For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?
Sleep With A Pillow Between The Legs
Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.
The Benefits
Some potential benefits of sleeping with a pillow between the knees.
Reduce Back and Hip Pain
When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.
Reduce Sciatica Symptoms
Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.
Reduce Herniated Disc Symptoms
A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)
Improve Posture
Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)
Increased weight leads to increased pressure on joints.
Significant change in the center of gravity.
Hormonal changes make connective tissues more lax.
Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.
Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.
What Causes Disc Herniation?
References
Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777
Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248
O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4
Wobble cushions are small round inflatable support pillows made of a flexible material that can be used to stand and sit on. The cushion creates instability, hence wobble, to engage the lower back, hips, and core muscles. They promote core stability, strengthen muscle tone, and improve balance and body posture. A flexible body helps in injury prevention. At Injury Medical Chiropractic and Functional Medicine Clinic, we utilize innovative techniques and therapies to reduce stress, assist in healing musculoskeletal damage from injuries, disease, or conditions, and keep the spine and whole body healthy.
Wobble Cushions
A common reason for back aches and pains is sitting for long periods. Individuals unintentionally slouch or hunch over as they go through their day, causing strain to the back muscles, gluteal muscles, core muscles, hips, and spine. This causes the lower half of the body to weaken and causes the top muscles to take up the slack to support the torso and lower body.
Muscle Spasms
Muscle spasms can be the acute type that is forceful and involuntary, and chronic sustained stiffness, tightness, cramping, and pain. Lower back discomfort and/or sciatica symptoms vary depending on the cause, location, and severity of the strain or injury. Signs could be dull, burning, or sharp at a single point or over a broad region that could spread into one or both legs. Types of low back discomfort:
Acute symptoms last less than three months. Most individuals with acute episodes will have at least one recurrence.
Recurrent means the acute symptoms return.
Chronic symptoms last longer than three months.
Cushion Benefits
Encouraging active sitting improves posture allowing individuals to sit and stay focused for longer as their body awareness improves, reducing hunching, slumping, slouching, and fidgeting. Other wobble cushion benefits include:
Decreased muscle stress and strain on the joints and ligaments, which improves proprioceptive sense or body awareness.
Increases blood circulation and oxygenation throughout the body.
Helps rehydrate the discs and circulate spinal fluid. Spinal discs do not have a direct blood supply; therefore, movement is required to pump and circulate healthy fluids.
Allows more flexibility in the spine, hips, and core muscles.
Improves overall posture.
The purpose of wobble cushions is not to provide comfort. They are supposed to be uncomfortable and unstable to make the individual sit up straight. The cushion can be placed on a chair or the floor to effectively practice balancing without putting pressure on the back, knees, or feet. They can also be used for practicing standing balance. Various factors to consider when looking for a cushion include:
Stability
Comfort
Resilience
Alignment
All play a role in determining the best option.
Discussing options with a doctor or chiropractor is recommended to ensure that the cushion meets your needs and preferences.
Spinal Hygiene
References
Alrwaily, Muhammad, et al. “Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial.” Brazilian journal of physical therapy vol. 23,6 (2019): 506-515. doi:10.1016/j.bjpt.2018.10.003
Haksever, Bunyamin et al. “The Dynamic Innovative Balance System Improves Balance Ability: A Single-Blind, Randomized Controlled Study.” International journal of sports physical therapy vol. 16,4 1025-1032. 1 Aug. 2021, doi:10.26603/001c.25756
Honert, Eric C, and Karl E Zelik. “Foot and shoe responsible for the majority of soft tissue work in the early stance of walking.” Human movement science vol. 64 (2019): 191-202. doi:10.1016/j.humov.2019.01.008
Ostelo, Raymond Wjg. “Physiotherapy management of sciatica.” Journal of physiotherapy vol. 66,2 (2020): 83-88. doi:10.1016/j.jphys.2020.03.005
Shahvarpour, A et al. “Active-passive biodynamics of the human trunk when seated on a wobble chair.” Journal of biomechanics vol. 49,6 (2016): 939-945. doi:10.1016/j.jbiomech.2016.01.042
Sleeping with a bulging disc can be challenging for the body to achieve the proper rest. And sleeping in an awkward position can add stress to the spine, making the bulge worse, which can cause tingling, numbness, pain, and digestive problems. This can disrupt the sleep cycle and prevent proper healing of the spinal injury.
