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Say Goodbye to Back Pain: Selecting the Perfect Mattress

What is the recommended way to choose a mattress for individuals with back pain?

Back Pain Mattress

When choosing a back pain mattress, one size does not fit all in selecting one for those with spine pain. Several other factors play a role, as well. However, whether a firm or soft mattress is the best option for individuals whose back pain keeps them up at night, most health experts say the choice is yours and that the mattress that makes you feel most comfortable is likely the best option. The research says that medium firmness seems to provide the most painless sleep. A review gathered information from 24 controlled trials where participants used soft, medium-firm, firm, or custom-inflated mattresses. The results showed that medium-firm and self-adjusted mattresses were best for sleep comfort, quality, and spinal alignment. (Radwan A. et al., 2015)

Medical Status

Selecting the back pain mattress best suited to your spinal condition is more than just how hard or soft the mattress is. Individuals and their healthcare providers should thoroughly review their medical history to tailor the mattress to their needs. Before purchasing a mattress, check the following:

  • Age
  • Medical history
  • Injuries current and past
  • Current diagnosis or diagnoses
  • Disease and/or Conditions
  • Sleeping preferences

For example, symptoms of spinal stenosis tend to present themselves when one is standing and walking but not when lying down. For this reason, mattress firmness is not a big issue only for people with spinal stenosis. However, it must be taken into consideration for those who have degeneration along with spinal stenosis.

Individuals with spinal arthritis without stenosis, disc problems, or non-specific back pain need to consider the relative firmness or softness of the back pain mattress. People with these conditions do better with more support, i.e., a firmer mattress. While everyone needs some back support when they sleep, those who have undergone multiple back surgeries often need less. The tissues have been altered and may be stiffer after several surgeries. In this case, a softer mattress may be more suitable and comfortable.

Mattress Age

Mattress springs break down over time, which makes the bed softer. This can aggravate the spine and back muscles. Based on this, investing in a new mattress makes sense, or pain and stiffness can worsen with the current one. While this will vary among individuals, medical research may help shed some light: A study measured the comfort and quality of sleep for 27 participants with low back pain and stiffness. The participants recorded their sleep comfort and quality in their beds for 21 days and then with a new prescribed mattress and bedding system, which they used for 12 weeks. The study found that the participants showed significant and progressive improvement in back pain and stiffness on the new mattresses and improved sleep quality significantly. (Jacobson B. H. et al., 2010)

Sleeping Position

The position usually slept in makes a difference in the support needed for the back pain mattress. Some recommendations for back sleepers, side and fetal position sleepers, and stomach sleepers:

Side Sleepers

  • Most people are side sleepers.
  • They sleep in the fetal position with their knees drawn up toward their chest.
  • This position tends to place pressure on the hips and shoulders.
  • For side and fetal sleepers, a slightly softer mattress is recommended.
  • The foam the mattress is made of conforms to the body, especially in the thoracic and lumbar regions of the spine.

Stomach Sleepers

  • For the stomach sleeper, soft mattresses can irritate the back.
  • A soft mattress encourages the abdomen to sink into the bed.
  • The resulting position is known to increase the arch in the lower back and cause pain.
  • A medium-firm surface is good for stomach sleepers.
  • The idea is to derive support from the chosen mattress without the abdominal sinking.
  • The sinking effect is amplified if you have a large abdomen.
  • For thin individuals, sinking may not be as much of an issue.

Back Sleepers

  • For support, place a thin, rolled towel or pillow under the knees and lower back of those who sleep on their backs.
  • A pillow/s under these areas will help support them and provide more comfort.

Researchers divided the participants according to their usual sleep position. They were assigned to a medium-firm mattress with foam and latex layering based on their preferred sleep position. The participants rated their sleep comfort and quality daily for three months. The researchers found that the new mattresses improved back pain and stiffness. For this reason, they concluded that sleep surfaces relate to sleep discomfort and that replacing a mattress with one uniquely suitable to your spinal condition can reduce and relieve pain. (Jacobson B. H. et al., 2010)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right back pain mattress ultimately comes down to personal preference. Individuals should try various mattresses and see which one they like best. Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Chiropractic Care Can Transform Pain Into Relief


References

Radwan, A., Fess, P., James, D., Murphy, J., Myers, J., Rooney, M., Taylor, J., & Torii, A. (2015). Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep health, 1(4), 257–267. https://doi.org/10.1016/j.sleh.2015.08.001

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. https://doi.org/10.1016/j.apergo.2010.05.004

Improve Your Health with Bed Pilates: Try These Adapted Exercises

Can Pilates exercise movements be performed in bed for individuals recovering from illness or injury?

Bed Pilates

Pilates exercises can be practiced in bed. Joseph Pilates’ exercises and equipment, such as his patented V-shape bed, were designed to help rehabilitate injured individuals who had to stay on or near a bed. After a healthy night’s sleep, Pilates exercises dynamically stimulate circulation and the nervous system. They can also be used to calm the mind and body before going to bed.

  • Those with health concerns should check with their healthcare provider before starting any exercise program to ensure safety.
  • Beginners are recommended to learn the Pilates principles and movement fundamentals.

