The Best Bedtime Stretches for Back Pain

Back pain is, unfortunately, a very common complaint. So common that, according to the World Health Organization, “lower back pain is the leading cause of disability globally.” In the United States alone, roughly 16 million Americans (8% of the population) experience chronic back pain, with it also being one of the leading causes of missed work, according to the Georgetown University Health Institute Policy.

For many of us, the discomfort of back pain can persist well into the night, disrupting sleep. This can result in a loss of restorative sleep that helps our body heal, plus potentially increasing the likelihood of depression or similar consequences of chronic pain and lost sleep. (1)

But just because back pain is considered fairly normal doesn’t mean you have to grin and bear it. As a lover of kickboxing, hiking, marathon biking, running, and an array of high-impact sports, I am no stranger to back pain. I have had “flare-ups” that have me staring at my bed after a rigorous training session, wondering how to even get situated on it.

However, as I write today, my back pain is calm enough to train and sleep, despite having had back pain issues just two months ago. This is because of a conscious effort to manage back pain through a combination of movement, postural self-awareness, sleep, and stretching.

According to one systematic review, “stretching may help relieve pain by increasing the ROM (range of motion) and reducing muscle stiffness, which could alleviate pressure on nerves and decrease muscle spindle activity.” This review also found improvements in back pain over 4 weeks to 6 months of stretching, leading to “significant reductions in pain or pain prevalence in individuals.” (2)

I understand that sometimes you are so exhausted from work, training, or the back pain itself that pushing yourself to stretch at the end of the day may feel like an extra task you can’t manage. But stretching is something we can do on our own schedule, without hefty gym or fitness studio fees, and it has been shown to improve people’s sleep and overall well-being. So while it may seem optional or something you can put off, the consequences of not stretching or tending to your back pain may objectively not be worth the procrastination. (3)

In this article, I’m going to focus on accessible stretches that may help you fight back pain and make it easier to fall asleep and stay asleep. I’ve gathered information from experts, conducted extensive research, and drawn on my own experiences to better understand how to manage back pain, with the hope of offering an effective nighttime stretch routine that may reduce its severity before sleep and help you sleep better.

Disclaimer: Please note that the content in this article is meant for informational purposes only and should not be construed as medical advice or serve as a substitute for seeing a medical professional regarding any sleep problems you may have. Please see your doctor regarding any urgent medical issues.

What Causes Back Pain? 

There are over 40 muscles located in the back, each contributing to your movement, balance, and posture. These muscles work together to support your spine and facilitate various upper-body movements. (5) When one or more of these muscles gets tweaked, injured, or overused, the resulting pain can be debilitating. So what causes back pain, anyway? 

Vivek Babaria, D.O., board-certified interventional spine & sports medicine physician at DISC Sports & Spine Center, says the most common culprits of back pain he sees in his practice include: 

• Strains, often due to heavy lifting, car accidents, or even the sudden awkward moments we’ve all experienced as part of our day (like jolting your body in a weird way to pick something up from the floor)
• Herniated or bulging discs
• Arthritis, particularly osteoarthritis, can affect the lower back and lumbar joints
• Skeletal irregularities, such as scoliosis (abnormal curving of the spine) 
• Osteoporosis, a condition of porous bones that can increase your risk of fractures
• Poor posture when sitting and standing, which can put a strain on your muscles and ligaments and cause pain
• Sacroiliac joint pain, which can cause pain in your lower back

Dr. Thomas Pontinen, M.D., LCP-C from Midwest Anesthesia and Pain Specialists agrees, saying that sprains or strains are to blame for most instances of back pain, but he also sees patients managing pain from car accidents, slips and falls, degenerative disc disease, arthritis, or overexertion. (6)

Another important factor that isn’t uncommon to see is when individuals are carrying extra body weight, which can put further stress on the back and joints and worsen pain. Overall, Pontinen says, “If the body can’t process daily activity or exertion effectively, the joints in the back can pick up a lot of stress, and they’ll start to hurt.” (7)

In other words, there are so many possible causes of back pain that you may have trouble pinpointing the exact one. While getting to the root of the problem is important, especially if you have ongoing back pain, the most immediate thing you can do is find ways to alleviate it — like nighttime stretching. 

The Importance of Challenging Our Sedentary Habits and Committing to a Bedtime Stretch Routine

Darcie Pervier, MSPT, PES, and Owner of Newburyport Wellness, LLC, says, “It’s so important to address bedtime back pain if it is disrupting your rest because sleep is such a vital pillar of health. Often, it doesn’t take much to reduce your pain and get a good night’s sleep.”  

She also says most of us are simply sitting too much and not getting enough variety in how we move our bodies during the day.

