Rest easy: Sleep tips from AdventHealth Avista neurosurgeon Dr. Sharad Rajpal to keep back pain at bay

When it comes to back health, how you sleep matters just as much as how you move during the day. According to Dr. Sharad Rajpal, a neurosurgeon at AdventHealth Avista, your nighttime habits can either support spinal health—or silently sabotage it. Here are his top tips for sleeping smarter and waking up pain-free.

1. Choose the Right Sleeping Position

The best sleeping positions for spinal alignment are those that preserve the spine’s natural curves. Dr. Rajpal recommends sleeping on your back or side. If you’re a side sleeper, place a pillow between your knees to keep your hips and pelvis aligned. Back sleepers should tuck a pillow under their knees to reduce lower spine strain. Stomach sleeping is discouraged, but if unavoidable, skip the head pillow and place a thin one under your pelvis to ease pressure on your back.

2. Understand the Impact of Poor Sleep Posture

Spending 7–10 hours in a misaligned position can lead to muscle strain, joint irritation, and even disc issues. “Just like poor posture during the day can cause pain, poor sleep posture can contribute to chronic back problems over time,” says Dr. Rajpal.

3. Tailor Your Sleep Setup for Chronic Lower Back Pain

For those with chronic lower back pain, Dr. Rajpal suggests sleeping on your side with a pillow between the knees or on your back with a pillow under the knees. Elevating the legs slightly can also help relieve lumbar pressure. A firm or medium-firm mattress is key to maintaining spinal neutrality.

4. Sleep Is Spinal Maintenance

“During sleep, the body undergoes tissue repair and regeneration,” Dr. Rajpal explains. This includes spinal discs, ligaments, and muscles. Quality sleep supports long-term spinal health and helps the body recover from daily stress.

5. Pick the Right Mattress

A firm or medium-firm mattress supports the spine’s natural curves and distributes body pressure evenly. While soft mattresses may feel cozy, they often lack the support needed for adult bodies. If you prefer softness, consider a firm mattress with a plush topper. Memory foam and latex mattresses can be very supportive as long as they maintain firmness and resist sagging over time. Hybrid mattresses, which generally combine springs and foam, offer good support and airflow. The key to any mattress is stability and consistency—avoid materials that can disrupt sleep quality by breaking down quickly or retaining excessive heat.

6. Know When It’s Time to Replace Your Mattress

Most mattresses should be replaced every 7–10 years. But if you’re waking up stiff or sore—and feel better as the day goes on—it might be time for a new one. Visible sagging or feeling “stuck” in the mattress are also red flags.

7. Don’t Fall for Sleep Myths

One common misconception is that the firmer the mattress, the better. In reality, overly hard mattresses can increase pressure on joints. Another myth? That back pain during sleep is just part of aging. “Pain is not inevitable,” Dr. Rajpal emphasizes. “It’s often tied to modifiable factors like posture, exercise, and mattress quality.”

8. Stretch Before Bed

To help your spine relax, Dr. Rajpal recommends a few minutes of stretching or mindfulness before bed. Try gentle moves like knee-to-chest, child’s pose, and cat-cow stretches to ease tension and improve flexibility.

Sharad Rajpal, MD, FAAN, is a board-certified neurosurgeon specializing in spinal disorders for patients ages 18+. Dr. Rajpal is an advocate for innovative approaches to spine surgery and works closely with industry leaders to develop cutting-edge technologies in advanced spinal robotics and image-guided spine surgery.

Click here to learn more: Sharad Rajpal, MD | Neurosurgery | Louisville, CO | AdventHealth