Sleeping With a Bulging Disc
When sleeping, most back pain occurs in the lumbar or lower back, in one of two places where the spine meets the pelvis. Around 95% of lower back herniations happen in the L4-L5 spinal segment or the L5-S1 Lumbosacral joint. Any back pain can turn into a vicious cycle of:
Sleeping with a bulging disc requires maintaining the ears, shoulders, and hips aligned to keep the spine aligned.
Sleeping on The Back
Back sleeping done correctly is the best way to sleep for the spine’s health. The important thing is to ensure the entire back is supported when sleeping. If there is a gap or space between the mattress and the back, the weight and gravity force the spine to lower in an unnatural way to fill the space. This can cause back muscle soreness, injury, and sciatica. A thin pillow, blanket, or towel can be used to fill the space, giving the spine the support it needs. Back sleepers can also benefit from a pillow or two under the knees to elevate the legs and help maintain the natural curve of the pine.
Sleeping on The Side
Side sleepers can try pulling the legs up toward the chest, and placing a pillow between the knees can provide relief when sleeping with a bulging disc. Pulling the legs up in the fetal position can relieve pressure on the discs. It is recommended to switch sides to keep the spine balanced. This helps maintain hip alignment, which helps keep the spine in a neutral position.
Sleeping On The Stomach
It is recommended to avoid sleeping on the stomach. This pulls the spine down into an unnatural curve that can cause and exacerbate back pain. For individuals that naturally stomach sleep, it is recommended to place a pillow under the hips and lower abdomen to prevent unnatural spinal positioning.
Chiropractic Relief
Utilizing the right sleeping position can provide pain relief and thorough rest. However, sleeping with a herniated disc is far from what is needed to get back to a normal healthy sleeping pattern. This depends on the location of the bulging disc, severity, and cause. A chiropractor can:
Help the individual develop an optimal sleeping routine and positioning.
Body Composition
Sleep and Growth Hormone In Children
Growth, in all ages, is primarily controlled by growth hormone. The hormone is regulated by the hypothalamus and pituitarygland which plays an important role in sleep. Growth hormone has been found:
It peaks during the beginning of deep sleep.
There are multiple smaller peaks during the other stages of sleep.
Those who have a delay at the beginning of deep sleep have delayed rises in growth hormone levels.
For children to grow they need to have proper levels of growth hormone. This means they need to have the proper amount of sleep for proper body composition. Research has found that increased levels of sleep resulted in less overall fat mass and a reduced percentage of body fat allowing their bodies to grow.
References
Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560878/
Desouzart, Gustavo et al. ‘Effects of Sleeping Position on Back Pain in Physically Active Seniors: A Controlled Pilot Study. 1 Jan. 2016: 235 – 240.
Kose, Gulsah et al. “The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 51,4 (2019): 184-189. doi:10.1097/JNN.0000000000000446
Sener, Sevgi, and Ozkan Guler. “Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.” The International Journal of prosthodontics vol. 25,4 (2012): 348-52.
The low back is made up of five vertebrae, L1 to L5. Pain in the low back is common, specifically because of all the sitting at work, school, and home. Individuals dealing with low back pain know how difficult it can be to sit without discomfort and have found that a low back support pillow can help.
Low Back Support Pillow
A lumbar pillow is a pillow that supports the low back region of the spine. Different types include:
Specially shaped pillows made from materials like memory foam.
Lumbar pillows can be used on any chair at the office or home.
They are also helpful for travel with small-sized versions that can be packed and easy to carry.
How Lumbar Pillows Help
According to the CDC, the average adult spends around 6.5 and 8 hours a day sitting. Constant sitting hurts the body, specifically the spine and the back muscles, and is a significant cause of muscle stress. Properly supporting the low back helps remove the stress and strain. A low back support pillow can help correct sitting posture.
Pillow Options
There are plenty of options for low-back support pillow shapes, sizes, fillings, and materials. These include:
Some look like a half-cylinder in shape, rectangular, and curved.
Personal preference and comfort are different for everybody, and it could take some trial and error to find the right lumbar pillow. Some pillows are customizable, allowing the ability to add or remove filling as needed. Talking with a spine specialist, orthopedist or chiropractor can help in figuring out what type is best. Pillows come in various price ranges, with some at $10-15, while others can cost $100 or more. However, any pillow that provides enough support for the low spine’s natural curvature can work. It is important to be comfortable and supported to prevent pain and injury no matter where you sit.