While I’m going to focus on stretching in this article, it’s important not to forget the importance of an exercise routine. Research shows that even people with nonspecific low back pain (meaning, it just hurts and they don’t know why) benefit from doing core stabilization exercises. Furthermore, while stretching offers benefits, one study suggests that Doctors of Physical Therapy (DPTs) promote some of the best exercises for strengthening weakened muscles, even more than stretching them, to reduce pain. Moreover, if weight training or more high-impact strength conditioning is out of reach, another study found that core stabilization exercises were more effective in reducing back pain than general strengthening exercises. (8)(9)(10)(11)

Isometric exercises, such as the plank, or classic core-building exercises like crunches, can help strengthen your core and potentially reduce strain on your lower back. If you manage to find time to work out, focusing on your core can be a gateway to reducing back pain and enhancing everyday mobility. However, many people struggle to find the time or the will to manage a consistent exercise program. So, I’m going to focus on accessible stretches you can do before you sleep (and throughout the day) that may help relieve back pain.

As I’ve said before, while stretching before sleep or after work may seem like a feat compared to watching a movie, the effort you exert making up for a lack of mobility will almost always require more effort, loss of time, and pain. So, I suggest approaching stretching as a long-term investment, like a therapist for your back.

Maybe you’ll hear a crack or two, and feel a moment of relief, but then, when the back pain returns, you tell yourself, “This is a waste of time.” However, science suggests it is absolutely not!  (2)

Easier said than done, but patience and consistency are key with mobility exercises like stretching. So while it may seem challenging, I want to remind you that any boredom or annoying effort of stretching one might feel is a small (affordable) price to pay for potentially improving your quality of life.

Below is a simple nighttime stretch routine to get you started.

Do This Tonight (Quick Routine for Bedtime Back Pain)

Here are five simple, beginner-friendly stretches you can do before bed that target lower back pain. I am only focusing on back-pain-related stretches here, but I want to remind the reader that our whole body is connected. Pain in one area can lead to stress or overcompensation in another. So, while this is a start, we should always be looking to enhance our stretching routine to target our whole body.

Additionally, exercise and postural awareness (remember to use your legs when picking things up, not your lower back, for example) when moving through our day are two more ways to fight back pain and are worth considering as you look to live a healthier life with reduced pain and increased mobility. However, below is a good start, and we all have to start from somewhere (full-stretch routine should be around 15 to 20 minutes).

1. Single Knee-To-Chest Stretch:

Start by lying on your back. Raise and bend your leg, then place your hands on the area just below your knee or on top of your shin, and pull your bent knee towards your chest until you feel a stretch in your lower back, glutes, and hips. Hold the stretch for 20 to 30 seconds. Do these 2 to 3 times on each leg.

Where you’ll feel it: lower back, glutes, hips.

2.  Double Knees-To-Chest Stretch:

Here, we are doing a similar stretch as the single knee-to-chest stretch. However, this time you’re pulling both knees to your chest simultaneously, resembling a tucked position. When you feel the pressure or stretch, hold for 20 to 30 seconds, and repeat 2 to 3 times.

Where you’ll feel it: lower back, sacroiliac area, hips.

3.  Seated Spinal Twist

Begin by sitting upright, with your legs extended. Place and bend one leg over the other, with your foot planted next to the outside of the opposing leg’s knee. Use your hand opposite to the bent leg to keep your balance, then place your other hand on your bent leg’s thigh, right under the knee.

Then gently pull on the thigh area under your bent knee while looking in the opposite direction of your extended leg. While keeping your balance, gently pull and twist your body until you feel a stretch in your back and hips. When you feel a good stretch or begin to feel pressure, hold for 20 to 30 seconds. Do these 2 to 3 times on each leg.

Where you’ll feel it: outer lower back/lumbar region, obliques, glutes, hips.

4. Cat-Cow Stretch

With a starting position on all fours, looking forward (palms and knees on the ground). While looking forward, try to slowly elevate and arch your spine until you feel a stretch, then slowly bring your spine back down until you are arching downwards. This is a dynamic, or moving, stretch rather than a holding (static) stretch. Repeat this slowly for 8 to 10 reps.

Where you’ll feel it: lower and upper back spinal area, abdomen.

5. Reclined Bent-Leg Crossover Stretch (Reclined Figure-4)

Start by lying down with your legs extended. Elevate and bend one of your legs, then use your opposing arm to pull the bent leg over and pass your extended leg. Extend your arm on the side of your bent leg for balance, and pull on your bent leg until you feel a good stretch. Try to keep your spine aligned and head in place while doing this. When you feel a good stretch from the bent leg, hold it for 20 to 30 seconds. Switch to the opposing leg and do the same stretch. Repeat on each side for 2 to 3 sets.

Where you’ll feel it: lower back, glutes, hips.