Here are a few Pilates mat exercises adapted for individuals who need or prefer to exercise in bed. A firm mattress is recommended, as a soft mattress will mess up the correct form, making the exercise ineffective.

Spine Twist

This exercise helps improve the flexibility of the spine and core, making it easier to move around, and supports healthy posture. (Geremia J. M. et al., 2015) Pilates exercises like the spine twist have been found to reduce low back pain and disability. (Notarnicola A. et al., 2014) To perform:

  • Sit up in bed, torso straight, abs engaged, and inhale.
  • Exhale as you turn your head and shoulders to the right.
  • Keep your torso straight, and imagine growing taller through the turn.
  • Inhale as you return to the starting position.
  • Exhale and turn to the other side.
  • Repeat five times on each side.

Tendon Stretch

The tendon stretch helps by improving flexibility in the hamstrings and calves. (Chinnavan E., Gopaladhas S., & Kaikondan P. 2015) To perform:

  • Sit up straight, legs straight out.
  • Bring heels together and use a towel to pull your feet towards you while pushing your heels away.
  • Hold for three seconds.
  • Next, without the towel, point your toes away.
  • Hold for another three seconds.
  • Do ten reps.

Double-Leg Stretch

The double-leg stretch is an intermediate exercise that works the abdominals and the core. If this move feels difficult, start with one leg at a time. Another option is to keep the knees slightly bent instead of extending the legs fully. To perform:

  • Bring both knees to your chest and, with your hands, press down on the ankles to stretch the lower back.
  • Pull in the abdomen.
  • Exhale and extend the arms up and the leg or legs as far out in front as possible.
  • Hold the position for ten seconds and then release.
  • Do ten reps.

Pelvic Curl

The pelvic curl builds strength in the lower back and core. To perform:

  • Bend knees and place feet on the bed hip-distance apart.
  • Curl your pelvis, squeeze the glutes, and lift your body.
  • Hold for five seconds.
  • Slowly count five seconds while lowering back down, imprinting the spine into the mattress.
  • Do ten reps.

Hip-Opening Exercise

A hip-opening exercise, or frog, can be done while lying down or sitting in bed. Hip openers help keep the spine and hips flexible and in alignment. To perform:

  • Bring the soles of your feet together and as close to the torso as possible.
  • Let the knees open up as far as possible, and that feels comfortable.
  • While in the stretch, breathe in and out as deep as possible.
  • If sitting, place hands on ankles and use forearms to push down on the knees for added stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Home Exercises for Pain Relief


References

Geremia, J. M., Iskiewicz, M. M., Marschner, R. A., Lehnen, T. E., & Lehnen, A. M. (2015). Effect of a physical training program using the Pilates method on flexibility in elderly subjects. Age (Dordrecht, Netherlands), 37(6), 119. https://doi.org/10.1007/s11357-015-9856-z

Notarnicola, A., Fischetti, F., Maccagnano, G., Comes, R., Tafuri, S., & Moretti, B. (2014). Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study. European journal of physical and rehabilitation medicine, 50(1), 59–66.

Chinnavan, E., Gopaladhas, S., & Kaikondan, P. (2015). Effectiveness of pilates training in improving hamstring flexibility of football players. Bangladesh Journal of Medical Science, 14(3), 265–269. https://doi.org/10.3329/bjms.v14i3.16322

Understanding Heartburn: Waking Up to Discomfort

Individuals who wake up with a burning feeling in the chest or throat, along with a bitter taste, more than likely are experiencing morning or waking heartburn. Can simple steps, like not having any food three hours before going to bed, help prevent heartburn when waking up?

Waking Up With Heartburn

Heartburn is characterized by a burning sensation in the chest and neck and an acidic, bitter taste. It occurs when stomach acid flows into the esophagus tube that connects the throat to the stomach and often happens when lying down. Heartburn is a symptom of acid reflux, a digestive disorder that occurs when the stomach contents back up into the esophagus. Waking up with heartburn throughout the night or when waking in the morning is common during pregnancy and after drinking alcohol. (UCSF Health, 2024) But chronic acid reflux can also be a sign of a health condition like gastroesophageal reflux disease (GERD) and hiatal hernia, or another condition may cause it and can be triggered by stress, certain foods, and other factors.

Causes

Having occasional heartburn is normal. However, frequently waking up with heartburn may indicate gastroesophageal reflux disease (GERD). Other possible causes of this condition and factors that may contribute to frequently waking up with heartburn include: (National Library of Medicine, 2023)

  • Increased stress
  • Wearing belts or clothes that are tight around the waist.
  • Medications include sedatives, bronchodilators, beta-blockers, calcium channel blockers, and tricyclic antidepressants.
  • Pregnancy
  • Hiatal hernia – the top area of the stomach pushes through an opening in the diaphragm.

Sleeping and Heartburn

Research shows a relationship between sleep disorders like insomnia and an increased risk of acid reflux (Qin S. et al., 2023). A study of over 6,000 people found that those who woke up less often during the night were 50% less likely to experience heartburn than those with disrupted sleep.

