Lower back pain when lying down on back
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Lower Back Pain When Lying Down on Back: Causes and Solutions
Introduction to Lower Back Pain
Lower back pain (LBP) is a prevalent condition affecting individuals of all ages and is a significant contributor to disability worldwide. The complexity of LBP arises from its varied manifestations, potential causes, and the impact it has on daily activities and quality of life2. Understanding the factors that exacerbate or alleviate LBP, especially when lying down, is crucial for effective management.
Mattress Firmness and Lower Back Pain
Impact of Mattress Firmness
The firmness of a mattress plays a critical role in the management of chronic non-specific low-back pain. A study comparing firm and medium-firm mattresses found that medium-firm mattresses significantly improved pain and disability outcomes. Patients using medium-firm mattresses reported less pain while lying in bed, on rising, and during the day compared to those using firm mattresses1. This suggests that a medium-firm mattress may provide better support and comfort, reducing the strain on the lower back.
Musculoskeletal Risk Factors
Range of Motion and Flexibility
Restricted range of motion in the lower back and hamstrings, as well as limited lumbar lordosis, are significant risk factors for developing LBP. A systematic review highlighted that reduced lateral flexion and hamstring flexibility, along with limited lumbar lordosis, were associated with an increased risk of LBP3. These findings underscore the importance of maintaining flexibility and proper posture to prevent and manage LBP.
Aggravating and Relieving Factors
Common Aggravating Factors
Certain activities and positions can aggravate LBP. Stooping and prolonged sitting are commonly reported as aggravating factors, with many individuals experiencing increased pain as the day progresses4. Understanding these triggers can help in modifying daily activities to reduce pain.
Effective Relief Strategies
Lying down and walking around are among the most effective strategies for relieving LBP. Over half of the individuals in a study reported that lying down alleviated their pain, while a significant number also found relief through walking4. These simple adjustments can provide immediate relief and improve overall comfort.
Psychological Factors
Pain Perception and Catastrophizing
Psychological factors, such as pain catastrophizing, can influence the perception and management of LBP. Patients with high levels of catastrophic thinking tend to overpredict pain, which can exacerbate their condition. However, exposure to movements that initially cause pain can help correct these overpredictions, although this effect does not generalize to dissimilar movements5. Addressing psychological aspects is essential for a comprehensive approach to LBP management.
Conclusion
Lower back pain when lying down can be influenced by various factors, including mattress firmness, musculoskeletal flexibility, daily activities, and psychological perceptions. Medium-firm mattresses, maintaining flexibility, and understanding aggravating and relieving factors are key to managing and alleviating LBP. A multidisciplinary approach that integrates physical and psychological strategies is essential for effective LBP management.
Sources and full results
Most relevant research papers on this topic
Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial
A medium-firm mattress improves pain and disability outcomes in patients with chronic non-specific low-back pain compared to a firm mattress.
RCT
Large Human Trial
Rigorous Journal
Highly CitedRestriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies
Restriction in lateral flexion, hamstring range of motion, and limited lumbar lordosis are associated with an increased risk of developing low back pain.
Systematic ReviewRigorous JournalHighly CitedA prospective study of low back pain in a general population. II. Location, character, aggravating and relieving factors.
Low back pain is most common in the lower lumbar area, with stooping and sitting positions as aggravating factors, and lying down and walking around as key relief factors.
Observational StudyExposure to physical movements in low back pain patients: restricted effects of generalization.
Exposure to physical movements in low back pain patients can correct initial overprediction of pain, but does not generalize to other dissimilar movements or perceived harm.
Non-RCTHighly CitedMass media campaigns are needed to counter misconceptions about back pain and promote higher value care
Mass media campaigns can counter misconceptions about back pain and promote higher-value care, improving outcomes and reducing workers' compensation costs.
Very Rigorous JournalMechanisms of low back pain: a guide for diagnosis and therapy
This paper provides a guide for clinicians to identify specific pain generators in chronic low back pain, aiding in safer and faster diagnosis and therapeutic management.
Highly CitedA Prospective Study to Find Out the Association between Supine Lying Low Back Pain and Retrolisthesis
Supine lying low back pain is strongly associated with retrolisthesis, a subtle instability in the lumbar intervertebral segments, and diagnostic evaluation should be performed to rule out retrolisthesis.
Lower back pain
Pregnancy increases the risk of lower back pain due to increased lumbar lordosis and increased spinal compression, leading to muscle strain, joint capsule pain, disc herniation, and bone degeneration.
The global burden of low back pain: estimates from the Global Burden of Disease 2010 study
Low back pain causes more global disability than any other condition, with an increasing prevalence and burden with age.
Systematic ReviewHighly CitedLow back pain: a call for action
Low back pain is the leading cause of disability worldwide, with its burden growing alongside the aging population and is unrelated to specific spinal abnormalities.
Rigorous JournalHighly Cited