For the 266 million individuals suffering from lower back pain, restorative and therapeutic things like sleep and movement can heal — but they can just as quickly aggravate lumbar pain. And it doesn't help when general back pain turns into more serious issues like stenosis or degenerative disc disease.
Even if you know that over-the-counter pain relievers are not the right long-term solution, the question still remains — how do you sleep through the night if you're experiencing DDD?
There's a lot you can do to alleviate the chronic pain related to degenerative disc disease. As regional experts in spinal rehabilitation, JAG PT can help you reduce DDD-related pain and restore spinal mobility. You can get started by scheduling an appointment with a JAG PT clinic near you.
For now, let's dive into what you can do to alleviate chronic pain related to disc degeneration — from how to sleep with DDD to preparing yourself for a good night's rest.
Cervical or Lumbar? Distinguishing Between Two Types of Spinal Cord Pain
Degeneration of the spinal discs occurs in both the cervical (neck) and lumbar (lower back) regions as these areas undergo the most movement. The small discs between the length of the spinal column can experience structural changes, which then lead to low-grade, chronic pain because of factors like:
- Twisting or lifting injuries.
- Small, circumferential tears in the outer layer of the disc.
- A decrease in water content in spinal discs.
- A decrease of disc height or compression of the disc space due to aging. Both decreasing disc height and water content place added pressure and stress on facet joints (the connections between the bones of the spine) and other muscles that support the vertebrae. It's not uncommon for a disc to “collapse,” then triggering pain in the arm or leg muscles or even leading to nerve pain because of pinching or irritation.
- Inflammation caused by contact between the proteins in the disc's interior and the nearby muscles, joints, and nerve roots.
If you're experiencing degeneration of the lumbar spine discs in particular, you're likely to face:
- Moderate to low continuous back pain in the region.
- Occasional pain flare-ups that last for a few days and intensify over time. Eventually, your spine stabilizes itself to account for the degenerating intervertebral discs — which is not a good thing.
- Leg pain, including numbness and muscle weakness in the area, as well as sharp or shooting pain in the buttocks, hips, and/or back of the leg.
- Pain with sitting, especially for long periods of time, and stiffness after maintaining only one position.
- Intense pain radiating from the spinal column after you twist or bend from side to side.
- Trouble lifting heavy objects or performing everyday movements like bending to pick things up.
Meanwhile, neck pain associated with cervical spine DDD feels like:
- A stiff neck, low-grade pain that radiates across the neck and shoulders, even progressing into the arms.
- Acute pain caused by movements that aggravate the area.
- Sensations of pins-and-needles or tingling radiating from the shoulder down to the arms.
- Sharp or severe pain that feels like an electric shock, which could be a sign of related nerve pain across the spinal joints.
DDD is quite a common condition, and rarely does either cervical or lumbar DDD lead to restricted or lost mobility. However, it can and does put you at risk for other issues like disc herniation. Your best first step is to work with your health care provider and assess your condition. They'll gather a medical history (as DDD is sometimes linked to genetics and is definitely exacerbated by risk factors like obesity).
Next, your health care professional will also test your neck and lower back range of motion. Depending on the severity of your pain, they'll then progress to imaging for confirmation of degeneration. The combination of these diagnostic tests can help them determine both the presence of DDD and if something else (like stenosis) is causing the issue
What’s Really Going On? How Sleeping Positions Affect the Intervertebral Discs of the Spine
Besides sitting, sleeping is the next most common position we find ourselves in for a prolonged period of time. Even though sleep and rest are good for muscle spasms and acute back pain, assuming the wrong sleep position all night long can aggravate and worsen DDD. From muscle spasms to neck sprains, the aftermath of poor sleeping positions only serves to extend your back pain.
So, what's really going on with the spine when we sleep? Well, a lot depends on your dominant sleeping position. Generally speaking, the spine should be at rest and your position should help the body perform its nighttime restoration routine of rehydrating the discs between the spine. Of course, therapeutic exercises can greatly help this process and provide pain relief (and we'll cover more about that below).
For now, the key takeaway is that after a full day of supporting you and your body, the spine needs support — but, when you're sleeping, there are quite a few factors that can bend, twist, and stretch a spine out of a healthy, natural curvature, adding stress and pressure on cervical and lumbar regions.
When you sleep on your side, your spine elongates. It has a natural curvature and what it needs most is support. Keeping your legs straight, rather than curled in a fetal position, is best as the latter can lead to sore joints, along with unevenly distributing your weight on the spine.
Usually, pillows that are too high or too low are what knock your spine and neck out of shape and can lead to unnatural and painful dips in the cervical or lumbar spine.
Back sleepers really have it the best, as this is when the spine is in a neutral position. This means it maintains a light, natural curve but it's mostly straight, with no major dips across any of the regions. Sleeping this way supports optimal spinal alignment:
- Chin up
- Shoulders low
- Back straight
- Knees relaxed, and
Hips aligned with the shoulders.
A neutral spine also allows the surrounding muscles to remain elongated and loose, which reduces any soreness or tightness. Finally, this natural, neutral position is symmetrical, which means that one side of the body isn't working any harder than the other.
Spinal alignment for stomach sleepers is traditionally the worst. When you sleep on your belly, your shoulders press upward and your spine is forced into an unnatural position. Meanwhile, your neck's scalene muscles are strained because you have to turn your neck to the side just to breathe. Finally, the spinal region around the stomach and hips sinks inward and causes strain in this area.
With so many affected regions, it's unsurprising that stomach sleepers often suffer from neck, back, and shoulder pain.
Take a Load Off: The Best Tips to Sleep Well With DDD
Let's face it: pain treatments in the form of muscle relaxants just aren't going to cut it. The best way to alleviate DDD is to address the issue from multiple angles. And, if you're concerned that your general back pain may turn to DDD, committing to any (or all) of these strategies can help prevent the degeneration of your spinal discs.
#1: Get the Right Mattress
Without a doubt, a firm mattress is going to serve you best when it comes to sleeping with DDD but avoiding pain. This type of mattress stops the spine from sinking down into the bed and alleviates additional trigger points and stress on the joints.
#2: Try Low-Impact Stretches Before Bed
There are several exercises you can perform right before going to bed that will help get that spinal fluid moving and those discs nice and lubricated.
- The pelvic tilt
- Supine lower trunk rotation
- Bird-dog extension
#3: Sleep With Additional Supports
To recap, stomach sleeping is the worst position for back pain, especially if you have DDD. Side sleeping is okay and sleeping on your back is the most supportive and comfortable position to sleep in if you have DDD.
However, it's best if you use supports to keep your spine neutral all night long.
- Back sleepers: Sleep with a pillow under your knees to maintain your spine's natural lower back curve.
- Side sleepers: Sleep with a pillow between your knees to keep your hips, pelvis, and spine in alignment.
- Stomach sleepers: Not recommended, but if you need to ease out of the habit and into another position, place a thin pillow directly under your stomach and hips to maintain that spinal curvature.