The Best Sleeping Positions for Lower Back Pain 😴

Back pain is a thief—it can rob you of your all-important zzz's. Whatever the cause, low back pain can make it hard to get comfy at night. And there are times when your pain will wake you—especially if you don't snooze in the best sleeping position for lower back pain.

This lack of sleep makes the pain worse. Sleep loss may impair healing or affect your mood, heightening pain sensitivity, or disrupting chemicals in the brain that are known to be involved in pain.

Finding the best sleep position for lower back pain may help you get a better night's rest and relieve your pain.

This takes some trial and error. In general, it is best to try to keep the normal curvature of your back when you sleep.

That said, there is no one-size-fits-all sleeping position for lower back pain. The best sleeping position is one that feels most comfortable for you.

Here are the best sleeping positions for lower back pain.

BACK SLEEPING AND LOW BACK PAIN

When sleeping on your back, try placing a pillow under your knees or a small pillow under your lower back. This will support the natural curve of your spine and reduce pressure on your lower back.

SIDE SLEEPING AND LOW BACK PAIN

When sleeping on your side, try putting a pillow between your legs. Keeping your knees bent will reduce pressure on your lower spine, too.

Finding the best sleeping position for low back pain can help you get a better night's sleep, resulting in spillover effects on your pain. Experiment with different positions and pillow placements to find one that works for you.

#sleep #sleepingposition #lowbackpain #chiropractor #chiropracticcare #newhamburgchiropractic #rehabilitation #wecanhelp #2020recordreadawards #newpatientswelcome #newhamburg #wilmot

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Physiotherapy Now Available!

PHYSIOTHERAPY NOW AVAILABLE

WITH JERE BUKICH, PT

At New Hamburg Wellness Centre, we work with patients of all ages, and treat a wide range of health conditions, which include, but are not limited to:

At

·        Muscle and joint injuries

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·        Neck pain and low back pain

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Low Back Or Leg Pain Aggravated By Back Extension

By Dr. R. Greg Lusk, DC

Spine flexion, or bending forward of the spine, has been the main movement or function discussed in the articles I've written to date, and rightly so as it is the dominant activity that produces and perpetuates low back pain. However, it's counterpart, spine extension, which often plays a relieving role for most cases of low back pain, can be a source of aggravation in others. Specifically, in a low back with prominent osteoarthritis (OA), which is the general term for degenerative disc and/or joint disease, the structural changes can result in disc space narrowing between our vertebrae, the development of bone spurs, and/or the thickening (i.e. hypertrophy) of the bony sides of the joints (facets) or other soft tissues (e.g. ligamentum flavum). Collectively, these changes can narrow the hole(s) between the vertebrae (foramen) where our spinal nerves exit and even compress the nerve(s) as it passes through the opening. Back extension exaggerates this narrowing (i.e. stenosis) further and can lead to low back and leg pain, numbness, weakness, and a reduced ability to stand or walk. Medically, this is referred to as neurogenic claudication or degenerative lumbar spinal stenosis (DLSS).

Now, since low back OA is incredibly common, particularly with increasing age, it is important to realize that this doesn't mean that back extension is bad for everyone with OA. Remember that disc bulges are in fact part of low back OA and can irritate nerves that travel down the legs, but that they often respond well to back extension exercises while being aggravated by spine flexion. This highlights the need for case by case management with investigation of the patient's symptoms and then confirmation via assessment. With respect to a patient with DLSS, it is often reported that low back or leg symptoms are aggravated with either standing or walking, but alleviated with sitting or bending forward. It may even be noted that walking while pushing a shopping cart or riding a bike, which flex the lumbar spine and open up the spaces where the nerves exit the spine, are comfortable. Assessment of ranges of motion and nerve tension in the legs are components of an examination that could then be done to increase confidence in the diagnosis of DLSS.

