Impact of the Wrong Sleeping Position on the Back

    An incorrect sleeping position can lead to a stiff back and back pain. This also applies to a mattress that does not provide the right support.


    Half turned on the side: causes twisting and tension in the neck and back

    tension-in-neck-and-back

     

    On the stomach: very stressful for the neck and somewhat stressful for the back.

    stomach-position-neck-and-back-tension

     

    On the back: somewhat stressful for the back. If the head turns to the side: stressful for the neck.

    back-pain-in-back-position

     

    The best sleeping position: on the side with a Body pillow

    The neck, back, and shoulders are in a neutral position and can optimally recover from the strain of the day (more info: best sleeping position - fewer complaints).

     

    good-sleeping-position-with-body-pillow

     

    Chronic Lower Back Pain

    Sometimes the cause of chronic lower back pain is clear, such as with Bechterew's disease (stiffening of the back), rheumatism, and a hernia. However, often the cause is unknown or doubtful. The main culprit is probably a damaged intervertebral disc (discus). In addition, chronic complaints from joints and muscles are common.

     

    1. Chronic Lower Back Pain Due to Damage in the Discus

    The Discus

    LWK-and-HNP-and-discus

    The discus consists of a core with a kind of liquid ‘gel’ inside. Around it are about twenty layers (lamellae) that together form a strong ring-shaped band, the annulus.

    The liquid substance in the core of the discus remains fairly well in place in a healthy discus: namely in the core. However, due to improper use of the back, lamellae can start to leak. The core content can then enter the annulus. Sometimes fibers tear, which accelerates the leaking. Sometimes not.

    Top view / cross-section:

    Discus-cross-section-single-leakage-between-lamellae

    Leakage in annulus tear / Leakage is extensive between lamellae

    When moving the back, only the discus deforms, not the vertebrae. Without that deformation, no movement of the back is possible. If liquid material from the core has entered between the lamellae, the discus can deform less easily. The back then becomes stiff and movement can become painful.

    People with chronic back pain who have been sitting or standing in a bent position for too long sometimes find it difficult to stand upright again: it is difficult for the discus to deform properly because the leaked liquid from the core ‘gets in the way’.

    How these kinds of leaks occur and how they can lead to hernia and lumbago is clearly explained in four videos. The ipeltest is also explained and how you can use it to push leaks back toward the core. And back pain can improve!

    The sleeping position often influences the development or persistence of chronic back pain (more info: back pain and sleeping).

     

    2. Other Causes of Chronic Lower Back Pain

    Vertebral Joints

    Besides a damaged discus as a cause of chronic back pain, the joints in the spine can also cause chronic complaints.

    LWK-facet-joint

    The location of a joint between two vertebrae.

    Sleeping position is also important for joint complaints. Whatever the condition, if joints lie in a relaxed neutral position, tensions are minimal and fewer complaints arise than if that is not the case. For more info: back pain and sleeping.

    Muscles

    Muscles can also cause chronic back pain, such as in fibromyalgia. Local pea-sized hardenings in muscles – trigger points – can also be responsible.

    triggerpoint-in-muscle

    Trigger point in a muscle

    These kinds of muscle conditions are often treatable by therapists.

    Pelvic Joints

    Problems in the pelvic joints can also lead to lower back pain. The ligaments of these joints are a notorious source of complaints.

    Friction between the legs can cause tension in the pelvic joints, which can cause or worsen complaints.

    Chronic Upper Back Pain

    The area between the shoulder blades can cause pain behind the shoulder blade and sometimes also a ‘strange feeling’ in the arm and a painful sensation in the chest. Usually, the joints between the ribs and the spine are the cause. This is often not recognized. If it concerns the left side, it sometimes resembles a (threatening) heart attack.

    triggerpoints4

    Back pain radiating into the arm

    These kinds of complaints from, often stuck, rib-vertebra connections can be the result of sitting postures where the shoulders are pushed forward for a long time (slouching in a corner of the couch) as well as from a wrong sleeping position where the shoulders hang forward for a long time.

    ©2025, Author: Jan Willem Elkhuizen, physiotherapist and movement scientist

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