I was working with a patient who started to describe to me the back pain she felt mostly at night. It started when lying on her stomach, so she adapted to sleep on her back or side. Then lying on her back was uncomfortable too, causing stiffness and pressure in the low back. These were recent problems, and did not coincide with activity, injury, or pain during the day. When I questioned the age of the mattress she slept on, she had to think about it…at least 10 years old she thought.

An older mattress may be less supportive, uneven, or sag, thereby not providing adequate support and cushioning for the body while sleeping. The life of a mattress is usually about 10-15 years, but may vary depending on the type of mattress and other factors (like how often the kids jump on it!) You will know it’s time if your mattress sags, you wake up sore, and have trouble getting comfortable and getting a good night’s sleep.

Since a mattress is an investment, it’s important to find a mattress you are comfortable with. There are so many different types, some even adjustable firmness now, and I recommend you find a store where you can trial mattresses and have the ability to return within 30 days if not satisfied. In the New England area, there is a large furniture store with a sleep lab and sleep technicians who help guide you towards the best fit for you.

If you do suffer from back pain it may be helpful to know this: a study of over 300 people found that a medium-firm mattress reduced pain and disability among people with chronic, non-specific low back pain.1

1 Kovacs, et. al. “Effect of firmness of mattress on chronic non-specific low back pain:randomised, double blind, controlled, multicentre trial.” Lancet,2003 Nov 15;362(9396):1599-604.

About 10 years ago I had problems with SI joint pain and sciatica. I had a lumbar backrest, like the one shown here, that I placed behind me to support my lower back in my car, but sitting or driving in the car remained the activity the aggravated my pain the most.

One of my colleagues suggested I try sitting on the backrest cushion, with the thicker end to the back. This elevated my hips higher than my knees (because my car had lower seats) and relieved a lot of pressure on my back. I noticed an immediate improvement. This isn’t necessarily what these backrest cushions are designed for, but I’ve continued to recommend this to patients over the years and all have found it to be extremely helpful.

When seated, whether in your car, office chair, or sofa, be mindful of whether you are slouched, if the knees are higher than the hips, or if you’re always turned to one side. If you can keep your back straight and tall, with the support of a lumbar support, and possibly a cushion under the hips as well, your spine will be happy.

I used to be a stomach sleeper…really for as long as I can remember. Then about 6 years ago, my neck started to bother me. It started as a tightness on one side and some days felt like the joints were pinched and my muscles would spasm. I had a feeling it was probably from from my lopsided sleep habits, so I trained myself to sleep on my back or side.

When sleeping on your stomach, the head turns to one side, and for many people it almost always turns to the same side. This sustained position places stress on the muscles and joints of the neck and shoulder (that is either tucked underneath you or stretched out to the side) and can be a real source of neck problems. But when that’s the only comfortable position your body knows to sleep in, it can be difficult to change.

When I work with patients on changing their sleep position, I usually recommend that they use pillows to help with the adjustment process. For example, a contoured cervical pillow will provide nice support to the neck in a back or side lying position. In addition, a pillow or wedge under the knees (for back sleeping) or between the knees (for side sleeping) will help encourage you to maintain a new position. Of course, there will be nights and even many times in one night where you find yourself on your belly with pillows on the floor. When you are aware of it, change your position and return the pillows to a comfortable place for sleeping. Gradually, you will be able to retrain yourself to sleep in a way that allows the joints and muscles to be in a more neutral alignment.

My neck pain slowly resolved as I changed my habits, and I’ve worked with many patients who have seen dramatic improvement in pain levels by making these types of modifications. We do spend (hopefully) close to 8 hours a day sleeping, so the more comfort and support there is for the body during this time, the better we’ll probably feel upon waking.