Beds ~ and sleep ~ are important



Beds ~ and sleep ~ are important. Assuming we live to the age of 80, we are likely to spend 26.4 of those years sleeping ~ and that means in bed. Beds are even more important if you have a bad back. There is certainly a 'best bed for back pain'. 

A bad bed can be the undoing of a not-so-bad back. This happens when a bed that's too soft brings a lurking stiff spinal link to the fore through lying spread out on a weaker support. An insubstantial mattress and bed-base combo allows a stiff link hiding in the spinal machinery to sag, as the body gets heavier in sleep and sinks incrementally deeper into the mattress overnight. This often happens on holiday when ‘that bed’ was the cause of untold mischief. 

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The best bed for back pain should be firm and 'buoying up' to let your body fall out of the crimps and kinks acquired through the day

Of course, a soft bed is often seductively cuddly and welcoming on first getting in. It yields to your pointy shoulder or hip bone and cossets your tired body after a long day. But a bed that is too soft will let you down through the night. A bed that is too soft will not give your spine the support it needs ~ and by this I mean spinal decompression ~ to prepare you for the next day. In short, a soft bed will contribute to causing a painful back.

what are the features of

a best bed for back pain?

The perfect bed manages to be vigorously supportive without simply being too hard. (The recent vogue of pillow top beds has tried to deal with this but in my opinion failed through lack of firmness underneath.) The best bad for a bad back is actually therapeutic as you sleep as it helps the spine decompress. It can only do this if the bed is firm enough. 

If you have read various other pages of this website, you may know that our skeletons, and spines in particular, suffer from stooped working postures and excessive sitting. During the day, the spine can remain crumpled for hours in the mental concentration of work. As the body weighs down earthwards, deeper and deeper into its three spinal bends, the lower end of the spine becomes increasingly more compressed, like one end of a concertina not pulling out.

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awkward and prolonged sedentary postures by day . . . need gentle rectifying realignment at night while you sleep

There is tangible and valuable job done by the discs taking in water overnight. It forms part of the cycle of the stately fluid exchange that keeps the discs nourished and healthy. The same quantity of the fluid lost by day - through the weighing down effects of gravity and the forces of muscles compressing the spine - is brought back in again by night. Although this exchange is competent, its slowness is one of the main reasons why discs break down easily and struggle to repair themselves. It’s both cause and effect in the discs having a slow metabolic rate - and you need to do everything you can to help. This very much includes a good bed. The best bed for back pain helps you get fluid back into your discs overnight. 

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lumbar discs need minimal overnight pressures in order to imbibe fluid. Sleeping flat on your back is better than on your stomach or sides 

Our spines actually grow by nearly 2cm overnight, as the discs discreetly imbibe fluid. If we add to this the straightening of the spinal curves and the prizing open of our other big joints (the knees, hips and shoulders) we are all considerably taller by morning. At least, we should be.

Being best armed to face the next day is all about a supportive bed. The best bed for back pain helps straighten out a bowed-over and bent skeleton - and therefore is not about being too accommodating! You won’t get prized straight and realigned if you stay sunken down deep in a soft mattress overnight. You won’t get back each night the same quantity of fluid you lost through the day, and the discs and spine will suffer.

OK, but What specifically should the

best bed for back pain do?

The best bed should make you lie so flat and stretched out on your back that your head almost feels too low and you want to put an arm behind it.

It’s really important that your body drops open and doesn’t stay crumpled overnight - and for this to happen, you need a vigorously firm and ‘buoying up’ bed. The best bed for back pain has a firmly supportive mattress which means your body can literally fall out of its crimps and kinks acquired through the course of the previous day. 

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A firm surface gives your better spinal decompression while you sleep

The bed needs to be firm enough to give gentle decompression through your entire body.  This is perfect, as total relaxation is achieved by this posture! It lets the body flop completely backwards, decompressing everything, as it encourages the spine to elongate incrementally along the mattress. Think of your spine growing as it undulates out like an earthworm overnight and you will wake up in the morning feeling light and refreshed, with a spring in your step. 

What are the ideal features

of the different beds?

In earlier days, the best mattress for back pain was a thin layer of kapok on a slatted wooden base, similar to today’s futons.  This was ideal for aeration underneath and is still a very good surface to sleep on.

