Sleeping w lower back pain (L4-L5)

[thefirstmrsdewinter]

I'm seeing a physio for lower back pain, what she says is a result of wear and tear to L4-L5. The main problem is waking in the night feeling like there's a nail in my spine and then having trouble turning over in bed.

If anything it's got worse over the last six months. I'm doing the physio exercises (the usual: cat/cow, pelvic tilts, leg lengthening, windscreen wipers, knee to chest stretches, extension etc) and using heat and massage, sleeping with a pillow between my knees etc but I'm still waking every night. Pain relief only lasts 4hrs-ish so doesn't see me through to the second half of the night, which is when I have the most trouble.

I'm a healthy weight, I did a year of weekly Pilates classes and I see a personal trainer who is very switched on, but for logistical reasons those are both a bit sporadic now (once a fortnight-ish).

Is anyone having more success with this than I am and can you recommend anything? It's driving me nuts!

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Could you get slow release pain relief so that it doesn’t wear off until the morning?

Yes, thanks. I bought some slow-release ibuprophen but I did a number on my stomach taking iron at bedtime and it took months to get better so I'm leaving this as a last resort. So that is a possibility.
I've been using ibuprophen gel but it doesn't last until morning, and even if I was up in the night to apply it, it takes ages to dry and I'd probably drop off with my bum hanging out. :)

'Ibuprofen'

This may be a silly question, but have you discussed your worsening pain with your physio? Perhaps the exercises are not helping and you need something else. Have you ever had an MRI of your back?

Could your bed be contributing to the pain? Maybe a new mattress might be needed.

I have some suggestions as I had similar issues, but I need to go to sleep, so will post tomorrow.

Firstly, I would speak to GP about pain relief. I fractured L1 year's ago & had to be on much stronger meds for a long time. Developed arthritis & was back on them. There are much better meds than ibuprofen & sounds like NSAIDs don't suit your stomach.

When I've had lower back issues (L5-S1) I did a lot of stretching at night (& often in the night) & one that helped most was - lie flat on back, keeping left leg straight, bend right knee & move it across left leg as if towards left shoulder. I would pull the knee over to increase the stretch. Hope that makes sense!

I've also had to take muscle relaxants for my back, as the muscles can often go into spasm.

Definitely worth seeing GP if it's affecting your sleep so much.

Not silly! Yes, she tells me to do the same things I'm doing. No MRI. I'm going to make another appointment. To be fair to her she has successfully treated everything else I've had (tennis elbow, jaw and neck stuff).
We have a firm memory foam mattress so that shouldn't be an issue. I stayed with my mum for over two weeks and had the same problem in her brand new memory foam bed.
I've found some new things to try via youtube so will try a lumbar support roll tonight. Have also been sitting on a hard chair with a lumbar cushion instead of the sofa, which actually seems better already so maybe the sofa (and my arse being on it) is the problem.

I feel your pain (literally) I have had a bulging disc since 31st October with little relief and now I have pregnancy related PGP - the only thing that really helped me (which I can't use now as pregnant) was the red tiger balm. I can't recommend it highly enough. Magic stuff. That with the heat and exercises and trying to walk around as much as possible. Good luck, it's horrible. I still can't get a decent nights sleep.

Dusty thank you, that's good to know re painkillers. I think I had a panic when the physio had no further suggestions.
It's not that the pain itself is such agony (it's uncomfortable but bearable and I have no trouble going to sleep), it's that I struggle to change positions and I feel like a turtle on its back. My back is so stiff I have a few false starts before I can move much. By the time I shuffle myself onto the other side I'm frustrated and cross and usually cold because the covers go everywhere etc. Sometimes I only manage to get halfway and I fall asleep again and wake up very sore. It's such a PITA.
Thanks again. I'll make an appointment with the gp.

Make bless you, how awful. I'll put the red tiger balm on my list. (I forgot, I do have some of that physio hot/cold menthol stuff somewhere, I must look for it.) Good luck, I hope you get some relief.

I have degenerative disc disease and memory foam KILLS my back. I think it’s because there’s no movement to it, you just sort of sink into a mould.

The best bed I ever had was a dunloppillow foam mattress. I’m ok on my pocketsrung at the moment but find that sleeping on my side with a pillow between my knees and another one pushed up against my tum, helps.

Hope you get some respite soon.

A wheat bag really helps me but it's not easy to heat up in the middle of the night. An XL one for backs.
Ibuprofen works well for me and doctor prescribed omniprezole (spelling!) So I could look after stomach a bit better.

If you can tolerate it, bit of cocodamol just before bed might help, or a large gin!

