Which position puts the greatest pressure on the discs in your lower back?

A herniated disc can make going about your everyday life extremely painful. Here are some tips to help you get relief. 

If you’ve been diagnosed with a herniated disc, your first question to your orthopedic specialist will likely be, “How can I reduce the pain?” Things you once took for granted like sitting at a desk and getting a good night’s sleep now seem more challenging or entirely out of reach. 

A herniated disc is a common orthopedic injury, but it can be very disruptive to living a full and active life. It occurs when one of the gel-filled discs that acts as a shock absorber between the vertebrae in the spine ruptures or slips out of place. The damaged disc then irritates the nearby nerves, causing uncomfortable and painful symptoms. 

Fortunately, herniated discs often respond well to physical therapy and pain medication and rarely require surgery. As part of your recovery, your physical therapist will show you the best ways to sit and sleep in order to reduce the pain.

How to Sit and Sleep With a Herniated Disc

A herniated disc can happen anywhere along the spine, from the neck to the lower back, and is usually the result of aging or something as simple as a forceful sneeze, lifting a heavy object, or sleeping in an awkward position. If the herniated disc doesn’t touch a nerve, you won’t experience any symptoms. But if it does, you’ll likely feel pain radiating along the buttocks, legs, and feet. Tingling, numbness, and a feeling of weakness can also accompany a herniated disc. 

When you sit or lie down to sleep, the pain can be intense. However, properly aligning your spine can ease the pressure on your back and significantly reduce your discomfort. Your orthopedist and physical therapist will model the best sitting and sleeping positions, but here are some general tips to make sitting and sleeping less painful. 

Sitting. Sitting for long periods of time isn’t ideal for people with a herniated disc. A standing desk is a great option, but if you must sit, rest your spine firmly against the chair back, sit up straight, and don’t slouch (which strains the spinal ligaments and aggravates a herniated disc). Your knees should be level with your hips, or slightly above the hips if you’re seated at a desk. The chair should be at a height that allows you to keep your feet flat on the floor. 

To provide extra support, wedge a rolled-up towel or small pillow between the chair and the arch of your lower back. This also works when you’re in your car. If you do have to sit for a long period of time, be sure to take frequent breaks to stretch your muscles.

Sleeping. It’s hard to get a good night’s rest when your back is aching. But you can sleep comfortably if you know the right positions. Sleeping on your stomach is not a great option because it shifts the natural curve of the spine out of alignment and puts pressure on your back and neck. If you must sleep on your stomach, put a pillow under your hips and knees to maintain the proper curvature of the spine and relieve the pressure on the herniated disc.

Better alternatives are sleeping on your side or back. Side-sleepers can place a pillow between the knees to relieve any stress in the hips, or elevate their legs on a pillow. You can also slip a rolled-up towel between your waist and the mattress as you sleep on your side. And always lie on the side where you don’t feel any pain.  

The optimal sleeping position for a herniated disc is on your back. Lying on your back keeps your spine in a neutral position so you have less chance of pinching the nerve. For added comfort, nestle a small pillow or rolled-up towel under your knees and lower back. A wedge-shaped pillow that raises your legs and ankles may also lighten the pressure on the herniated disc.

Get Relief from Back Pain

If you’re suffering from an aching back, the specialists at New York Bone & Joint can diagnose and treat your pain, whether it’s due to a herniated disc or another orthopedic condition. Once you’ve identified the source of your pain, our doctors and physical therapists will help minimize your discomfort with proper treatment. Contact us at New York Bone & Joint today to set up a consultation.

Whether you use one pillow or opt for two, you should resist the urge to always sleep on the same side. Doing so many cause issues like muscle imbalance and even scoliosis.

How does this position help?
Sleeping on your side alone won’t make you feel better. It’s using the pillow between your knees that’s the trick. The pillow will keep your hips, pelvis, and spine in better alignment.

2. Sleep on your side in the fetal position
If you have a herniated disc, you may want to try sleeping on your side curled in a fetal position:

1. Lay on your back and then roll over gently onto your side.
2. Tuck your knees toward your chest and gently curl your torso toward your knees.
3. Remember to switch sides from time to time to prevent any imbalances.

How does this position help?
Your discs are soft cushions between the vertebrae in your spine. Herniation happens when part of a disc pushes out of its normal space, causing nerve pain, weakness, and more. Curling your torso into a fetal position opens the space between vertebrae.