In modern times, a densely sprung pocket-spring mattress on a dense base has become the ideal. These have a dense inner architecture of independently acting springs that almost bear you aloft on top of the bed, as if offering you up to the gods. The inner spring of a good mattress has its own quivering sort of up-thrust that helps you turn unconsciously in your sleep. Instead of hauling yourself out of a deep cavern of soft bedding, the perfect mattress spring-loads your turns and whips you over lightly and easily. It’s as if you’re romping delicately on the surface of the bed.

As a rule of thumb, the best bed for back pain should also keep firm and resilient if you plonk down on the side of it, to sit. And here’s the clue: it should almost feel too jarring. In other words, it doesn’t collapse under you in a deep scoop under your bottom.

The final point is that you really have to try the bed in the shop – ideally with your partner beside you - because the ideal bed does depend a bit on your weight. And look for the special feature of it springiness helping to turn you over.

So you’ve chosen the best bed for back pain with a wonderful firm mattress and now all you need is a back pain pillow?  Perhaps. 

But the best bed in the world and the best pillow in the world are not going to solve your back problems on their own.  My daily decompression routine using the BackBlock will help keep your back healthy and prevent any further degeneration.

a word of warning when changing to a firmer bed!

The transition can be tricky changing to a new, firmer bed and for the first couple of weeks you may feel you have made a dreadful (read expensive) mistake. But do stick with it. In changing to the best bed for back pain you are needing to incorporate the bed in the healing process if you are to get the best from it. This will mean often, in the first instances, your back will complain volubly at the change of rules. In short, you will be uncomfortable through the night and stiff in the mornings. This may last anything from a few days up to a month. I say again, stick with it, ideally making sure to do your BackBlock regime at night before you go to bed. 

| |

|You can go beyond simply relying on a better bed to make your back pain go away. You can do your own spinal decompression |

|using a simple yoga block or BackBlock to more pro-actively pull your jammed spinal segments apart. Whatever is giving you a |

|painful back, decompression is the first pre-requisite of active therapy.  |

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General Sleeping Guidelines

While there are no absolute rules, there are a few general guidelines about sleeping positions that are most comfortable for the spine:

• In general, the best sleeping position is to lie on your back with a small pillow tucked underneath the back of the knees. This position completely unloads the stress on the spine and allows for the natural curve of the lower back.

• For people who prefer sleeping on their side, it is helpful to place a pillow between the knees to help keep stress off the hips and lower spine.

• For people who sleep best on their stomach, placing a flat pillow beneath the stomach and hips can reduce stress on the spine.

• See Practicing Good Sleep Hygiene

While these guidelines are true in general, the position that is most comfortable to sleep in is again largely dependent individual preferences and on the type of back pain one has.

When shopping for a mattress, it is important to be aware of the quality and value of each potential purchase. The following are things a patient should consider when purchasing a new mattress:

1. Shop for the best value and quality of the mattress rather than for price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.

2. Be aware of mattress advertising gimmicks. Claims that a mattress is “orthopedic” or “medically-approved” should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.

Key Components of a Good Mattress

The following physical components are the important features of most high quality mattresses.

Mattress springs and coils provide back support. The wire in the coils comes in different thicknesses, where a lower gauge number denotes thicker, stiffer wire and a firmer mattress (2). A higher concentration of steel coils may indicate a higher quality mattress, but this does not mean that the highest number is best: patients should use their own judgment regarding which mattress is best suited to provide support and help alleviate their low back pain.

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[pic][pic]In This Article:

• Choosing the Best Mattress for Lower Back Pain

• Considerations When Buying a New Mattress

• How to Evaluate a Mattress

• Video: What is the Best Mattress for Back Pain?

Mattress padding provides comfort. In addition to the spring coils in a mattress, the padding on top of the mattress can indicate quality. Mattress padding is usually made of materials such as polyurethane foam, puffed-up polyester or cotton batting (2). Extensive mattress padding is often more expensive, but many people find it more comfortable and worth the extra cost.