I have arthritis of my lumber spine due to my CP I use all/ some of the following nightly
Pillow between knees, knees bent
Cocodamol
Diclofenac ( with omeperazole to protect stomach)
Stick on heat patches( cura-heat or own brand)
Deep heat or similar
Nefopam( an atypical prescription painkiller)
Mini Tens machine( Lloyd's pharmacy £20 one is excellent, also available from Amazon)
Double measure of any spirit( seriously!)
Hope something helps very soon

You really need to get an MRI done but in the meantime get rid of the memory foam mattress, get the softest, least firm mattress you can find, it will make a huge difference. MF mattresses are the absolute worst if you have lower back pain.

Soft mattress and stronger pain relief

I have back pain, also L4 and L5, for about 5 years. Had MRIs which show bulging discs. Pain fluctuates but often worse at night. Self manage generally during day but take Nortriptyline at night. Had the same pain of feeling like a nail was going in. Nortriptyline definitely helps and most nights I am in far less pain. I also suffered from taking ibuprofen - will only take very occasionally now.

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I was getting deferred nerve pain to my knee from the same complaint, taking lots of pain relief etc, my gp recommended a rolled up towel (similar to a lumbar roll) under my back at night...the relief was incredible, no pain to my knee, better on my back and good nights sleep. I still do core exercises as find this really helps

For those recommending soft mattresses, i'm not sure that's a good idea.
I have degenerative disc disease and suffer as the OP does.
A soft mattress does not provide proper support.

Maternity type pillows that go between the knees are very helpful for me.

I was told memory foam was not a good idea with my lower spine issues. I have an amazing firm one from Ikea and it was the best investment for me. I actually sleep.

Are you on any medication like amitryptaline? I’ve found that helps me get some sleep plus a short course of diazepam.

I’d highly recommend you ask for an mri because when mine was done I was convinced it would show at most sciatica, but it showed arthritis in my lower spine and a whole host of other issues. It meant my physio had to change how I was treated. Really important not to overdo it if that’s the case!

I agree with getting rid of the memory foam mattress mattress. I have lumbar spondylosis and bought one thinking it would help but the turning over was an absolute nightmare as you're sunk in it and I was awake every half hour or so.

Changed it to a medium firm pocket sprung and the turning over issue has much improved.

I am increasing my back strength using weight machines at the gym which is very slowly helping. I find the Deep Freeze stick on patches help overnight.

notwork i think individuals have to find what works for them. Certainly the recommendation is a firm mattress..I perservered for years. It was only staying at a hotel which made me realise soft mattress improved my pain

Sorry that you are having to put up with back pain OP. It's awful.

Sorry to sideline the OP, I am ok sleeping but struggle driving. I've tried every possible seat position but nothing helps? Does anyone have any magic tips

I have degenerative disc disease, spondylolisthesis in L5-S1, facet joint osteoarthritis of the spine, rheumatoid arthritis and other conditions all triggered by an accident.

The worst bed for me as actually been a memory foam, even though it was a Which Best Buy.

I've now got a soft Flaxby pocket spring mattress and sleeping better then I ever did on memory foam (I'll never sleep great asthe pain is too much, but this mattress at least isn't making it worse!).

I do sympathise though. It isn't nice, and at night, when you're just laying there, it's hard to focus on anything else.

I don’t know if this is helpful, but I’ll share my experience:

I had really bad lower back pain that had been steadily getting worse over the last 4 or 5 years. I went privately to see an Osteopath and then a Physio but didn’t get much improvement from the exercises or treatment. After a couple of months the Physio refused to treat me any more and said I should go to my GP and request an MRI. This is why I think it is strange your Physio is not suggesting further investigation is needed. My GP did agree to refer me for an MRI and the scan showed I have degenerative disc disease in L5/S1 worse on the left side.

I had a lot of trouble sleeping with the pain. I could deal with the pain during the day but the nights were the worst. My GP put me on a low dose of Gabapentin which helps me to sleep at night and reduces the pain. I didn’t find Ibuprofen or cocodomol helpful. Like others I also use the stick on heat pads. Another suggestion is to try Biofreeze (you can buy it in Boots), I think the spray is better than the gel) which numbs the area and reduces the pain and tension – it’s brilliant stuff!

I sleep on a firm pocket sprung mattress. Anything soft or memory foam just makes my back pain worse. I get a cheapish one and then chuck it after 3 or 4 years when it gets too saggy for my liking.

To help improve my back I have been going to one-to-one Pilates sessions. This has been amazing for me and I can really see improvements in my walking, posture and a reduction in pain. My Pilates teacher has looked at my body as a whole and my left side is a lot weaker and the muscles and joints (especially my legs and ankles) don’t work as they should which exacerbate my back issues.

I don’t think there’s any one magic answer as everyone is different.