Notes:

• With all the stretches, try to be conscious of your breathing. Try to breathe in as you set up the stretch, and out as you hold it. 
• Try to keep your spine aligned and remain balanced throughout the stretching exercises. Balance is critical to avoid injury and feel the full targeted benefits of the stretch. 
• If there’s time, I’d suggest taking a hot shower before your stretching routine.
• Do not push your stretch to a point of sensitive or agonizing discomfort. If you feel any sharp pain, reduce the stretch or discontinue it entirely.
• If you have a disc herniation, recent surgery, or severe injuries, it’s important to consult your doctor before engaging in any of these stretches.

Research-Based Benefits of Stretching to Ease Back Pain

Stretching is an ancient exercise with proven benefits. One meta-analysis found that hamstring stretches alone may alleviate lower back pain while increasing general mobility. Another study found that stretching was a critically helpful addition to injury recovery, helping regain not only mobility but also emotional confidence in everyday movements. (12) (13)

While I want to stay focused on lower back pain as it relates to better sleep, I should point out that stretching can make daily activities easier and reduce post-activity stiffness. This is why athletes stretch before and after training. Athletes perform multiple dynamic stretches to warm up, and static stretches to cool down, as dynamic stretching can increase blood flow and static stretching can reduce muscle stiffness after training. This logic can be applied to stretching for everyday activities, helping your body better prepare for and recover from the stress you put on it. (14)(15)

In addition to flexibility and mobility, stretching can also help relax the body and muscle groups, potentially making it easier to get to sleep or find calm. In one study, stretching was found to help alleviate muscular cramps in older adults, making it easier to fall asleep. (16)

I want to note that experiences may vary depending on the individual, just as studies also vary. However, overall, I want to stress that stretching is a free way to potentially reduce back pain, improve sleep, increase flexibility and mobility, and make everyday life easier. (3)

Best Stretches for Your Condition

Below are a few common conditions people struggle with when trying to fall asleep. I matched each one with a potentially helpful stretch to overcome it.

Lower back pain

Single Knee-To-Chest Stretch:

Start by lying on your back. Raise and bend your leg, then place your hands on the area just below your knee or on top of your shin, and pull your bent knee towards your chest until you feel a stretch in your lower back, glutes, and hip flexors. Hold the stretch for 20 to 30 seconds. Do these 2 to 3 times on each leg.

Sciatica

Figure-4 Stretch:

Lie on your back with your legs bent and feet planted on the ground. Cross one leg over the other so one ankle sits slightly above the other leg’s knee (on the quadriceps). Place your hands under the knee of your uncrossed leg and pull your legs towards your chest. When you feel a stretch, especially in the glutes, hold for 20 to 30 seconds. Repeat 2 to 3 times on each leg.

Stiff Hips

Butterfly Stretch:

Sit with your feet touching and knees bent outward. Place your hands on your feet or ankles and use your elbows to press down on your inner thighs until you feel a good stretch. Hold for 20 to 30 seconds and repeat 2 to 3 times.

If this stretch is too hard, you can also try it lying down. In this case, instead of your elbows, use your hands to slightly push your bent legs’ inner thighs towards the ground until you feel a stretch.

Poor Posture

Doorway Pec Stretch:

Stand in between a doorway with your forearms planted on each side of the doorframe. Gently lean forward while keeping your shoulders down and spine in a neutral position, and hold for 20 to 30 seconds. Repeat 2 to 3 times.  

Types of Stretches

Who you are and where you are can affect stretching. Here are a few examples:

In-bed Stretches

In bed, stretches can be done, but if your bed is too soft, it may result in spine misalignment or a lack of balance while performing them due to sinking into the mattress. I wouldn’t generally recommend stretching on an unstable surface like a mattress, but if it’s your only choice, I would suggest a firmer mattress or paying extra attention to your composure while stretching.

Floor Stretches

The floor offers a firm surface for sturdier balance and spinal support. However, some may find the floor too rough on their joints. In this case, I suggest using a thick towel or yoga mat to cushion your joints and create a slight buffer between you and the ground.

Easy (or Gentle) Stretches

If you have mobility issues or conditions like osteoarthritis, you’ll want to be careful not to overstretch your joints and muscles. Move slowly and cautiously during your stretches, and stop immediately if you feel sharp pain. While some people can do a split, flexibility and mobility depend on an individual’s physical state. It’s important to ease into stretches, breathe when doing so, and remember that with time, your range of motion can be built through stretching, but should not be forced. Try to think that you are working through stiffness, not pain, and a gentle stretch can still offer plenty of benefits.

Advanced Stretches

Dynamic (moving) stretches and advanced flexibility stretches are great for preparing for activities or maintaining one’s advanced mobility. However, these stretches are best done for athletic activities with more advanced muscular demands. I would stick to simple, calming, static (holding) stretching to reduce back pain before bed.

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