When new back pain is keeping you up at night
Dr Nicola Tik
When your lower back has started hurting recently, night-time can be the hardest part. Every time you turn over, it catches you, and the harder you try to get comfortable, the more awake you feel. This guide will help you find positions that ease the strain on your back, and explain why good rest is part of helping it settle.
Broken sleep is one of the most common parts of back pain. In a large study of nearly 2,000 people seeking care for lower back pain, around six in ten said their pain disturbed their sleep. That was true even for people whose pain had only started recently.
The encouraging news is that recent back pain usually improves well. A large review found that most people improve markedly within the first six weeks, with the biggest changes early on. As your back settles, your sleep usually follows.
Sleep is when your body does much of its repair work, and when your nervous system gets a chance to reset. After a poor night, discomfort tends to feel stronger, because your brain turns the volume up on pain signals when you are tired. A better night often means a slightly calmer back the next day.
Resting at night is different from resting all day, though. Research consistently shows that staying gently active during the day helps recent back pain settle faster than staying in bed. Moving during the day and resting well at night work together.
There is no single right position. The best one is whichever lets your back muscles relax. Some options to try:
It is worth trying each one for a few minutes to see which feels easiest. Many people find what work changes from night to night as the pain settles.
Getting in and out of bed is often when recent back pain catches you most. Something to try is the log roll.
To get up, roll onto your side with your knees bent. Then push yourself up with your arms as you swing your legs over the edge of the bed, so your body moves as one unit rather than twisting. To get into bed, do the same in reverse: sit on the edge, lower yourself onto your side using your arms, then lift your legs up together.
You do not need a new mattress to sleep better with a sore back. But it is worth knowing that firmer is not always better. A trial in people with longer-lasting back pain found that a medium-firm mattress was linked with less pain on waking than a firm one.
If your mattress feels very hard, a mattress topper can soften it. Extra pillows are often the quickest and easiest change. Placing them between your knees, under your knees, or behind your back to stop you rolling can make a real difference.
If your back wakes you, gently changing position is usually the first thing to try. If that does not help, getting up for a few minutes and walking slowly around the room can ease stiffness. Then settle back down in a supported position.
Some people find a warm shower or a heat pack before bed helps their back muscles relax. Your VIDA pain check-in is a good way to keep track of how things are shifting over time, including how your nights are going.