Sleeping on your back is better for your spine, says chiropractor

For many people, going to see a chiropractor is their last hope. If you sleep badly, wake up with tense muscles or struggle to even sleep through the night because you’re in pain, you should get advice from a specialist who knows their way around the human musculoskeletal system. I went to see chiropractor Patric Beereuter at his practice in Obfelden – not as a patient, but out of curiosity.

About Patric Beereuter: content

Patric, when people come to you in pain, why do you want to know what position they sleep in?

Patric Beereuter: I ask almost every patient about their sleep. Especially when they say they wake up in the morning in pain. And I’m even more likely to ask them about it if their pain wakes them up during the night. In particular, people who sleep on their stomachs and have to turn their head sideways because of it often have neck pain. They also experience frequent discomfort in the pelvic and hip areas, especially if they sleep with one of their legs bent.

Despite spending hundreds of francs on mattresses and slatted bed bases, many people have problems. In Japan, on the other hand, people sleep on thin tatami mats, but don’t have the same difficulties.. How does that work?

The main difference is probably that sleeping on a tatami mat involves lying on your back a lot. On firmer mattresses, the supine position is often better for your spine because it doesn’t bend as much as when you’re lying on your side. On a tatami mat, you’re less tempted to roll on to your side because it quickly starts to hurt.

When I lie on my back, it takes me much longer to fall asleep. Is learning to fall asleep that way just a question of practice?

A lot of people prefer child’s pose, i.e. lying on their side. If that’s your preference, though, your mattress should be soft enough for your shoulders and pelvis to sink into it. There shouldn’t be too many pressure points either. If you sleep on your back, a slightly firmer mattress is often a good choice.

Pia Seidel, who works with me in the Editorial Team, reviewed a very popular knee cushion from our range. From your point of view as a chiropractor, is it a good idea to use a product like that?

These products can definitely be useful. Since they keep your legs on top of each other, they stop your pelvis from twisting as much.

Pillows are even more complicated. If you sleep on your back, you need a flatter pillow than if you sleep on your side. But which one should you choose if you switch things up?

That’s one of the major issues. You’d need one that changes height depending on which position you’re sleeping in. But since these don’t exist, I recommend a pillow that’s at the right height for your preferred sleeping position. For example, if you tend to lie on your back but sleep on your side, you should choose a slightly flatter pillow than someone who spends the entire night on their side. You can also get pillows that are touted as «all-round», but I’ve never come across a pillow that can do it all. I have loads of patients who have as many as ten pillows at home because they’ve tried a bunch of them and not really been happy.

What role does your mattress play in all of this?

Mattresses are a piece of the puzzle when patients come to my practice. Still, it’s certainly not the number one issue. My main goal is to diagnose and treat musculoskeletal complaints, for example releasing tension and blockages, and identifying and improving poor posture. But if a patient has recurring problems, we look at their sleeping position and how ergonomic their working environment is. I hear from a lot of people that they have a ten-year-old mattress that’s worn out and needing to be replaced. I think it’s important that people get good advice from specialist retailers and don’t just look for the best discount.

Are we just wimpier nowadays than our ancestors were? I never heard my grandparents complain about having muscle tension or pain after waking up.

This might be a little controversial to say, but yes, it’s a bit of a First World problem. There probably used to be way more people with these issues. Although people did much more physical work, they didn’t whine about it. Many people only went to the doctor when there was no other option – say, when the pain made it difficult for them to breathe or walk. A lot of people wouldn’t have taken the time to go to the doctor. They had to build their businesses, provide for their families, work on farms. Moaning wasn’t an option – you just had to grin and bear it.

So, have things improved now?

Yes, people have simply realised that if you tackle a problem early enough, you’ll feel better. That’s why people take advantage of the selection of medical services available, which is, of course, better and more comprehensive in this day and age.

So we haven’t just become oversensitive?

Fortunately, we’re also more health-conscious nowadays. And since more work is done on computers, new problems have come about. During the pandemic, we saw significantly more patients with head and neck pain. People went from well-equipped workplaces with standing desks and decent office chairs to sitting in front of a laptop at their dining table at home.

Would it do us good to build up a few more muscles? Like the ones our parents and grandparents probably still had?

In the past, people were more physically active, so their muscles were in better condition. Today, lots of people are reluctant to walk even the shortest distances, choosing instead to go every metre by electric scooter. We definitely don’t get enough natural exercise these days. On the other hand, we’re seeing an increasing number of people taking advantage of the opportunity to work out at gyms and elsewhere.

What advice would you give to an office worker who comes to you with neck pain?

The key thing is what they do after spending eight hours sitting in an office chair. There needs to be a balance. It helps to get up from time to time during the work day. Doing exercise in the evening is also really important, whether it’s a gym session or a Pilates workout. Mind you, getting the right amount is key. Excessively working out and never taking any breaks creates problems too.

Do you have any general tips on what type of exercise is helpful, and when?

It’s hard to say what kind of exercise is «the right one». Jogging can help with tension headaches. But if you’re 60 years old and have never run in your life, I wouldn’t recommend starting now. There are alternatives that are easier on your joints.

People of that age are usually recommended swimming.

Swimming or aquafit are good options. Both put little strain on the joints. Patients who’ve enjoyed swimming in the past are bound to be happy to follow that advice. But getting someone who’s new to the sport to try it rarely works. Joining a sports club, taking Pilates or cycling are good alternatives. People can stay active for especially long if they use an e-bike. But there’s no one sport that’s always a good fit.

Some people even find sitting upright physically demanding. Not me, though, obviously...

Oh, obviously not (laughs). But seriously, one problem that crops up consistently is protraction of the head, neck and shoulders. Or to put it in non-medical terms, when we’re sitting at the computer, we automatically assume a slightly bent posture, causing our head and shoulders to hang too far forward. That’s why I work with my patients using tapes. They give the patient a feel for how they could improve their posture. However, the postural muscles then have to be rebuilt.

What do you think of gadgets like posture trainers?

I have mixed feelings about them. Sometimes the straps are too tight or pull in the wrong direction. But it never hurts to try them out. Given they cost 30–50 francs, you don’t have much to lose if they end up not being for you. But if you only manage to stand up straight with the help of a posture trainer, you’ve got a fundamental problem.

And how important is ergonomics in the workplace?

Your sitting position is, of course, important. It also helps to have a decent chair and a height-adjustable desk. In practice, however, people raise and lower these desks much less often than you might imagine. Incorporating exercise into your day-to-day routine is often easier and more effective. All you have to do is start.

Thanks for taking the time to talk to me, Patric.