For patients with severe symptoms, surgery may be an option where bone and ligaments around the stenosis are removed to decompress the nerve. However, for those with mild to moderate symptoms related to DLSS there have been encouraging results published when participants completed a 6 week spine mobility boot camp. The multimodal program included manual therapies to improve mobility in the low back and hips, numerous daily exercises that promote spine flexion, and education with respect to body repositioning for symptom relief. Self-rated disability, leg pain intensity, and improved walking tolerance were improved upon completion of the program and persisted for 3.5 years. Exercises examples include lying on your back and pulling either one or both knees to your chest, pulling one knee to the chest and then leaning it across the body toward the opposite hip, seated toe touching, and riding of a stationary bike. Walking with a posterior pelvic tilt, where you rotate your pelvis to tuck your tailbone and/or raise the area where a belt buckle would rest, which opens up the lumbar joints, is an example of body repositioning during activity. Timing your baseline walking duration prior to symptom onset, and then re-checking after performing these sorts of things for a number of weeks would allow you to monitor your progress and assess the value of your effort.

This article is for general information purposes only and is not to be taken as professional medical advice.

Tips for Bending With Low Back Pain

By Dr. R. Greg Lusk, DC

Sitting and standing were discussed thoroughly in my last article as they are common activities that trigger low back pain (LBP). Modifying how they are done form part of our daily upkeep of our backs, referred to as spine hygiene, which when coupled with appropriate exercises can help make you more resilient to symptoms. Bending is another frequent trigger for  low back pain and how it can be performed in a more spine sparing or friendly way will form the focus of this article.

If you have or had LBP, it is highly likely that bending is or was an aggravator to your symptoms. Imagine yourself flexing forward to put on socks, stooping to brush your teeth, or trying to pick up that pen you dropped on the floor. Many of you will dread the thought of having to do that when you have LBP. However, you can employ strategies to do this that spare the spine, allowing it to stay in neutral, thereby minimizing pain. Squatting, by moving predominantly at the hips and knees, will allow you to lower yourself without rounding your back. To get even lower you could use a lunging pattern. To perform this move, you stagger your feet one in front of the other and offset side to side, so you don't feel like you're standing on a balance beam. Once again, you move about the hip and knee joints while lowering the rear leg toward the floor, keeping the back straight throughout. From the bottom of this position you can generally reach near the floor with your hand with minimal spine motion needed. Good technique is paramount to minimize stress on the hip and knee joints so symptoms are not produced there, which may be particularly challenging for some of you with a history of injury and or arthritis there. An alternative that may be helpful is referred to as the golfer's lift or pick-up. Similar to the action you'll see a golfer perform to retrieve the ball from the hole, you balance on one leg while you hinge about the hip joint, lowering a hand toward the ground while the free leg extends backward as a counter-balance. Particularly for relatively light items, this is an effective way to get your hand low while keeping your spine neutral and your core tight. Balance may be an issue for some so using your free hand to lean on a wall or hold onto another firmly rooted object will provide another contact point for improved stability in this position.

The stooped (i.e. slightly bent) posture you can observe when someone is brushing their teeth over the sink, gathering laundry out of the washer or dryer, or kneeling to do gardening can also be modified to become more kind to your spine. With these activities we use our arms but really only need the free motion of one hand to be efficient. The other hand, which is typically non-dominant, can instead form a contact point of support on either the vanity counter, the appliance, or ground, while you also hinge at the hips and keep your spine neutral. The support hand now bears much of the load that leaning forward imposes on the spine, which is surprisingly substantial when you consider how much the upper half of our bodies weigh coupled with the multiplying power of leverage.

Good luck employing some of these ideas to bend with increased ease. With low back pain the more we can reduce all of the contributing sources of aggravation the more likely you'll experience decreased symptoms and prolonged relief. This article is for general information purposes only and is not to be taken as professional medical advice.

Solutions for Overcoming Poor Sitting Posture

By Dr. John A. Papa, DC, FCCPOR(C)

An ideal posture allows an individual to maintain an efficient, strong, and balanced position while interacting and adapting to their physical environment.  Good postural habits can help decrease abnormal and excessive physical strain on the body, thereby minimizing the chance of injury.