Body Composition
Fermentable and Nonfermentable Fiber
The entire body can host trillions of beneficial bacteria. The majority live in the intestines and are referred to as the gut microbiome. Also known as the forgotten organ, these bacteria have a say in the body’s composition and overall health. The beneficial bacteria thrive on fermentable fiber, and fermentation in the gut produces short-chain fatty acids like:
“Association Between Sitting Time and Cardiometabolic Risk Factors After Adjustment for Cardiorespiratory Fitness, Cooper Center Longitudinal Study, 2010–2013.” Centers for Disease Control, Atlanta, GA. December 2016. www.cdc.gov/pcd/issues/2016/16_0263.htm
“Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees.” BMC Public Health, London, UK. May 2021. pubmed.ncbi.nlm.nih.gov/33957889/
Waking up with neck soreness, stiffness, achiness, and pain can take a toll throughout the day. Individuals, that experience this regularly wonder what happened while laying down in bed? Individuals can wake up with one or a combination of these symptoms after sleeping. A few ways to prevent neck pain after sleeping and self-care to relieve any symptoms.
What Is Happening?
The spine keeps the body upright and moving and regularly resists gravity and other forces acting upon it. The neck, aka the cervical spine, is a little more delicate. The neck has the important job of holding up the head. The human head weighs around 10 to 12 lbs, and that’s using proper posture. According to a study, the head’s weight can increase up to 60 lbs. with a 60-degree tilt. This can happen from looking down at a phone for too long. All that weight makes the muscles that support the head and neck work overtime contributing to fatigued muscles.
Then when sleeping, cervical spinal misalignment starts to set in, producing torticollis. Torticollis, aka wry neck, is a condition where the neck gets twisted or tilted at an awkward angle. Babies can be born with it, known as congenital torticollis, and individuals can develop it from various sources. It can be temporary, chronic, and it can be caused by acute trauma. Torticollis is not considered a condition like ankylosing spondylitis but more like a symptom with overlapping sources.
The neck’s ligaments can become irritated and inflamed.
Neck muscle spasms can cause soreness and inflammation.
Either of these can be caused by sleeping in an awkward position or by using the wrong pillow.
Waking With Neck Pain
When waking up with neck pain, it could be that the pillow no longer provides sufficient support, the pillow is too thick, placing the neck in an awkward position, the individual’s sleeping position strains the muscles and ligaments, or a combination. It is usually a pillow that is too soft with no support that causes neck pain. Maintaining spinal alignment when sleeping is just as crucial as during the day, as it helps to prevent overly taxing the muscles and ligaments.
How to control posture when sleeping?
The pillow could be the answer. A firm pillow will keep the spine in a straight line from the atlas, which is the first cervical vertebra/C1, down to the coccyx or the tailbone. The way an individual sleeps also affects how they wake up. The most recommended sleeping position for individuals with morning neck pain is on the back. Back sleeping might not work for everyone as it can aggravate conditions like sleep apnea. If that is the case, sleeping on the side is the next recommended position. It is recommended to avoid sleeping on the stomach. The head could slip down the pillow edge causing the head to be in a tilted position. This can place added pressure on the nerves that start in the neck, leading to further neck pain or radiculopathy pain that spreads out to the arms or legs.
What To Do?
If neck pain presents after waking, get some ice or a cold pack on it. Try 20 minutes on, 20 minutes off. This will reduce inflammation. Also, over-the-counter nonsteroidal anti-inflammatory medications like ibuprofen can help. If neck pain continues, switch from ice to heat also 20 minutes on, 20 off. If the pain is caused by spasming muscle/s, heat can relax the area and increase blood circulation. A gentle massage on and around the area can help spread the circulation and ease the spasm.
Stretching the neck
Stretching the neck will keep the muscles loose and reduce the risk of ligament, muscle and tendon strains, and torticollis.
Body composition change and losing fat mass are also related to sleep. Losing fat requires the body to be in a caloric deficit. This means having the body use more energy than the body takes in. This is accomplished by restricting calories through diet or increasing calories used through physical activity/exercise. However, most individuals utilize a combination. This can be referred to as calories in/calories out. Losing sleep can sabotage fat loss goals by stealing both the calories in and calories out.
References
Hansraj, Kenneth K. “Assessment of stresses in the cervical spine caused by posture and position of the head.” Surgical technology international vol. 25 (2014): 277-9.
