The most common causes of back pain while sleeping include a mattress that is not the correct firmness or is simply poorly constructed, as well as poor sleeping positions or a pillow that is not properly fitted based on one's sleeping position. The mattress is by far the most common cause of back pain while sleeping, and stiffness upon waking up in the morning. It may be necessary to get a new mattress to address this problem; some stores even allow customers to try mattresses in the home for 30 days before making a purchasing decision to be sure the mattress offers the correct amount of support.
For years, people were told that firmer mattresses were the way to go to prevent back pain, but recent research has shown that this is not actually the case. In fact, medium to soft mattresses can often be much more comfortable as well as being more supportive of the natural curves of the spine. Thus, it is more a matter of personal preference, than a need to choose an extra-firm, orthopedic mattress. Back pain while sleeping is often caused by a mattress that does not offer enough support to certain areas of the spine, such as the lower back; this is why it is important to replace the mattress if it begins to sag or wear out.
Improper sleeping position can also contribute to back pain while sleeping. Sleeping flat on one's back is a good way to prevent back pain, but many people find that uncomfortable and prefer side sleeping or sleeping on the stomach. Sleeping on the stomach can cause back pain because it often forces the spine into a slightly unnatural angle. Side sleeping can be a good choice, especially on a softer mattress; it is best to place a pillow between the knees to avoid collapsing the hips and stretching the lower back.
In addition, a pillow that is the wrong size is another cause of back pain while sleeping. Whether sleeping on the side or the back, the pillow should support the back of the neck and the head without tipping the head to one side or the other, leading to neck strain. Again, the softness or firmness of the pillow is a matter of personal preference, as long as it supports the neck; most experts recommend selecting a flatter pillow just because it keeps the spine more in its natural alignment.