of sleepless nights

Pain during the night can be a negative cycle - without sleep the healing process is slowed down greatly and sometimes even stopped. Furthermore, if sleep is limited or absent then our coping skills are also limited, and the effect the pain has on our bodies can be greatly increased to the detriment of our rehabilitation. So it is really important to focus on how to help ease pain at night time.zzz Pain during the night can be a negative cycle - without sleep the healing process is slowed down greatly and sometimes even stopped. Furthermore, if sleep is limited or absent then our coping skills are also limited, and the effect the pain has on our bodies can be greatly increased to the detriment of our rehabilitation. So it is really important to focus on how to help ease pain at night time.

Quite often, night time pain can cause anxiety and severe worry for people. It is true that night pain is commonly worse in severe pathological conditions, as it is also true that children’s toothaches are commonly worse at night! This is not usually an unhappy child determined to give you a sleepless night, but a simple expression of inflammation.

Basically our circulation and metabolism slows at rest time - so inflammatory pain increases!

This underlines how important diagnosis is in the overall management of your back pain. If you allow sleep deprivation to continue over time you may be ignoring a sinister situation, or simply prolonging your rehabilitation time unnecessarily.

It is my opinion that if back pain interferes with sleep at any level, then it warrants immediate expert attention. However, the following may help you gain some rest!

Symptoms of back pain while sleeping.

Panic and despair are common results of symptoms of back and neck pain while sleeping! My first line of enquiry when I assess my clients is to ask them what symptoms they get while trying to sleep, and where they are?

The most common symptoms at night time associated with back problems are lower back pain, commonly worse on one side to the other. Another common symptom my clients report is pins and needles in one or both legs, and intermittent numbness over the outer aspect of the lower leg. Pins and needles in both hands are also quite frequent.

Most people tell me that their symptoms are worse if they lie in a particular posture or position. For example, people with lower right back pain often report the pain to be worse if they lie on their backs, or on their right side, but to be easier if they lie on their left side.

The reason for this is due to the mechanical nature of your injury. If you lie in a position that compresses the damaged part it will hurt, if you lie in a position that takes pressure off the damaged part it won’t! That is a simple mechanical explanation and is the most common presentation. However, if no position gives you ease the situation we have is more difficult to cope with, and ultimately deal with.

If changing positions at night time does not ease your symptoms - seek immediate medical attention and investigation please. More serious pathological conditions may be underlying this presentation.

Another area requiring immediate attention are symptoms which ease by day and appear by night. Although these can be mechanical in nature they may also suggest more serious conditions and pathologies. I do not mean to worry you, but as always “if in doubt shout”.

Treatment of back pain while sleeping.

Simple advice in this situation is - if it hurts try another position. This is a common starting line of advice that I give. Finding your position of ease is the primary aim.

Most of the mechanical back injuries are direction based. This, in simple terms, means that if the injury occurred while bending forwards, you must avoid bending forwards at the early stages of healing to avoid pain. If it occurred while twisting you must avoid twisting and turning in the early stages.

If this is your situation, then if you sleep in the opposite direction to the injury the pain should ease. A common example is if you injured your back while bending forwards, lying on your tummy will ease your pain and allow you sleep. So this explains basic management of easing symptoms while sleeping.

Common devices and techniques I advise my sleepless night clients to try are:

1. Lying on your back: Place a pillow under your knees to unload your lower back.
2. Lying on your tummy: Place a pillow under your tummy to unload your lower back. 3.Lying on your side: Place a pillow between your knees with your knees bent up.
3. Use a Swiss orthopaedic pillow to support the natural curves of your spine.
4. Assess your bed and ensure it is firm but not too firm.
5. Place a hot water bottle on your pain frequently to ease the pain.

However, if it is not this simple please do not ignore the signs. You must find ease, and help may be required. It is normal, in my opinion, to have sleep interference after an obvious mechanical injury for three nights - but if it continues beyond that time then seek professional investigation, advice and treatment.

Sleep is necessary for your healing and if getting sleep continues to be a problem - then take it as a sign that you have a condition that requires attention from a physiotherapist.

Exercises for back pain while sleeping.

This is a difficult area to advise on specifically, however, I will share with you a few aspects of exercises for night pain that may be of help to you during a difficult nights rest. Exercises for your back pain at night may require specific advice, so if these do not help seek individual professional attention please.

Firstly, identify your position of ease and sleep in it as much as possible. If you turn in the night and pain wakes you try to reposition yourself into a position of ease. If you wake and cannot find ease, get up and walk around slowly with small strides.

Avoid sitting, unless you are forced by pain to sit, as the sitting posture is generally not the best posture for back pain. Move all parts of your body that do not hurt. Apply heat directly to the area of pain, and where necessary take back pain medication for relief. More specifically, if you know bending forwards hurts you then try arching backwards 10-12 times to see if the opposite movement eases your pain. However, never arch back into pain, work in a pain free range. If it does not ease your pain stop immediately and seek advice.

If you are in the acute stages of your back pain and cannot lie down due to pain, try sleeping in a semi-lying position on the couch or bed with three pillows behind you, and one under your knees. This is the ultimate unloaded position for your lower back. If you are in the in between stages of acute and chronic back pain then try the pillow methods described above. If this is not proving easy then please seek help.