Unfortunately, modern technology has significantly influenced our daily postural habits, which has resulted in having people sit more often and for longer periods of time.  Individuals exposed to these sitting positions may adopt a poor posture that includes losing the natural hollow of the low back, rounding or slouching of the upper back and shoulders, and a forward head poking position.

Less than ideal posture puts cumulative compression, stretch, and shear forces on the body.  The cumulative effects of sitting are often offset by the body’s ability to compensate.  However, even in the absence of pain, these compensatory changes may begin a vicious cycle of unbalanced motion, muscle and joint stress, and secondary areas of discomfort.  As a result, the physical consequences of chronic poor posture can lead to symptoms such as muscle and joint stiffness, nerve pain, headaches, shoulder pain, neck pain, upper and lower back pain.

Listed below are some potential solutions that can minimize the chance of postural injury, specifically as it pertains to the sitting position:

1.    Pay attention to how you sit by making sure weight is evenly distributed in your seat, your shoulders are not rounding forward, and you are not slouching.  Your head should be resting on your torso and not poking forward.

2.   Take a break from sitting with 10 to 30 second stretch or posture breaks every 20 to 40 minutes.  Some activities such as computer work, talking on the phone, and business meetings can also be done while standing.

3. The use of a properly designed workstation (i.e. adjustable chair and desk), along with ergonomic tools and assistive devices (i.e. speakerphones, foot stools, lumbar supports) can help maintain mechanically advantageous positions while working in a seated position.

4.    Avoid unnatural positions such as looking down, awkward twisting, or slouching for long periods of time as this can cause unnecessary strain.  A simple solution may be to bring your smartphone, tablet, or book closer to eye level, or adjusting your seat position to help you maintain a more natural/neutral position.

5.    Engaging in regular physical activity and exercise can keep your body strong and help overcome the effects of cumulative strain associated with poor posture.  Exercise activities can include general cardiovascular conditioning, along with postural, stretching and strengthening exercises for the neck, shoulders, upper and lower back regions.

Prolonged sitting and poor posture can undeniably cause real physical change and breakdown in the body.  If you have ongoing pain as a result of postural strain, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Changing How You Move To Relieve Low Back Pain - Part 1

By Dr. R. Greg Lusk, DC

If you've read my last few articles you'll recall that I've been trying to create more awareness of a functional diagnosis for low back pain (LBP), versus only knowing what is structurally wrong with a specific anatomical tissue. In other words, it is important to figure out which movements or biomechanical loading directions cause LBP. You may also remember that bending forward (i.e. spine flexion) was identified as a very common direction of motion that results in LBP. With that in mind, practicing "spine hygiene" with common postures and activities of daily living can reduce the amount of flexion imposed on your low back, thereby keeping it relatively neutral, which in turn minimizes unwanted symptoms.

Changing how we move and rest, with the goal of sparing the low back, can be challenging as our current methods of doing things and moving our bodies are well rooted. However, with increased attention and regular practice new habits and patterns of motion can be adopted. Starting with sitting, affectionately referred to as "the new smoking", many of us have a tendency to slouch, especially with prolonged time in this position. The fact that we often sit on soft, minimally supportive couches or recliners doesn't help as they encourage sagging of the spine into a rounded position. I often suggest to put a small pillow or rolled up towel behind the lower back to help support and maintain the neutral curve. Better yet, and particularly if you're in significant discomfort, sitting on a more firm piece of furniture such as a dining chair can offer more relief. Move one into your living room if you must to discourage use of the alternatives. You want to sit as far back as possible though as not having your behind against the back of the chair encourages more slouching. The same advice can be applied to sitting while driving and sitting at work, which most of us do much of daily. Use that pillow, towel, or rolled up sweater for that matter, to support the low back curve if your vehicle seat or desk chair doesn't offer enough lumbar support intrinsically. Adjusting the back rest to a more upright, vertical position can also help you achieve the goal of a more neutral spine position. Variable, adjustable height workstations have become increasingly popular and the options out there are numerous. Thankfully, the cost of some are quite reasonable, well worth the value it could add to managing low back pain. Not that standing all the time is the answer, but having the flexibility to alternate body positions regularly changes how we stress our spines and disperses the accumulating stresses that occur if only a singular posture is used.

