body-pillowBack pain, like insomnia, has been a rival of mine for decades. My mild scoliosis didn’t bother me much in my teenage years. But by adulthood, low back pain was an intermittent feature of my life. It got harder and harder to find a comfortable position for sleep.

The fabulous stomach sleep-a-thons I remember during adolescence, when I awoke hugging my pillow, were the first thing that had to go. Then I had to give up sleeping on my back. (But while sleeping, I’d sometimes flip to my back and wake up to a backache). Finally there was nothing to do except sleep on my side curled up in fetal position. But even this was no guarantee of a pain-free night.

A Relationship between Insomnia and Back Pain

Research now shows that back pain and insomnia go hand in hand. Two studies published just this year, one conducted in Morocco and the other in the UK, show the prevalence of moderate to severe insomnia in people with back pain is 44 to 47 percent—quite a bit higher than the prevalence of chronic insomnia in the general population.

Insomnia, in turn, increases sensitivity to pain. In a recent study in the European Journal of Pain, insomnia subjects had lower pain thresholds than healthy control subjects and less ability to inhibit pain. It looks like back pain increases the risk of insomnia, which can then make back pain worse.

Steering Clear of Pain

By trial and error I found ways to hold the pain at bay. The rules I now live by at night are simple:

  • Never sleep on a too-soft mattress. If friends offer me a bed with a soft mattress, I ask to sleep on the sofa instead. Never take a hotel room without first checking the mattress.
  • Avoid hard mattresses as well. Inflatable camping mattresses spell doom.
  • Use a pillow that provides just enough support so the spinal cord feels straight. When a pillow loses its loft, get a new one.

But following the rules and making other adaptations didn’t allay my back pain completely. Frequent low-level pain was something I resigned myself to, thinking I had no other choice.

An Accident with a Silver Lining

Then last year I tried rollerblading with an 8-year-old friend, and I fell and broke my wrist. The pain was so bad I passed out. But it was short-lived compared to the shoulder pain I developed from wearing a heavy cast, which forced me to sleep on my back—and then my back pain returned with a vengeance. I was a mess!

Fortunately I got a referral to a good physical therapist. First, she dealt with my shoulder pain. Then she started on my back. She had me lie on my right side in the same position I use for sleeping.

“That’s not quite right,” she said. “Can’t you feel the torque in your spine? Try propping your left leg up on a pillow,” she said, sliding a pillow under my knee. “Doesn’t that feel better?”

It DID feel better—a whole lot better. In fact, propping my knee up on a pillow night after night led to months and months of pain-free living, and also probably helped to consolidate my sleep. Who knew such a simple change could have such a profound effect?

Have any small changes you’ve made led to marked improvements in your sleep or your sense of wellbeing? Please share for all to see.

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.

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