Back Pain When Lying Down: Causes, Symptoms, and Treatment


Seven to nine hours of sleep is considered the ideal time to rest at night, according to a study by the National Sleep Foundation. Of course, this is only an orientation and some people need less or more sleep. However, short and long sleepers have one thing in common: back pain while sleeping or afterwards interferes with a restful night. What can be the reason if your back hurts while lying down, in which position you sleep best and more tips.

Causes of back pain during or after sleep

The good news first: back pain does not necessarily have to be caused by wear and tear of the intervertebral discs and spine. In many cases, back pain during sleep is simply caused by muscle tension or a wrong sleeping position. A physical “state of emergency” such as pregnancy can also be the reason for the pain.

Back pain after lying for a long time = back tension?

Sitting in the office for long periods of time or standing at the workplace for hours: most of us are familiar with one-sided strain in everyday life. Sufficient exercise can counteract overloading of tendons, ligaments, muscles and joints.

If this compensation doesn’t take place, the back will sooner or later become noticeable in the form of tension and weakened back muscles. The constant tension of the back muscles can also have psychological causes: Overstrain, the pressure to perform, etc. are possible triggers.

In the worst, but unfortunately not uncommon case, the complaints in the upper, middle or lower back continue into sleep. This is because in the deep sleep phases (shortly after falling asleep) we usually lie completely motionless.

An unfavorable posture in these phases leads to permanent muscular tension, because the muscles reflexively try to “straighten” the spine. Thus one either wakes up at night with complaints or feels rusty in the morning when getting up – the exact opposite of a restful night …

Back pain due to the wrong sleeping position and hollow back

The prone or side position is the favorite sleeping position for many people. Unfortunately, this quickly leads to an unfavorable posture in which the spine is not straight. If, for example, you sleep on your stomach, a hollow back often occurs – not the ideal posture for several hours of sleep.

You are a belly sleeper and don’t want to give up your favorite sleeping position? Then you can counteract back pain by laying a flat pillow under your stomach.

Types of back pain: Where does it hurt?

Back pain is not the same as back pain and so no general judgment can be made about causes and countermeasures. First of all, therefore, just one advice: if the pain persists over a longer period of time, we recommend a medical examination. Even if you suspect psychological reasons behind the tension or pain, professional support can be very helpful.

Lower back

The lumbar spine, i.e. the lower back, does all the work in everyday life. Sitting for long periods of time means that the intervertebral discs are subjected to a constant heavy load. But don’t worry: If it hurts in the lower back, it doesn’t have to be a slipped disc!

In fact, most cases of back pain in the lower back are unspecific, i.e. no clear trigger can be identified. However, it is important not to place too much emphasis on protection in the case of lumbar vertebral pain while lying down: Compensation through movement is often the best way to combat the complaints. Because if we move, and it is only by regular going for a walk, the muscles remain supple and the intervertebral discs can regenerate clearly better.

Middle / upper back and neck

The fact that the thoracic spine actually triggers back pain is rather rare. As a rule, the problems arise in the lower back or manifest themselves as neck pain. If the pain does occur in the middle back at night or in the morning, it may be due to muscle tension.

These are caused, for example, by a one-sided posture in everyday life. In addition, a mattress that is too soft can be the origin of the problem, which does not sufficiently support the spine. And since the thoracic spine is comparatively immobile, incorrect postures in this area become noticeable more quickly. You can counteract this, for example, with exercises for a healthier posture.

How to sleep with back pain?

The right sleeping conditions can make a difference when it comes to back pain-free nights. This includes the sleeping position on the one hand and the bed itself on the other, or rather the mattress and pillow.

Back, side, belly – what is the right sleeping position for back pain?

The spine can regenerate best at night if it lies as straight as possible and retains its natural double S shape. Ideally, the body should have the same posture when asleep as when standing upright during the day. The back position is therefore the best sleeping position.

However, theory and practice are often far apart – not everyone can sleep well on their back. All the more important is a point-elastic mattress which balances the preferred sleeping position well. And another tip: If you prefer to sleep on your side, try not to put on your legs. That’s the sitting posture again – and we take it often enough during the day.

Is it better to sleep without a pillow?

No pillow, no back pain? It is not quite like that! First and foremost, it is important that the space between the chin and shoulder is filled and that the neck doesn’t bend. If, for example, you sleep on your side and put your arm under your head, this will most likely lead to tension just as much as a wrong pillow.

You are on the safe side with a height-adjustable pillow (e.g. with Swiss stone pine chips as filling). If, for example, you notice that your sleeping habits have changed and you sleep more on your back, simply remove part of the filling from the pillow. This will lower you immediately – your spine and neck will be happy!

Which mattresses and beds are back-friendly?

In addition to effective support for the head and spine with a suitable pillow, an ergonomic mattress on a suitable slatted frame is also important. Latex mattresses, for example, are extremely point-elastic and provide ideal support. The alternative is sleep systems: they are individually adapted to body, contour and weight and thus guarantee the correct lying position of the spine.

The size of the lying surface should also not be underestimated. Apart from the quiet deep sleep phases, we rotate around 20-60 times at night! In order to always have enough space on the mattress and to avoid unnaturally “bending” and cramping, the lying surface should be at least 8 inches longer than the body size. The width should be 35 inches or more.

Lie right, sleep right!

Do you have the perfect bed and equipment? Then all you need now is a few room conditions to finally ban back tension from the bedroom! We recommend:

  • Temperatures between 60 °F and 65°F and a natural room climate, as promoted by solid wood furniture, for example.
  • The security of a wall in the back, instead of placing the bed freely in the room without “back covering”
  • Computers, telephones, work documents – get them out of your bedroom, your place of rest and relaxation!

All these factors can cause us to be constantly tense even when we sleep. This is often the main cause of back pain while lying down or after sleeping.

However, with the right bed, a suitable mattress, a supporting pillow and enough compensatory movement in everyday life, you are optimally equipped for pain-free nights and optimal regeneration of the spine – every night!


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