A little nighttime reading


Do you suffer from nighttime back pain? Here are some tips to help manage back pain at night naturally.

With an estimated 100 million Americans affected by chronic back pain, we’re not surprised that so many people ask what they can do to help with back pain in bed. Sleep disorders and back pain at night are intimately connected, with a significant percentage of chronic back pain sufferers also reported to have clinical insomnia. Furthermore, evidence is mounting that sleep deprivation and disruption occurring over just 3 nights or more can diminish a person’s ability to handle pain and mimic symptoms of fibrositis (inflammation of connective tissue typically affecting the back).

One study found that people most frequently experience lower back pain between 7 pm and midnight, which inevitably impacts many people’s sleep lives.

Have you ever been woken in the middle of the night or too early suffering from back pain? Back pain sufferers should follow an overall pain management regimen as prescribed by their doctor and practice basic good sleep habits. But here are additional tips to help alleviate issues with nighttime back pain while in bed:


Meditation or visualization
When you fall asleep at night, traditionally, a sleep specialist will tell you to get “quiet” - quiet your environment, quiet your mind, quiet any movement. But when your mind has nothing to distract it before falling asleep, that can inevitably cause you to focus more on your back pain. A primary pain management tool is often distraction, so when all your mind has to focus on is the pain at night, this can intensify the perception of pain.

After quieting your environment of all distractions, instead of leaving your mind to focus on the back pain, focus your mind on meditation, visualization or another form of mindfulness. This keeps your brain distracted from the pain and instead gently focuses it on a peaceful, calming yet engaging activity that likely will induce sleep. It also releases endorphins, which blocks pain signals from registering with your brain.

If you’re looking for effective bedtime meditations, we share some simple and restful meditation options to do before sleep here.


Check your mattress
Not surprisingly, many people get relief when they switch out their mattress. Have you ever stayed in a hotel or friend’s place where the mattress kept you up at night? We probably don’t need to tell you that a mattress is integral to your sleep experience and can help prevent nighttime back pain.

If you’re wondering what type of mattress is best for lower back pain, the answer is that there is no definitive recommendation. Sleep specialists will say there is no one-size-cures-all, and you should shop around until you find a mattress that helps you sleep without pain and stiffness. However, some studies indicate that a medium-firm mattress is more likely to provide back pain relief than a firm mattress, as it allows the hips and shoulders to sink in. The amount of sink you need will also vary, depending on your preferred sleep position.

At the very least, make sure to replace your mattress at least every 7 years, as mattresses sag and lose support over time. If you’re over 40, consider a new mattress every 5 years. As your body ages, it becomes more sensitive to pressure changes.

If you’re looking for a new mattress and need help knowing what to look for, check out Slumbr’s Unbiased Mattress Buying Guide, Because we don't sell mattresses, our guide provides a neutral perspective to help you navigate today’s mattress buying landscape. Things have changed a lot with all the online mattress brands out there, and we explain what you need to know to get the best fit and value (and what doesn't really matter). 


Upgrade your pillows
Similar to a mattress, a poor pillow can cause neck and back pain that radiates down your spine. It’s important to find a pillow that keeps your head, neck and spine in “neutral alignment,” which basically means that your body should rest in a straight line. Your head shouldn’t be craning too far back, and your chin shouldn’t be pushed too far forward.

The pillow should properly fill the space between your head and the mattress to support your head throughout the night. Your sleep position will generally determine how high the pillow should be. In general, side sleepers want a firmer, higher pillow. Back sleepers benefit from a medium height and level of support, while stomach sleepers should sleep with a lower, softer pillow. If you suffer from back pain however, stomach sleeping will typically cause strain on the neck and exacerbate back pain.

Back pain sufferers typically benefit from a firmer pillow that will not flatten out or have its fill shift around during the night, as this can cause the head to move too much while you’re half-asleep.

There are special cervical/orthopedic pillows that have extra support under the neck and a depression where the head lies. These pillows keep the neck in alignment with the spine, but often lose support after 1-2 years. They are also more rigid so if the height and placement of the pillow fill does not suit your body, the pillow can end up putting pressure on the wrong points of your body.

An alternative option that provides a consistent, firm feel while allowing for personalized support is a buckwheat pillow, like Slumbr’s Ara Buckwheat Pillow. These all-natural, healthy pillows contour to your head and neck for long-lasting personal support. They work for every sleep position and have adjustable height. If you’re interested in learning more, this post explains the reasons why the Ara Buckwheat Pillow is great for neck pain and nighttime back pain.

You might also alleviate back strain by putting a second pillow between the knees (if side sleeping) or under the knees (if back sleeping). For side sleeping, a pillow between the knees can keep your spine in neutral alignment. On your back, 1-2 pillows under the knees keeps the lumbar spine flattened, putting less force on your facet joints.

At the end of the day, pillow comfort and support is very personal to your sleep style and personal preference. After testing over 250 pillow options with real sleepers in their home, Slumbr knows how personal pillows are. If you’d like to understand what makes the best pillow for sleep, check out Slumbr’s Pillow Guide. Or if you just want an easy way to find the comfiest pillow you can take Slumbr’s Pillow Quiz for a quick and easy way to find a comfy pillow that works well for you.


Use hot or cold therapy
Heat therapy is often prescribed for back pain since it stimulates blood flow and inhibits pain messages being sent to the brain. It also diminishes muscle spasms. While you’re lying in bed, consider applying a heating pad directly to your back. Alternatively, applying an ice pack may help, as it reduces inflammation and swelling.


Nighttime back pain alleviation fundamentally calls for a holistic approach, including sufficient physical activity, good sleep hygiene and a nutritious diet. It may also require more acute therapies such as medication, physical therapy and chiropractic care. Regardless, finding ways to deal with this condition can vastly improve your sleep health over time.

© Can Stock Photo Inc. / dolgachov (photo credit)