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Low back pain is one of the most common reasons people visit the chiroprctor.  When I see new patients for an initial visit, I ask them about their sleeping patterns and whether or not they awaken with pain.  It’s not uncommon for patients to ask me “Do you think it could be my mattress?” 

When we sleep, it is the only time our muscles and ligaments get to actually relax.  Even simple actions like sitting on the couch require muscles and ligaments to hold our posture.  So this resting period is critical for our body to repair itself and heal tissues that have been injured during the day.   Unfortunately we don’t always wake up feeilng refreshed.  The support that our back and neck receive while we sleep is very important considering especially how many hours we spend in bed.  Here a few things to consider that may give guidance regarding your bed and your back.

Types of Mattresses – There are a wide variety of mattresses from which to choose.  Innerspring or coil mattresses are the most traditional and come in a variety of tensions and types within the coils themselves.  They also have a wide variety materials that top and cover the mattress so that you can choose how much cushion suits your needs.  There are latex core mattresses replace the traditional springs with latex while still providing the traditional type of covering material.  Memory foam has become incredibly popular over the past ten years.  It also replaces the coils with an elastic compound that is believed to distribute weight more evenly, thereby reducing the need for a person to change positions in the night.  It conforms to your shape because your body heat actually allows the material to mold to your body.  The down side to this is that they tend to run warmer than other mattresses although some manufacturers have technological advances to mitigate the warmth of the mattress.  There are also beds containing chambers filled with air that can be increased or decreased to the preference of the individual.  This allows for a different level of firmness for two people in the same bed.  The best way to know what works for you is to test them out extensively before you buy.

Sleeping Positions – Everyone sleeps differently and often will switch positions over the course of a night.  The most important thing to remember for any position is to try and support the natural curves of your spine.  Back sleeping allows for your weight to be distributed over a larger surface area.  With this position, most people will use a pillow to support their neck, but don’t forget your low back.  A small pillow under your knees when falling a sleep with take pressure off the curve of your low back and may alleviate early morning back pain.  Side sleeping can be helpful for people with significant back injuries.  A small pillow between the knees with help keep your pelvis aligned and be sure to support your head so that it remains parallel to the bed and doesn’t drop lower than that.  Tummy sleepers are often reluctant to admit it their chiropractors, but the truth is many people end up on their stomachs during the course of any given night.  Because this position puts extra rotation in our necks, I advise patients to place a pillow underneath their upper chests to give their neck and head a little more room and limit rotation.  Additionally, sleeping on our stomachs can aggravate conditions like facet syndrome and even certain types of arthritis.  A pillow underneath the hips may soften some of the pressures on the curve of our low back.

When to take notice – Some conditions like osteoarthritis tend to be worse in the morning.  So if you are noticing that you tend to have back pain in the morning that “works itself out” as the day goes, be sure to mention this to your chiropractor.  If you notice that you are waking up exhausted, this may also be a sign of a breathing difficulty, such as with sleep apnea.  So be sure to mention any excessive snoring or long-term exhaustion.  If you notice that your pain tends worsen during the course of the night and perhaps even awakens you, this is especially important to discuss with your chiropractor.  Some diseases, even including cancer, can present with this type of pain history.  So bring it up.  Finally, if your symptoms are worsening, no matter when they occur during your sleep cycle, make sure you bring this to light.  Doctors are trained to ask all the right questions, but sometimes things get overlooked.  So take it upon yourself to bring it up as well.

Finally, there’s been much discussion about how long your mattress should last.  Should we replace it every 10 years or every 8 years?  Much of this depends on you and the quality of the mattress at the time you purchased it.  Also, as our bodies change with age, we may have different requirements for our sleep.  Certainly if you’ve been on your mattress a decade and you notice that you are suddenly waking with stiffness in your back, it may be time to head to your favorite sleep store.  But don’t hesitate to discuss any new onset of pain with your chiropractor so that together we can rule out anything more complicated and point you in the direction of a new mattress and a happy night’s sleep.