Preventing Neck Pain from Sleeping: National Sleep Foundation. (n.d.) “How to Prevent Neck Pain While Sleeping.” sleep.org/articles/prevent-neck-pain-while-sleeping/
Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.
Importance of Pillows
Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.
Shape
The shape of the pillow has a definitive role in the cervical/neck’s curvature.
Posture
Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.
Sleep quality
Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.
Height
Cervical alignment can become significantly impacted by the shape and height of the pillow.
Pillow Comfort Importance
Trying to find the right pillow will require trial and error. The basics to consider include:
One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed. Make it as comfortable as possible.
Body Health
Sleep Body Composition Importance
Not getting enough sleep makes it difficult to gain muscle.
Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.
Not getting enough sleep makes it difficult to lose fat.
Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. pubmed.ncbi.nlm.nih.gov/27635354/
“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. pubmed.ncbi.nlm.nih.gov/25008402/
“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. pubmed.ncbi.nlm.nih.gov/33895703/
Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14
Back pain during the holidays takes the joy out of everything.�All the�activities, events, and shopping can worsen spinal injuries or cause new ones.�And trying to power through the pain makes family traditions like tree-trimming, cooking, baking into a very cautionary experience.�When selecting a gift for friends or loved ones with back or neck pain they would appreciate something designed to help them feel better.
Although the massage devices and foam roller sets don�t work miracles they can ease the stress and discomfort that comes with living with pain.
There is a wealth of products that:
Support the back
Relieve muscle tension
Improve sleep quality
Affordable Back/Neck Gifts
Epsom salts –�A warm Epsom bath reduces muscle soreness, eases stress and soothes the skin. The salts’ magnesium helps the body reduce inflammation along with improving muscle and nerve function. The sulfates help the body absorb nutrients and flush body toxins.
Along with the health benefits, a bath is a nice way to relax after a long day. Gift sets contain a bag of salts, bath bombs, bubble bath, and other goodies.
Back massage pads – A good massage can relieve aches and pains. Massage pads knead the muscles while you�re watching TV, riding in a car, or resting.
Massagers have various settings that focus on various areas of the back and thighs with vibration and heat. Each massager is different and they have all kinds of modes. You might have to do a little research but the great thing is that they fit in a car/truck seat, office chair, or reclining chair.
Lumbar (Low Back) cushions – These pillows make sitting in a car,� truck or office chair, a whole lot more comfortable with low back support.
Travel cushions are made to take with you on road trips, work commutes, and are heavy-duty to help prevent slouching and ease low back pain caused by long sitting times.
Foam Rollers – Rollers are great for working out muscle soreness and stiffness. There are a variety of styles that combine foam roller benefits with massage ball portability, as well as, kits that have specialized rollers in different sizes, and shapes for different parts of the body.
Roll out the hips, upper back, calves, feet, and other parts at the house or on the road.
Indulgent Gifts
Massage as a gift – Massages help ease muscle tension, relieve aches and pains, and promote relaxation.
Gift a massage from a local chiropractor or physical therapist.
Look for licensed therapists that are specially trained in treating people with spine or neck pain.
Ergonomic chair – These chairs are made to support proper posture and reduce stress from long periods of sitting.
Consider a quality office chair. A good chair will have multiple adjustments so you can adjust the armrests, headrest, seat height, and depth. Ergonomic chairs provide more support than a standard office chair.
An infrared heat lamp – Heat is a solution that increases blood circulation and reduces muscle stiffness.
Heat lamps offer deep penetration that can be used at home for the larger areas of the body like the chest and back. A study found a group of patients that reported their pain levels decreased after six weeks of use.
Yoga classes – for the fitness people in your life gift a yoga class package.
The American College of Physicians Clinical guidelines recommends yoga as a first step in treating low back pain. As with any exercise program, they need to talk to their doctor before beginning yoga. Yoga Alliance and The International Association of Yoga Therapists (IAYT) are good places to find top qualified instructors.
The gift of relaxation, back support, and especially stress relief of family and friends will give you that fuzzy feeling all over, knowing that you’re helping someone out in a very real way!
Individuals who sit most of the day, like those working in a computer while sitting in an office chair, are also at high risk for non-accidental spine injury. Office ergonomics, or computer ergonomics, can help minimize the risk such as the dangers associated with prolonged sitting in an office chair, and carpal tunnel syndromes, such as lower back pain, neck strain, and leg pain.
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