Middle padding in a mattress. This type of mattress padding is just below the quilted top layer and is usually made with foam. When looking at a cross-section of the mattress, softer foams feel almost moist to the touch while firmer foams won’t spring back as quickly (1). The next layer of mattress padding is made of cotton batting that may vary in thickness across different mattresses and even within one mattress. This causes the mattress to feel firmer in some areas rather than others, such as increased firmness in the middle of the mattress (2).

Insulation mattress padding. This padding lies on top of the coil springs so that they cannot be felt from the top of the mattress, and it also protects the coils from damaging the top layers of the mattress (2).

Mattress ticking and quilting. The outer layer of a mattress consists of ticking, which is usually a polyester or cotton-polyester blend in a good quality mattress. The mattress quilting attaches the ticking to the top layers of padding. It is a good idea to examine the quality of stitching on the mattress quilting, looking for consistent, unbroken stitches (2).

Mattress foundations. The mattress foundation or box spring adds another level of support to the mattress. Foundations usually consist of a wooden or metal frame with springs. A plain wooden frame may make mattresses feel harder than a frame with springs. A wood mattress foundation should only be purchased if the wood has no cracks and is straight. The Better Sleep Council recommends that purchasing a foundation and mattress as a set helps preserve the mattress (1).

Foam mattresses

As an alternative to traditional mattresses, some types of mattresses are constructed entirely or mostly from memory foam or latex foam. They can be purchased in different densities. Some foam mattresses are made of multiple layers of foam adhered together while others have a foam core in the center. Foam mattresses come in various degrees of firmness to give patients greater selection for back support and comfort. Choosing between a foam mattress and a traditional mattress is based on personal preference.

Asking questions, requesting written product information and examining each mattress thoroughly will help patients become more educated consumers. By following the practical guidelines for selecting a new mattress, patients will be well equipped to find the best mattress for sleep comfort, back support and reducing low back pain.

Getting a good night's sleep depends on a lot of different factors -- comfort, stress level, room temperature – but to get it right, you've got to start with the basics and your mattress is the first building block to a restful slumber.

If you're in the market for a new mattress and have recently taken a stroll down the aisle of a bedding store, you know that there is a dizzying array from which to choose. How do you know which mattress is best for you?

To start, says Arya Nick Shamie, MD, associate professor of orthopedic surgery and neurosurgery at Santa Monica UCLA Medical Center, the mattress needs to support your body in a neutral position, one in which your spine has a nice curvature and your buttocks, heels, shoulders, and head are supported in proper alignment

"If the mattress is too firm, it will push on those main pressure points and take you out of alignment," Shamie tells WebMD. "If it's too soft, those pressure points won't be properly supported, so your whole body flops back." Both of these scenarios can lead to an achy morning.

Generally speaking, one type or brand of bed isn't better than another, says Michael Breus, PhD, a WebMD sleep expert and author of Beauty Sleep: Look Younger, Lose Weight, and Feel Great Through Better Sleep.  But he does find that a firmer bed seems to be better for people with lower back pain.

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In fact, researchers in Spain studied people with long-term back pain and found that on a 10-point hard-to-soft scale people who slept on a medium-to-firm mattress

If you wake up in the morning and have some low back pain and can stretch and get rid of it in 15 or 30 minutes, that means you're on an inappropriate mattress for you," Breus says.

The right mattress, on the other hand, is one on which you feel no pressure, almost like you're floating in air, Breus says.

If you're looking for a new mattress, experts suggest testing it in the store and laying down on each mattress in the position in which you normally sleep. Breus suggests spending at least 10 to 15 minutes on the bed. And, bring your own pillow! The more you can replicate the way you'll be sleeping on the mattress once you get it home, the better your chances of picking the right one.

Innerspring Mattresses

Innerspring mattresses are still by far the most widely used. They support you with coil springs, and in most built today, each coil is individually enclosed. This helps the bed weather years of use and prevents the coils from popping out of the mattress. On top of the coils are a wide variety of materials added for comfort, from pillow to latex to memory foam. It's all a matter of preference.

Salespeople may try to sell you on the idea that more coils mean more comfort, but that's not necessarily true, Breus and Shamie say.

"You don't really need a coil count above 390," Breus says. Beyond that, the difference in feel is so small it would be difficult to notice. 

Pros: There are plenty of innerspring mattresses on the market from which to choose. They range in firmness, the fluffiness of the pillow top, and in price to fit nearly every preference and pocket book.

