Nocturnal, or Sleep related Back Pain – Should you change your mattress?

Back pain is a common issue that can significantly affect your quality of life – especially when it interrupts your sleep. One of the main reasons a person may decide to see a doctor or a physiotherapist for their back pain is because they are awake at night due to the pain, or they have difficulty getting out of bed in the morning due to stiffness and discomfort.

Here is one of the most common questions we are asked on a regular basis – you may find the answer helpful too!

Should I change my mattress?

Many people who experience nocturnal back pain feel that changing their mattress would improve their sleep quality and that a new or firmer mattress would help their spinal alignment. From a physiotherapist’s perspective, spines undergo most loading ‘axial loading’ when we are in an upright position, during the day. When we are standing and sitting in sustained postures over a long period of time, this causes load or ‘deformation’ of the tissues such as ligaments, discs, muscles and fascia or connective tissue. If the tissue can’t cope with the load being applied, it triggers pain sensitive tissues, or can initiate inflammation in these tissues. Overnight, when we are at rest several hours later, the inflammatory process takes place, in which the body tries to start healing itself with the formation of new tissue, a rudimentary type of scar tissue. When you turn during the night or load the spine as you move into sitting or standing in the morning time, this is when you feel the effects of the previous day’s load or activity – the result of the inflammatory process.

There are times when eg a large disc protrusion can directly affect your sleep position and keep you awake at night, but usually pain in the early hours of the morning is more related to low grade inflammation of the soft tissues of the spine from persistent loading the day before.

Our advice?

Try to move your spine and change position more regularly during the day and observe if this makes a difference to your nighttime or early morning back pain before changing your mattress which can be an expensive option with no guarantee of success. A suggestion would be to do some simple pelvic tilts in your chair at work every 15-20 minutes to begin and reach down to touch your toes and then raise your arms overhead.

‘Motion is lotion’ is a key concept in maintaining a healthy, pain-free spine, and backs not only love to move – they need to move.

Find reasons to get up and move from your desk to walk around the office or house during the day,  -getting a glass of water is a simple and often overlooked mini-task - try to avoid getting engrossed in a task to the detriment of movement and keeping up your hydration. Dehydrated tissues are more likely to become painful tissues.

 Our next blog will continue the focus on Nocturnal or Sleep related back pain, where will we suggest some mattress choices and explore good options for those who are due a mattress change.

*Please note that nocturnal back pain is sometimes associated with underlying medical issues, and in particular if it is persistent over a number of weeks with no improvement, or associated with night sweats, unexplained weight loss or bladder and bowel changes or any new symptoms of concern it is important to seek assessment from your doctor or physiotherapist.