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Ask an Expert: Chronic Back Pain and Sleep with Dr. Breana Prince
Did you know that an estimated 80% of Americans will experience back problems at some point in their lives? Now consider that 37% of those same people report difficulty sleeping because of their back pain, and 54% of people who suffer from low back pain spend the majority of their working day sitting at a desk.

Simply put, most of us are likely to have sudden or chronic back pain get in the way of a good night’s sleep at some point in our lives. Most cases of back pain require some medical intervention to alleviate — but what many sufferers don’t know is how their mattress could be contributing to the severity and length of their pain.

To get to the root of the issue, we caught up with a bonafide expert on back pain: Dr. Breana Prince of Limitless Physical Therapy in Phoenix, Arizona. She shared with us a few secrets, tips and tricks for back pain sufferers to fast-track your recovery and get a great night’s sleep.

Let’s start with the basics. In your experience, what is often the root cause of chronic back pain?
The very first thing that comes to mind is long-term malpositioning, which is just a fancy way of saying that many of us are staying in the wrong position for too long. A good example of this is sitting at a desk for many hours in a day. This immobility causes extraordinary stress on our mid and lower backs, and is linked to the highest incidence of pain in these areas.

Of course, there are many of other causes like improper lifting of heavy objects or athletic injury — but in my experience, the primary cause often comes back to the sedentary lifestyles that most Americans lead.

If someone is not currently experiencing back pain but works a desk job, what advice do you have for them to avoid issues down the line?
Our bodies are made to move, so my first advice would be to build in at least 120 minutes of light to moderate exercise per week. Ideally this should happen intermittently throughout the day, so even standing up and going for a walk a few times a day can help alleviate some sources of chronic pain and discomfort.

Let’s say someone is already experiencing back pain. What is their best course of treatment?
The first step would be to contact a qualified professional like a physical therapist to identify and treat the issue early on. That’s because people who have chronic pain that goes untreated will almost invariably develop secondary issues like compromised digestion, neck and joint pain and even decreased cognition caused by lack of exercise.

While the protocol used to be old fashioned R&R, new research shows that reintroduction of exercise and movement is more beneficial than more conservative medical management like ice, pain relievers and rest.

The best practice today is changing up how you’re using your body on a day-to-day basis. When you visit a physical therapist, you can re-learn how to move your body comfortably and start to build in exercises and movements that will ultimately help your body to heal and recover sustainably.

In your opinion, can a bad mattress cause back pain?
Let’s say someone already has issues with back pain. They could be receiving treatment with a physical therapist and go to sleep every night feeling just fine, only to wake up in the mornings with stiffness and pain. With that kind of situation, it very often has something to do with the mattress.

That’s because when you sleep, you’re in the same position for 6 to 8 hours — and if the position you’re in is causing extra stress on particular parts of your body, or you can’t get comfortable and end up tossing and turning, that can lead to lots of issues. That happens when your bed is the right type, the wrong fit or sometimes even because of low quality materials.

If your bed is causing the wrong force translation (i.e. uneven force throughout your body), it’ll cause more pressure on the wrong places. So let’s say you have a very firm mattress — so firm that it’s basically like sleeping on the floor on your side. That means it’s not giving you any off-weighting and has no give in the surface, which puts a whole lot of that pressure on your hips and knees. Ouch.

Now if you have a little more give, your bigger load-bearing joints won’t have as much pressure pushing on them — that’s really because you have both gravity pushing your body down on the mattress as well as the force of the mattress pushing up on your body.

Because you experience these two opposing forces, it’s really important to choose the right mattress firmness — selecting a level that will help you avoid chronic pain. I have had patients who were experiencing no pain go out and buy a new mattress that isn’t right for them — and suddenly experience increased pain in certain areas.

Why exactly do poorly fitted mattresses cause so much pain?
If you’re in a weird position and your body isn’t in a neutral alignment, your joints aren’t stacking up correctly. This creates an unequal force on your joints and muscles; because your body is a mirror image of itself, you want to have as equal as possible.

Since most pain comes from asymmetry, sleeping in a way that’s causing muscles on one side of your body to be tighter than the other creates an unequal translation of force — which, more often than not, equals pain.

For people that do have back issues and pain, what is your advice for choosing the right sleep setup?
If you are prone to back pain and injury, make sure you look for a mattress with a good complement of firmness and softness. It’s always a good idea to find a bed that provides you with the right support but with enough contouring so you can get comfortable more easily.

Adjustable bases are also a great choice for people who have long diagnoses of pain, especially if you need extra help with swelling or are currently going through any rehabilitation for past injuries or surgeries.

My last piece of advice for anyone would be to do a bit of light stretching right before you go to sleep. There’s new research that shows doing a light stretching routine right before getting into bed means you’ll move around less both while you doze off and during sleep, which can help reduce misalignment and pain.

Limitless Physical Therapy is based in Phoenix, Arizona, just a stone’s throw from Brooklyn Bedding’s state-of-the-art factory.