Cons:  There's no direct relationship in most cases between price and comfort, but Shamie suggests steering clear of the cheapest innerspring mattress. If there aren't enough springs and cushion to offer you proper support, he says, you'll likely wake up with an aching back.

Conditions: For someone who is very overweight, spring mattresses may offer a firmer support, making them easier to get in and out of, Breus says. Firmer versions are good for people with back pain. But spring-based mattresses can be comfortable for almost anyone.

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Memory Foam Mattresses

Memory foam mattresses are growing in popularity. They are made of layers of different densities of foam that respond to weight and temperature, and are known for comfort because they contour to the specific shape of your body. Memory foam toppers are also available.

Pros: By molding to the shape of your body as your weight shifts through the night, memory foam reduces pressure points, and relieves pain. Memory foam also absorbs movement, so if you sleep with a partner, you're not likely to be disturbed by his tossing and turning.

Cons: One of the biggest complaints with memory foam mattresses is that because these mattresses are temperature sensitive, softening and molding with your body heat, they can make you feel extremely hot during the night. Breus also says memory foam mattresses have been known to emit an unpleasant chemical smell.

Conditions: "If you have a hard time getting comfortable, if you have chronic fatigue, or some type of muscle pain, then a memory foam mattress would work well for you, assuming you don't have temperature issues," Breus says.

Latex Mattresses

Latex mattresses are made from either natural or synthetic rubber, and are known for providing a very firm, bouncy support that is uniform throughout the bed. 

Pros: "Quite frankly, I think one of the best materials is latex," Breus says. He likes it for being very firm and supportive, but also for providing comfort similar to memory foam. Unlike the memory foam mattresses, however, Breus says latex pushes back, ultimately providing more support.

Cons: If you don't like the feel of a firm mattress, latex is probably not the right choice for you.

Conditions: Either a latex mattress or latex mattress topper is great for relieving back pain because they offer the best combination of comfort and support, Breus says.

Air Mattresses

We're not talking about the blow-up mattresses you put your holiday guests on for a few days. Higher-end air beds look like a standard innerspring mattress, but use air-filled chambers instead of coils, and are covered by a foam layer on top.

Shamie notes that air beds have long been used for patients with spinal cord injuries who are lying in bed for a long time. They can be adjusted so they don't continue to press on the same areas of the body, which helps to avoid skin breakdown in patients who can't move.

Pros: "Couples who have dramatic differences in their individual preference for comfort and firmness levels might do very well with an air mattress," Breus says. The reason is that the firmness of each side of the bed can be altered. If you like it firmer than your partner, these beds can be adjusted for that.

Like latex and memory foam, you can also find air toppers for your mattress.

Cons: Shamie says people sometimes fail to make their air bed firm enough and wake up with back aches. Less sophisticated air mattresses also pop up on one side when you sit on the opposite end. For that reason Breus says, you want multiple chambers so that doesn't occur.

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Conditions: These beds are particularly useful when sleeping partners have different needs. If one of you has a bad back, one side can be made firmer than the other to provide greater support.

Adjustable Beds

These beds are able to bend and elevate at varying angles. As a result, the mattress has to be flexible. Different types of mattresses can be used on an adjustable bed – memory foam, latex, or air, for example. Spring mattresses are more difficult to use, however, because the springs don't handle the bending well.

Pros: For people who have difficulty getting in and out of bed or who like to watch television in bed, Shamie says, adjustables can make life easier by moving you closer to where you need to be.

Conditions: If you suffer from sleep apnea, sleeping flat can make the condition worse by cutting off airways and causing the tongue to fall into the back of the throat, Shamie says. People who experience acid reflux can also benefit by sleeping in a bed that elevates their upper body.

Shamie also suggests adjustable beds for people with hip or back pain who have a hard time moving from a lying position to sitting up or standing.

Sofa Beds

When you have guests staying for a night or two, sofa beds come in handy. The mattresses in these beds tend to be very thin so they are flexible enough to fold and collapse into the couch. It's a great convenience to have a sofa bed, but you'd be hard-pressed to find someone who raves about their comfort.

Pros: Sofa beds are convenient, especially if you have limited space. But from a health perspective, Shamie and Breus don't see any advantages.