3. Sleep on your stomach with a pillow under your abdomen
You may have heard that sleeping on your stomach is actually bad for back pain. This is partly true because it may add stress to your neck. But if you find yourself resting on your stomach, you don’t have to force another position. Instead:

1. Place a pillow under your pelvis and lower abdomen to relieve some of the pressure off your back.
2. Depending on how this position feels, you may or may not choose to use a pillow under your head.

How does this position help?
People who have degenerative disc disease may benefit most from stomach sleeping with a pillow. It can relieve any stress that is placed on the space between your discs.

4. Sleep on your back with a pillow under your knees
For some people, sleeping on their back may be the best position to relieve back pain:

1. Lay flat on your back.
2. Place a pillow underneath your knees and keep your spine neutral. The pillow is important — it works to keep that curve in your lower back.
3. You may also place a small, rolled up towel under the small of your back for added support.

How does this position help?
When you sleep on your back, your weight is evenly distributed and spread across the widest area of your body. As a result, you place less strain on your pressure points. You’re also able to get better alignment of your spine and your internal organs.

5. Sleep on your back in a reclined position
Do you feel most comfortable snoozing in a recliner? Although sleeping in a chair may not be the best choice for back pain, this position can be beneficial if you have isthmic spondylolisthesis. Consider investing in an adjustable bed so you can sleep this way with the best alignment and support.

How does this position help?
Isthmic spondylolisthesis is a condition where a vertebra slips over the one below it. Reclining may be beneficial for your back because it creates an angle between your thighs and trunk. This angle helps to reduce the pressure on your spine.

Remember: Alignment is key
No matter what position you choose, keeping proper alignment of your spine is the most important part of the equation. Focus specifically on aligning your ears, shoulders, and hips. You may notice gaps between your body and the bed that strain your muscles and spine. You can reduce this stress by using pillows to fill the gaps.

Be careful while turning in bed. You can get out of alignment during twisting and turning motions as well. Always move your entire body together, keeping your core tight and pulled in. You may even find it helpful to bring your knees toward your chest as you roll over.

What to look for in a pillow
Your pillow should cradle your head and neck and help to support the upper portion of your spine. If you sleep on your back, your pillow should completely fill the space between your neck and the mattress. If you sleep on your side, try using a thicker pillow to keep your head in line with the rest of your body in this position. Whatever you do, don’t place your pillow under your shoulders.

For back sleepers:
You may do best with thinner pillows and those that have extra padding in the bottom to support the neck. Memory foam is a good material that molds specifically to your own neck. A water pillow is another option that gives firm, all-over support.

For stomach sleepers:
You should aim to use the thinnest pillow possible or no pillow at all. In fact, you may try sleeping on your side while holding a body pillow. The body pillow will give you the feeling of something against your stomach while helping to align the rest of your body.

For side sleepers:
You may want to look for a firm pillow. Better yet, try to find one that has an extra-wide gusset that will help with the space between your ear and shoulder. And don’t forget to place a firm pillow between your knees. You may even substitute a rolled towel. Remember to change your pillow every 18 months or so. Those pillow protectors can be a good barrier, but pillows still hold lots of allergy triggers like mold and dust mites.

What to look for in a mattress:
Your mattress matters too. Doctors used to recommend very firm orthopedic mattresses to people with lower back pain. But don’t go out and buy one just yet. Recent surveys have shown that people who use extremely firm mattresses may have the poorest sleep. That said, a mattress that’s too soft won’t help very much with alignment. If you have the funds to buy something new, try choosing a firm or medium-firm mattress made with good-quality innerspring or foam. You may also improve the innerspring mattress you already own by adding a memory foam mattress topper.

It may be difficult to tell if that mattress at the store really feels comfortable after only a few minutes of testing. Some companies let you test out a mattress over a set period of time and then return it if it’s not for you. Not in the market right now? You can see if a firmer mattress would help you by placing an inexpensive plywood board under your current mattress. You can even place your mattress on the floor to see if lessening the movement of the springs helps with your pain.

Which position puts the most pressure on your back?

In which position is the most pressure placed on the spine and discs?

Does standing or sitting put more pressure on back?

What position is most stressful on the spine?