The question today is: “why do I get a sore back in bed?” If you’ve read a few of my blogs, you’ll know that I rarely have a straight answer to anything. So there are a number of possible reasons for getting a sore back in bed.

Before we dive into it, the first thing I’m going to encourage you to consider is the significance of the pain in the first place. Now, you’re reading this, and that suggests that you are concerned about the pain, and so you should be! Because pain is, remember, -I’ve blogged about this before- its biological function is a warning system. So if you are getting pain in bed, pay attention and try to establish which of the following reasons could be contributing factors and do something about it.

So remember, pain is there for a reason: investigate the cause and do something about it. Don’t just cover it with painkillers, which is essentially like swaddling your alarm bell in cotton wool, rather than investigating the underlying cause.

Then why do I get a sore back in bed? The first thing to consider is your position and how long have you been in one position. So the longer you stay in one position, there are a couple of things that happen. One of them is called “sustained loading”. If you stay in a position for a long period of time, you are maintaining a load in a particular way, whether that be sitting, or in this case, lying in bed. So if you’re staying on your side for a long time, you’re loading your tissues, whether that be muscles, tendons, discs and so on, and in a particular way. Yes, you’re off weight-bearing, and that should be easier for many back problems, but gravity is still having an effect on you, 

and so staying in one position for prolonged periods the tissues will slowly fatigue and slowly start to creep apart and stretch. And that’s one reason: the longer you that stay in one position, the more likely that you are to be in pain.

The second reason is that if your back is inflamed for any reason – and there are all sorts of problems that can cause tissues to become inflamed – the longer you stay still for, the more that that inflammation builds up, and the more painful it’ll become as a consequence. That’s why many people have more pain first thing in the morning, because they’ve been lying still for a prolonged period, and their inflammation increases.

Again, how long you’ve been staying in one position can be relevant, particularly if you have a disc problem, a disc herniation or bulge. When you are off weight-bearing, so when you’re lying down in bed, the disc absorbs fluid overnight. Therefore, if there is a bulge in it the bulge gets bigger the longer you are off weight-bearing for. So often disc bulges are worse the longer you stay still in bed. Duration is a big factor, and how do you get around that? Well, move around more frequently … I guess your pain may wake you up, and that’s time to move, but ideally move before it becomes more painful. So duration is a factor.

The other factor is the actual positions that you adopt. Some positions will load your tissues in your back in a way that they don’t like; other positions your back may be more comfortable with. Again, listen to the pain, so if you’re lying on your back and it is painful to do so, then it’s probably best to change position. Try lying on your side!

So I’d always be guided by pain itself, in terms of choosing which position is best for you, but beyond that, my observation would be that typically lying on your front isn’t a great long-term plan –and I’ve blogged about that particular topic before, so I’m not going to go into it in depth into that topic here, but yes, lying on your front is not a sustainable strategy, so best to avoid it. In the short term, if you are most comfortable, or feel the least amount of pain, when lying on your front, then that is your position, but typically, some problems are worse if you lie side-wise, or are worse lying on your back or on your front; so the position you’re in is relevant, and it’s definitely worth consideration.

Sometimes, if you have pain on one side of your lower back, particularly if that pain is travelling down your leg, you may find that lying on the opposite side helps.  So, for example, the pain is in your left leg, and you have sciatic radiation; lie on your right side, and bring your right knee up and straighten your left leg down, so that you’re effectively bending to one side. You can accentuate that by putting a rolled up towel or pillow under your waist so that it creates a fulcrum and you arch over that fulcrum and it takes some of the pressure off. For lots of people, that side-lying with one leg on top of the other leg straightened down helps, but if it doesn’t help you or it makes it more sore, then it’s not for you! The position is very relevant.

Of course, the other factor is your bed: the nature of the support that it provides you with, so both the bed itself, and of course, the mattress in particular. Again, I’m not going to go into great detail here because I have another blog post in which I talk a lot about mattresses and how to select the right one for you, but when it comes to pain, if you have a mattress that you have less pain lying on then that’s the mattress for you. Listen to the pain!

If it’s worse on one mattress than another, then avoid the bad mattress, and maybe it may be a good mattress for someone else, but it may just not be good for you.

So coming back to review “why do I get a sore back in bed?”; it’s more likely the longer you stay still for, that could have to do with the building up of inflammation, it could be constant and sustained loading on a tissue, the longer you stay still for, the position that you’re in is relevant, and the mattress that you’re on is relevant. And of course, the ultimate reason that you get a sore back in bed is that pain is telling you something is not right about your back, so investigate it.

If you’d like any help investigating your back problem, don’t hesitate to get in touch. You can reach me at the clinic or on our site and can book online here, either for an in-person or Skype consultation.

Thank you.