This article is not about recommending a specific brand or type of mattress or pillow ideal for preventing or “curing” back injuries, but rather about analyzing why this choice is important and how to make the right decision.
We spend between 7 and 8 hours a day sleeping, which amounts to about 50 hours a week, 1500 hours a month… in total it is estimated that we spend a third of our life sleeping, hence the importance of maintaining good posture on an appropriate support to avoid injuries and rest better.
According to a study by the Kovacs Foundation published in “The Lancet“ in 2003, they state that the firmness of the mattress should be intermediate, contrary to what was formerly believed, since a mattress that is too hard would not conform to the shape of our body to allow the back to remain straight, and one that is too soft would achieve the opposite effect, not providing adequate support to the bone structure of the back. Also, it is important to consider whether the mattress is new or old; the average lifespan of a mattress is considered to be 10 years, while pillows should be changed every 2-3 years.
We must keep in mind that we are not all the same height and do not have the same needs, and like almost everything in life, I always recommend that the pillow be personalized, that is, individual and adapted to each person’s size. This is even more important for couples where there is a significant height difference and who continue using traditional double pillows. The material of the pillow is generally a matter of preference in terms of firmness, as long as it’s not too soft, but regarding size, I usually make a recommendation: it should measure approximately the distance between the outermost edge of the shoulder and the neck, minus 2 cm.
Why minus 2 cm? Because that’s roughly the distance the body will sink into a medium-firm mattress and what the head needs to settle into the pillow; thus maintaining a correct alignment of the cervical spine with the rest of the back when sleeping on one’s side. If the material is not too hard, lying on one’s back will also provide adequate support. As for cervical pillows, we could apply the same principle; just because they have that name doesn’t mean they are ideal for everyone, and they are not quasi-magical.
It is NOT recommended to sleep on your stomach, as it promotes an increase in lumbar curvature and hinders normal breathing, resulting in less rest. The best sleeping positions are on your back with a pillow under your knees or on your side. Although for patients with knee arthritis, I usually recommend placing a thin pillow between the knees as well.
Source: Fisioenap.com
The Professional College of Physiotherapists of the Community of Madrid has warned about the high rate of health problems caused by poor posture during rest. For this reason, they recommend choosing the pillow and mattress based on the position adopted for sleeping, in order to avoid future musculoskeletal problems.
Source: Professional College of Physiotherapists of the Community of Madrid
The Role of the Mattress in Back Health
Resting on a medium-firm mattress improves the intensity of lower back pain and reduces the degree of disability. This is the conclusion of a study conducted by the Kovacs Foundation, which contradicts the widespread idea that very firm mattresses are more suitable for preventing or even treating back pain.
The study involved 313 patients with chronic non-specific low back pain who were assigned either a very firm mattress or a medium-firm one. For three months, a team of specialists including rehabilitation doctors, traumatologists, neurosurgeons, and methodologists assessed the intensity of pain while sleeping and upon waking, as well as the degree of disability and medication consumption of the participants.
According to the results, just the fact of changing the mattress already resulted in an improvement in back pain in all patients and nearly 40 percent were able to stop taking the medications they were using to relieve the symptoms. However, people who slept on mattresses with intermediate firmness achieved a 2.4 times greater improvement in bed pain, while the degree of physical disability improved 2.1 times more compared to the group that received the hardest mattress,” explained Víctor Abraira, specialist of the Clinical Biostatistics Unit at Ramón y Cajal Hospital, Madrid.
These data allow us to affirm that mattress characteristics decisively influence the development of lower back pain and disprove the idea that firm mattresses are the most suitable for maintaining back health. This belief, which according to a recent survey is shared by up to 95 percent of North American orthopedists and most patients, has been especially promoted in recent years by advertising messages that lack scientific rigor and basis.
From now on, the fact of sleeping on an inadequate mattress can be considered another risk factor that can be easily avoided, as the use of a good mattress has been shown to have a beneficial effect on the evolution of low back pain even greater than that obtained with other therapeutic measures,” indicated Francisco Manuel Kovacs, president of the Kovacs Foundation and coordinator of the study.
According to the specialist, to prevent back pain, it is essential to maintain correct postural hygiene, perform appropriate physical activities that improve muscle mass, avoid excessively firm mattresses, and promote health education among the general population in order to eliminate erroneous ideas that harm back health.
Source: DeMedicina.com
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