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Sleep is supposed to be a breather from our troubles, but sometimes the way we sleep – and the mattress and pillows we use at night – can actually contribute to troubling back pain, according to interventional pain management specialist Dr. Marcello Sammarone.

Back pain and sleep problems can be a chicken-egg situation, Dr. Sammarone says, since existing back pain can make it harder to sleep and certain sleep positions and products can ease back pain or make it worse. A 2014 study in the Asian Spine Journal indicated that one-third of people with low back pain dealt with disrupted sleep from their pain. Researchers also found the worst time for back pain was between 7 pm and midnight, with increased pain affecting sleep even more.

“But if your aching back is keeping you up, it might have less to do with your activities during the day than with how you’re positioning yourself during sleep and what you’re sleeping on,” explains Dr. Sammarone. “Back pain can make it tough to get a night of sleep, but a few simple changes can help remove the stress from your back and make a better sleep more probable.”

Sleep positions that help and hinder back pain prevention


Some sleep positions place more pressure on your neck, shoulders, hips and lower back – all of which can lead to an aching back, Dr. Sammarone notes. But what’s the position most likely to cause back pain? Sleeping on the stomach, which flattens the curve of the spine and requires neck rotation that can cause pain between the shoulders.

On the other hand, modifying your favorite sleep position can help take the strain off your back, he says.

Back sleepers can place a pillow under the knees to promote their spine’s natural curve;

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Side sleepers can pull their legs up slightly toward the chest and sleep with a pillow between the knees.

Changing your sleep position during the night is a good thing as far as your back is concerned, Dr. Sammarone says.

“It’s normal for someone to move around while they sleep, and shifting position helps relive pressure on the back,” he adds. “When you turn over, try not to twist or bend at the waist, but to move your body as one unit. This can prevent further back strain.”


Choose mattresses and pillows to promote pain-free sleep


Too many people buy mattresses and pillows without even trying them out, Dr. Sammarone says. But much more thought should be given to these highly important decisions.

Mattresses come in so many forms these days – hard or soft, memory foam or pillow top, and countless choices in between – that it’s impossible to point to one type of mattress and say it’s best for back health, Dr. Sammarone says. “When shopping for a new one, really spend some time lying on different mattresses in the store and don’t hurry the process,” he suggests. “Choose one that feels not only comfortable, but gives support for the curves of your spine.”

Pillow choice should be given just as much consideration, since ultimately pillows don’t just affect your head and neck. Pick a pillow that supports the curve of your neck, without being too high or low, Dr. Sammarone advises. “Depending on your sleep position, adding or removing a pillow can help keep your spine in the right position,” he adds.

The proof is found in how you feel when you rise each morning. “Waking up with achy, tense muscles is a clear sign your mattress, pillow or sleep position is off,” Dr. Sammarone says. “Since we spend nearly one-third of our lives sleeping spending some time optimizing your sleeping position and products such as mattresses and pillows is a worthwhile pursuit.”


Dr. Marcello Sammarone, MD ● 

Stomach sleepers can place a pillow under the lower abdomen to ease back strain; and

Ways to Reduce Back Pain and Get a Better Sleep

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Marcello Sammarone, M.D.

Pain Management

Parsippany /Morristown