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Lying Prone

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The prone position, or face down position, is a common position for sleeping. If back pain occurs only in this position, there can be several causes. The spine, particularly the lumbar region, is relatively flexed or bent forward in this position. This position causes an increase in pain for an individual with a herniated disc, according to physical therapist Mark Dutton. The flexed position would cause the disc to move further backward, away from its natural position. Also, if an individual has a strained back muscle, this flexed position could result in pain due to stretching of the injured muscle.

Lying Supine

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Lying supine, or face up, can also result in back pain in several instances. If there is direct trauma to the spinal column and surrounding muscles, then lying face up could result in pain. The face-up position results in relative extension, or bending back of the spine. Extension often worsens pain in individuals with facet joint syndrome, a condition in which the smaller joints between each vertebrae become inflamed. According to, spinal stenosis symptoms are often worse when the spine is in extension, which happens when someone lies face up.

Alternative Positions

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There may be simple solutions to the pain that occurs when lying flat. If pain occurs lying face down, then try placing a small pillow under the lower abdomen. This pillow serves to take some pressure off of the lower back. If pain occurs when lying face up, it may be beneficial to elevate the legs. This serves to bend the spine forward somewhat. Lastly, you can attempt to sleep on your side to decrease pain.


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Exercise has emerged as a cost-effective intervention strategy for back pain, according to the American Physical Therapy Association. Several health professionals, including physical therapists, occupational therapists, and personal trainers, can assist in prescribing an individualized program. The website Spine-Health reports that physical therapists are trained to teach patients proper technique for exercise, which can prevent further injury. In general, an exercise program for low back pain will consist of core strengthening, back and leg stretching, and aerobic activity.

Psychological Cause

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If medical treatment has no impact on back pain, there may not be a physical cause. claims that back pain that only occurs when an individual is trying to sleep "is almost always caused by repressed psycho-emotional issues creating a psychologically induced pain syndrome." The psychological process produces anxiety which, in turn, manifests as physical pain.

Is This an Emergency?

To reduce the risk of spreading COVID-19 infections, it is best to call your doctor before leaving the house if you are experiencing a high fever, shortness of breath or another, more serious symptom.
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