Chronic pain of any kind typically disrupts your sleep, and that’s true of back pain for most people. It’s common to try multiple sleeping positions. For many people, no matter what they do, they often find they must change position in bed or get up and move around multiple times a night. Once they’ve actually had lumbar spine surgery, the sleeping position may still be an issue for a while.
About Lower Back Pain
Many people suffer from lower back pain in their lives and in some cases, the pain becomes chronic. However, back pain alone is not sufficient reason for surgery, even something as “minor” as a microdiscectomy. Most doctors will first recommend conservative therapy such as weight loss, regular exercise and physical therapy to strengthen core muscles. Physical therapists can also teach you how to move your body to correct posture problems and prevent additional strain on the lower back. Surgery is likely to be recommended when there is pressure on the nerve that causes weakness or numbness in the legs, or bowel or bladder problems.
What Surgery Can Accomplish
The purpose of most back surgeries is to decompress or relieve pressure on the nerves that run off the spinal cord, or to decompress the spinal cord itself. In addition, a back surgery may include a bone graft (called a spinal fusion) to stabilize the spine and prevent further degeneration. Spinal stenosis surgery is aimed at making more room for the spinal cord, which again helps relieve pressure. A herniated disc (the spongy cartilage between the individual spine bones) can be trimmed or completely removed to decrease pressure on the spinal cord.
The Immediate Postoperative Period
Immediately after surgery, you’re likely to be positioned on your back. There are several reasons for this:
- Some bleeding in the incisional area is normal; sleeping on the back puts pressure on the surgical area and helps slow bleeding.
- You will have an intravenous line and may have other equipment like a surgical wound drain or a urinary catheter that function better when you lie in that position.
- It is easier for the nurses (and more comfortable for you) to elevate your head to eat and drink or for breathing treatments.
- Lying on the back offers the best spine support.
Sleeping on the Back
After the immediate postoperative recovery, many patients who have had spine surgery prefer to continue sleeping on their backs. If so, the best position is to lie face up on the bed with the head slightly elevated. This is easy to do in an adjustable bed, but the position can also be achieved in a regular bed with supportive pillows. In addition, it is best to place a pillow or rolled blanket under the knees, so the hips and knees are slightly bent. This helps relieve stress on the spine. A firm mattress is a requirement for anyone with back problems, as it will provide better spine support. The best arm position is at the sides.
Sleeping on the Side
Some people prefer to sleep on their sides after back surgery, and that is usually acceptable after the immediate postoperative period. Again, a firm mattress is recommended for good support. In addition, side sleepers usually do better with a pillow between the knees. This helps keep the spine in good alignment even when asleep. When turning over, a side sleeper should “log-roll” from side to side to prevent stressing the spinal column. Pillows against the back to prevent turning may be a good idea.
Sleeping on the Stomach
Sleeping on the stomach is definitely not recommended for someone who has chronic back pain or who is recovering from surgery. This position puts an arch in the lower back, which is stressful for the spine and much more likely to cause increased pain. However, once the recovery period is over, if this is the only position in which you can sleep, place a pillow under the pelvis/hip area and another flatter pillow under the chest. The pillows will help reduce pressure on your lower back. Again, while this is not recommended, adequate sleep is so important to someone who has back pain that the need for sleep may be more important than the position.
Sleep is vital to your overall health and the management of your back pain. Making sure you get enough sleep means taking extra care with your sleeping position, especially after surgery. You should also follow the basics of sleep hygiene. These include sleeping in a cool, dark room; avoiding caffeine, nicotine and alcohol; and turning off electronic devices and the TV at least two hours before bedtime. You’ll have a much better night’s sleep with these strategies.