Sleep & Body Pain

by Charles Platkin, PhD

Mieke found that yoga was an effective and safe complementary movement therapy to improve stability and strength while also increasing flexibility. She has recently relocated to Colorado and is integrating physical therapy with her expertise in yoga training for the Colorado Ballet Academy and in her own private practice. I was able to do an extensive three-part email with Dr. Scripps.

Diet Detective: There are a lot of people with back problems. How can doing things in bed besides sleeping contribute to these problems.

Mieke Scripps: To be blunt, the most dangerous place in your bedroom is the bed. What do you actually do in your bed besides sleeping? If you’re like most, you read, watch television, study, work and eat. And most of these activities do more harm than good to your back.

Your spine is made up of three curves. You can feel them as a hollow area at the back of your neck and lower back and a slight roundness of the upper back. Maintaining these three natural curves while working and resting would save many people a lot of pain, lost productivity and care costs.

When you use your bed for reading, watching television, using your computer, etc., you probably get comfortable by propping yourself up with pillows. This often violates the rule of maintaining a neutral spinal alignment. What happens is that the hollow in your lower back is now reversed into rounding, the roundness of your upper back is more accentuated, your shoulders are hunched forward and your head is significantly in front of your shoulders (probably pushed forward by the pillows).

Diet Detective: Why should you care about this positioning?

Mieke Scripps: If bad positioning is maintained over an extended period of time, it puts strain on your muscles, ligaments and joints. Strain can develop into inflammation, pain and permanent changes. Subsequently, the morning blues set in and degeneration accelerates.

Diet Detective: So should you use your bed for watching television or using a computer?

Mieke Scripps: No. However, if you can’t break the habit, then moderate the damage by getting up every 20 minutes and frequently rearranging your pillows. Finally, improve the ergonomics of your setup:

Your back should be on a gradual incline. Your lower-back hollow should be maintained with a lumbar pillow. Put a pillow under your knees to keep them bent. Your head should rest back on a pillow so it can fall back past your shoulders and allow the neck to maintain its natural hollows. Basically, try to maintain the natural spinal curvature.

Diet Detective: What’s the best position?

Mieke Scripps: Since you spend one-third of your life sleeping, position is very important. It is a difficult thing to train yourself to sleep in the proper position, but once accomplished you will feel refreshed and wake up without so many aches and pains. Try to fall asleep in the appropriate position. If you wake up in another position just reposition yourself and try to fall asleep again in the appropriate position.

1. Stomach: Don’t even think of sleeping on your stomach. It is impossible to maintain neutral alignment through your neck in this position. It also puts the lower back in an exaggerated curve. Try to slowly train yourself to sleep in another position.

2. Back: This is a good choice, but remember to accommodate the curve in your neck. Keep only a small amount of pillow under your head (to avoid pushing your head excessively forward). The hollow in your neck is where you need the most support. Here are some pillow options: Take a larger, malleable pillow and bunch it so there is more under your neck and less under the head. Another option is to use a small, soft pillow or rolled towel for the neck. You may also wish to place a pillow under the knees. This allows the soft tissues that run from your neck all the way to your toes to be relaxed and supported, decreasing back discomfort.

3. Side: Remember, the rule is to maintain the spine in neutral alignment. This is when pillows become important. Use three of them ­ that’s right three pillows. Pillow No. 1 should be placed under your head to lift it to a position centered on your shoulders (be sure to put more pillow under the neck than the head, so that the neck is fully supported). Pillow No. 2 should be hugged with your arm to decrease the strain on your shoulder, upper back and neck muscles. Finally, pillow No. 3 should be placed between the knees to decrease the strain on the hip and low-back muscles.

Diet Detective: What are some other points to remember regarding sleep position?

Mieke Scripps: Specifically, do not push the head forward or decrease the hollow in your lower back. Other common sleeping habits that lead to problems are putting your elbows above shoulder level (e.g., sleeping with your arm placed under your head), placing the hand under the head (reduces blood flow to the hands), and curling the fists inward as if in a fetal position (this is especially bad for individuals with carpal tunnel syndrome because it decreases blood flow and puts strain on the carpal tunnel nerve).

Diet Detective: Why do we feel stiff in the morning?

Mieke Scripps:
You get stiff because you stop moving for a considerable period of time while you sleep.

During those hours of sleep, the ‘s core temperature has fallen and viscosity of the joints has decreased. Also, the discs in the back fill with water to rejuvenate, which stretches the muscles and ligaments around them. When you pop out of bed it compresses the discs and surrounding structures, giving your back a bit of a jolt. Try the following process to get your day off to a great start:

Lying in Bed: While still lying in bed, turn onto your side or back and bend your legs. Gently rock your pelvis up and down. As you do this motion, you should feel your lower back change from arching to flattening. Start with a small motion and gradually increase the range. After you do this for a minute or so, roll onto your back. Once on your back, alternately pull one knee to the chest while straightening the other leg. Remember, move gently, you are just waking up.

Sitting up in Bed: Now it’s time to rise and shine, but we want to minimize the strain on the body. This means we do not sit straight up in bed. Instead, roll to your side, bend your legs and use your hands to push up from the bed while lowering your legs down over the side. This saves your back, because you avoid twisting and bending your spine before the blood is flowing and the tissues are ready for it.

Getting on your Feet: Finally, to get from sitting to standing, try this method. Scoot to the edge of your bed; push your feet into the floor. As you lift your bottom off the surface, make sure to keep your head up and push your feet into the ground, engaging your leg muscles. By doing this, you use your bigger leg and buttock muscles and avoid straining the back.

To finish things off, take a nice hot shower, which should complete a very positive beginning to your day

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