Symptoms

Symptoms can include: (Johns Hopkins Medicine, 2024)

  • A burning sensation in the chest that can last from minutes to hours
  • Pain in the chest when lying down or bending
  • Burning sensation in the throat
  • A hot, acidic, and/or salty sour taste in the back of the throat

Along with these symptoms, individuals who have GERD may also experience: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chronic cough or hoarseness
  • Pain and difficulty swallowing
  • Nausea
  • Chest pain

When symptoms are constant, it’s important to see a healthcare provider.

See a Healthcare Provider

If heartburn persists long-term, it can lead to inflammation, breathing problems, and narrowing of the esophagus. Seeing a healthcare provider is recommended if lifestyle adjustments don’t help or symptoms continue despite taking over-the-counter antacids. Other symptoms that need professional diagnosis include: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chest pain or difficulty breathing, like wheezing or hoarseness
  • Loss of appetite, nausea, vomiting
  • Unexpected weight loss
  • Difficulty swallowing
  • Signs of blood in the digestive tract or stool

Tell a healthcare provider when and how you are experiencing symptoms. It may be helpful to keep a journal of frequency, specific symptoms, times when waking up with heartburn, what foods and the time of day when eating, and any other information.

Heart Attack Symptoms

Heartburn can feel like the chest pain associated with a heart attack. See a healthcare provider if you’re unsure if your heart or digestive system is causing the discomfort. Seek emergency medical attention if you have any of the following (American Heart Association, 2022)

  • Squeezing pressure, fullness, or pain in the center of the chest that lasts several minutes or stops and returns
  • Shortness of breath with or without chest pain
  • Pain in either or both arms, the back, neck, jaw, or abdomen
  • Other signs include lightheadedness, nausea, and breaking out in a cold sweat 

Diagnosis

A healthcare provider can diagnose heartburn and related conditions based on the following (UCSF Health, 2024)

  • Discussing symptoms
  • X-rays, or imaging tests, that look at the esophagus, stomach, and small intestine
  • An esophageal pH monitoring test that checks how often and how long stomach acid stays in the esophagus
  • An upper endoscopy procedure where a small tube with a camera is inserted down the mouth to examine the esophagus and stomach

Prevention

Making a few lifestyle changes can reduce waking up with heartburn (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Elevate body when sleeping
  • Stop eating at least three hours before going to bed
  • Lose weight
  • Avoid spicy, high-fat, and acidic foods
  • Limit coffee and other forms of caffeine
  • Avoid carbonated drinks and alcoholic beverages

Staying hydrated helps with overall digestion. However, drinking too much water at once can make heartburn worse. Drinking small amounts throughout the day and avoiding sparkling water is recommended since carbonated drinks can trigger heartburn. (Harvard Health Publishing, 2023)

Treatment

There are various over-the-counter and prescription medications for heartburn. (National Institute of Diabetes and Digestive and Kidney Disease, 2020) Be sure to discuss the risks and benefits of the medicines with your healthcare provider. Heartburn treatments include:

Antacids

  • These oral over-the-counter medications help relieve symptoms of mild heartburn and GERD.
  • They should not be used daily or for severe symptoms as they can cause side effects like diarrhea or constipation.

H2 Blockers

  • Histamine-2 receptor antagonists – These medications reduce the stomach’s acid to help promote healing in the esophagus.
  • H2 blockers are available over-the-counter and by prescription.

Proton Pump Inhibitors (PPIs)

  • These medications, available over-the-counter and by prescription, reduce acid and help heal the esophageal lining in individuals with GERD.
  • They are often used for long-term treatment.

If medication and lifestyle changes don’t help, a healthcare provider may recommend surgery to strengthen the valve between the esophagus and stomach. (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

Injury Medical Chiropractic and Functional Medicine Clinic

Lifestyle and dietary changes, as well as medications, may be used to treat the condition. See a healthcare provider if your heartburn is persistent or accompanied by other symptoms. A healthcare provider can determine the most effective treatment strategies. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Functional Medicine’s Influence Beyond Joints


References

UCSF Health.(2024). Heartburn. https://www.ucsfhealth.org/conditions/heartburn

National Library of Medicine. (2023). Heartburn. Retrieved from https://medlineplus.gov/ency/article/003114.htm

Qin, S., Wang, C., Wang, X., Wu, W., & Liu, C. (2023). Causal association of gastroesophageal reflux disease with obstructive sleep apnea and sleep-related phenotypes: a bidirectional two-sample Mendelian randomization study. Frontiers in neurology, 14, 1283286. https://doi.org/10.3389/fneur.2023.1283286

Johns Hopkins Medicine. (2024). Gastroesophageal Reflux Disease (GERD). https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroesophageal-reflux-disease-gerd

National Institute of Diabetes and Digestive and Kidney Disease. (2020). Symptoms and causes of GER & GERD. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes

American Heart Association. (2022). American Heart Association. Heartburn or Heart Attack? https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack

Harvard Health Publishing. (2023). 9 at-home treatments for acid reflux. https://www.health.harvard.edu/newsletter_article/9-ways-to-relieve-acid-reflux-without-medication