Cons: A night or two on a sofa bed is OK. But "this is probably the worst kind of bed you can sleep on long-term," Shamie says. The mattresses used in most sofa beds are very thin and the springs quite weak. "It really leads to an uncomfortable situation," Shamie says.

If you're really tight for space and need a bed that folds up, Shamie says that futons, while not the most supportive, are better for your back than the typical sofa bed.

Conditions: There are no conditions for which a sofa bed will be helpful, according to the experts. But if you have a bad back or hips, these beds will be especially uncomfortable.

When to Part With Your Old Mattress

Today's mattresses are made to last a lifetime. But you probably shouldn't plan on keeping yours for that long. Our bodies change over time, Breus says, so the mattress that was once a joy to sleep on may no longer feel comfortable a few years down the road.

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In addition, mattresses collect dust mites, fungus, and other germs that can exacerbate allergies and impact your sleep patterns. After 10 to 15 years, it's time to think about buying a new bed.

Ultimately, the experts say that the best bed for you is the one that feels most comfortable. And remember, Shamie says, "There's no mattress that's going to save your body when you get only five hours of sleep." In order to feel your best, you need to get enough rest… no matter what type of mattress you're sleeping on.

It is probably no surprise that chronic back pain has been shown to significantly affect the quality of sleep.

For years, doctors and scientists have speculated that the mattress may be the secret villain robbing people of much-needed rest. The wrong mattress can make a bad back worse, which leads to a restless night and pain during the day.

When it comes to mattresses, the hard way isn't always best. Recent studies show that a medium-firm mattress greatly improves the sleep quality in people suffering from chronic lower back pain. This overturns the conventional wisdom that firmer is better.

Traditionally, manufacturers increased the number of coil springs in their orthopedic mattresses to provide more back support. Yet these extra-firm beds actually led to worse sleep quality in some clinical studies. For those who have been sleeping the hard way, switching to a medium-firm mattress may be the key to a better sleep and reduced back pain.

Because medium firmness is a pretty vague term, it's advisable to test different mattresses for comfort. Because the traditional cotton spring-coil mattress market is still partially operating on the principle that firmer is better, some of the innovative new mattress materials that have been popularized in the last 10 years may be the way to go. The new foam, latex and advanced air mattress designs are trendy for a reason: Recent studies suggest that they deliver a great night's sleep and reduce lower back pain.

Air mattresses aren't just for camping anymore. The air-column support of the humble inflatable mattress has been given a high-tech makeover in the form of the popular Sleep Number brand of mattresses. Sleep Number mattresses allow the user to change the firmness of the mattress by adjusting the flow of air, providing a counterpressure to body weight. A study conducted at Massachusetts General Hospital found that those who switched to the Sleep Number bed from regular spring mattresses experienced decreased back and neck aches; less soreness, stiffness and pain; and improved sleep quality.

Memory foam is used in mattresses to conform to body shape. The foam allows the body to remain in its natural shape and alignment, a circumstance that is believed to relieve pressure on the back and other areas of the body. TempurPedic, the most popular brand of memory foam mattress, claims to adjust to every movement of the body and distribute the weight of the body. A clinical trial by the Yale School of Medicine backs up the brand's claims of improved sleep quality.

Latex-core organic mattresses are an alternative to foam mattresses for those who prefer more natural materials. Latex-based foam mattresses provide similar support to their synthetic foam counterparts. An Oklahoma State University study showed that switching to a new mattress composed of foam and latex layers improved the sleep quality of those with chronic pains. After switching to foam and latex mattresses, back pains continued to decrease over time.

Study after study has shown that the new generation of mattress designs can improve sleep and reduce pain.

But the results should be taken with a grain of salt - some studies show that good, regular cotton-and-coil mattresses were best at improving sleep quality. The common thread throughout all of these latter studies was that patients with chronic back pain tried a new mattress of medium firmness and found one that was comfortable. New mattresses provide better support than old worn ones, and as a matter of common sense, comfortable mattresses improve sleep.

Investing in a new mattress is one of the best presents you can give to yourself if you have lower back pain. But there's no magic mattress formula for a better back - your personal taste is your best guide. Just choose a medium-firm mattress of any material that feels most comfortable to you and rest easy.

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