Standing with poor posture, where the shoulders are rounded forward and the head is drooped, is commonly observed in those with or without low back pain. Once again, this encourages mild spine flexion while also increasing muscle activity in our low back extensor muscles. This adds more compression to our spinal tissues which doesn't help when things are already sensitive. Instead, roll the shoulders back and lift your rib cage to position your upper body more over your hips. Interlacing your hands behind your low back while standing helps to maintain this posture if prolonged standing is needed, and is also preferable to standing with your arms crossed, which also increases demand on the back muscles.

Sitting and standing are two major culprits, but there are many other things to consider to practice good spine hygiene while performing the multitude of our daily tasks. More to come.

This article is for general information purposes only and is not to be taken as professional medical advice

Bending Forward - A Common Factor In Persisting Low Back Pain

By Dr. R. Greg Lusk, DC

In my last article in January, I discussed the value of applying a "functional" diagnosis to a complaint such as low back pain. To refresh, it is the process of identifying movements and/or activities (i.e. functions) that produce or aggravate symptoms, as well as those that may reduce or even abolish symptoms. Aiming for this better understanding of factors that influence pain offers great value to patients, beyond the anatomical diagnosis, as they can independently modify behaviour and movement to modulate pain, in addition to the traditional approach of receiving a form of treatment to manage and/or mask the symptom of pain.

With respect to neck or low back pain, flexion (i.e. bending forward) is by far the most common direction which produces, aggravates, and perpetuates pain. This is not surprising as most of us have a posture that tends toward slouching versus sitting straight up and many of our activities of daily living involve spine flexion - sitting, driving, computer use, looking down at our phones, washing dishes, putting on socks, etc. Conversely, how many things do you do throughout the day or how much time do you spend in positions that involve bending your spine backward or extending your neck to look up? Not many and not much would be my guesses. If you consider that most clients that present to my office with neck or back pain also report no trauma or specific mechanism resulting in their pain, this points to a more repetitive, cumulative, or sustained source of strain as the culprit.

Ironically, although spine flexion can be implicated as a functional source of pain in many cases, patients will often describe prior relief efforts that have been largely flexion based. For example, for low back pain, I often hear people tell me that they've been bending forward or lying on their back and pulling their knees up to their chest, to stretch the "tightness" in their back. I understand the reasoning that led to this as those positions would stretch the muscles of the back by lengthening them as you bend away. However, other than a temporary sense of relief that is achieved by stretching the tissues, there is often no prolonged benefit noted. Similarly, many patients will report that resting in a recliner-style chair with their legs up is comfortable....until they go to stand up. The common denominator - the low back gets rounded forward in all of these positions and flexion stress can accumulate. I've heard Dr. Stuart McGill, a world-renowned spine researcher, comment previously that if spine flexion is what someone needed to get better then their daily life would simply make them better due to the volume of spine flexion done daily. There is wisdom there that demands considering a different approach.

Practicing "spine hygiene" is a valuable part of that strategy as it involves sparing the spine from aggravating loading patterns, by modifying how we move while bending, rising from a seated or lying position, brushing our teeth, etc. A future article will address these things in more detail so stay tuned. While flexion is commonly not well tolerated, I do want to stress that it isn't bad 100% of the time and will happen naturally during many activities. Sometimes we just do too much of it which results in degenerative changes over time and a sensitization to biomechanical forces in that direction. By limiting this sort of functional intolerance often a longer duration of pain relief can be achieved.

This article is for general information purposes only and is not to be taken as professional medical advice.