Pain and sleep are not good bedfellows… as I am sure you know!   This article will detail some tips for reducing back pain in bed.

1) A nice firm mattress in order to preserve a ‘neutral S-shaped” spinal posture and avoid a “C-shaped” posture.

Three curves of the spine (Gray)


Our spine is designed, and is at its best mechanical advantage, and therefore least painful, when its 3 curves are maintained. Specificallly, the spine curves in toward the head at the neck at the “cervical lordosis”, out away from the chest at the “thoracic kyphosis” and in again toward the stomach at the “lumbar lordosis.”

Bad postures, including the most common “C-posture” are not mechanically advantagous for the components of the spine i.e. vertebrae (bones), ligaments (joining fibrous tissues), muscles, nerves (which exit from the spine), vertebral joints and discs (shock absorbing pads between vertebrae). As such pain can result. Also bad posture resutlt in more bad postures, as muscles weaken and strengthen depending on which are used frequently or not used at all.

“C-posture” is when the “lumbar lordosis” is flat and the “thoracic kyphosis” is exaggerated, resulting in a ‘slumped’ back. Think of the way your back is in a hammock.

2) “Memory Foam” mattresses may not be a good idea if you have chronic backpain.


This material is designed to “immerse” people to maximise contact with the surface of the mattress so that pressure is evenly distributed. While this feature is good for preventing pressure sores/bed sore when used in wheelchair cushions for people with paraplegia (one example) it may not be good when used in a mattress as it may ‘exaggerate’ the bad spinal postures that are causing your back pain in the first place.

For example, if in your waking hours you tend to have a too big Lumbar Lordosis (sway back in lay terms), when sleeping on a “memory foam” mattress you will sink into this position, thus aggravating your symptoms. A firm mattress and other positioning techniques, soon to follow, will help you to achieve a good posture to reduce aggravation of pain sympoms when sleeping.

3) Put a small pillow between your knees if you are sleeping on your side. Put a larger pillow, or positional equipent, under your thighs if you sleep on your back. Put a small pillow under your hips (between belly button and pubic area) if you sleep on your stomach.

WHY? Again we are trying to maintain optimal “S-shaped” spinal postures. These techiques alter the angle of the pelvis/hips, and since the angle of the hips directly affects spinal curves (due to the way the muscles attach and pull between the  back, hips and legs).

If the pillow doesn’t work for you…and you have quite a big sway back (anterior pelvic tilt) you may want to try commercial positioning products for example:

Back sleeping product


Side sleeping product

4) Don’t twist/rotate your back when sleeping.