Back pain can be a hindrance in daily life, but experiencing pain while lying flat on your back can be particularly frustrating, especially when trying to get a good night’s sleep.
In this article, we will discuss the possible reasons behind back pain when lying flat, and suggest some helpful exercises and tips to alleviate the discomfort.
Why Does Back Pain Occur When Lying Down?
It’s natural to assume that lying down would be the most comfortable position for your back since there’s decreased pressure from gravity compressing your spine, nerve roots, and discs[1]Mitchell T, O’Sullivan PB, Burnett AF, Straker L, Smith A. Regional differences in lumbar spinal posture and the influence of low back pain. BMC Musculoskeletal Disorders. 2008 Dec;9(1):1-1..
However, even when lying down, some individuals still experience pain.
The primary reason for this discomfort is the arch in your back. If you have a significant arch in your back while lying down, it can jam the spinal joints together and press on nerve roots[2]Kripa S, Kaur H. Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy. 2021 Dec;26:1-4..
This issue is especially common in people with tight back extensor muscles or tight hip flexor muscles.
Possible Causes of Back Pain While Lying Flat:
- Chronic Behavioral Patterns: The way we move, sit, and walk throughout the day can lead to chronic patterns that our body perceives as safe. However, when we lie down on our back, our body might feel unsupported, leading to discomfort and pain.
- Anterior Pelvic Tilt: An anterior pelvic tilt occurs when the hip bones tip forward, causing the lower back to arch. If you have a habit of standing or walking with an anterior pelvic tilt, your body may seek this position even when lying down, leading to increased tension and pressure in the lower back.
- Posterior Pelvic Tilt While Sitting: If you spend a significant portion of your day sitting, your body may associate a posterior or neutral pelvic tilt with hip flexion. When you lie down with your legs extended, your body might revert to an anterior pelvic tilt, causing discomfort.
Tips and Exercises for Alleviating Back Pain
- Diaphragmatic Breathing: Focus on slow, deep breaths to activate the parasympathetic nervous system and help your body relax. Inhale through your nose and exhale through your mouth to promote relaxation and alleviate tension in the back muscles.
- Adjust Your Sleeping Position: If your hip flexor muscles or spinal extensor muscles are tight, lying flat on your back can cause discomfort. To alleviate this, place a pillow (or two) under your knees, depending on the severity of your arch. This adjustment will allow you to maintain a more neutral and comfortable position for your back.
- Pelvic Awareness Exercises: Incorporate pelvic tilts, bridges, and hip hinge exercises into your daily routine to improve awareness of pelvic positioning. This can help retrain your body’s posture and promote a better balance between anterior and posterior pelvic tilts.
- Stretch and Mobilize Your Hips: To counteract the effects of prolonged sitting, incorporate hip extension exercises and stretches into your day. This can help improve hip mobility and make it easier for your body to find a comfortable position while lying down.
- Deep Core Activation: Focusing on the relationship between the diaphragm, pelvic floor, transverse abdominis, and multifidi muscles can help you find balance and a neutral pelvic position. This can lead to improved core stability and reduced back pain when lying flat.
Conclusion:
Understanding the root causes of back pain when lying flat is essential to finding relief. By incorporating targeted exercises, breathwork, and adjustments to your sleeping position, you can alleviate discomfort and improve your overall well-being.
Remember that progress takes time and patience, so be gentle with yourself as you work towards a pain-free lying position.
MD. Physiatrist at University of São Paulo
References
| ↑1 | Mitchell T, O’Sullivan PB, Burnett AF, Straker L, Smith A. Regional differences in lumbar spinal posture and the influence of low back pain. BMC Musculoskeletal Disorders. 2008 Dec;9(1):1-1. |
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| ↑2 | Kripa S, Kaur H. Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy. 2021 Dec;26:1-4. |