Left Side Sleeping Causing Upper Back Pain: Causes and Solutions

Pain in the upper left back when sleeping on the left side?

Hello doctor, I have a habit of sleeping on my side (either left or right), but recently I've been experiencing pain in the upper left side of my back and along the side after waking up, similar to a muscle strain, and it even hurts when I breathe.
However, this symptom disappears after two to three hours.
I have some issues with my lumbar spine, so sometimes sleeping on my back is uncomfortable, which is why I prefer side sleeping.
This type of symptom has occurred occasionally in the past, but previously, if I slept on my back for a few days and then returned to side sleeping, the pain would go away.
However, this time it seems I can't resolve it as I did before.
I'm unsure whether I should see a doctor or what exercises I can do to alleviate the pain.
Thank you for your help!

Mika, 30~39 year old female. Ask Date: 2020/06/28

Dr. Li Weiqiang reply Rehabilitation

Hello, regarding the sleeping habit of side sleeping (on both sides), I experience pain in the upper left back and side upon waking, which feels like a muscle strain, and it even hurts when I breathe.
However, this symptom disappears after two to three hours.
It may be related to my sleeping position and daily posture.
A thorough examination is needed to determine the cause and treatment options.
As for my lumbar spine, it is not in good condition, and sometimes sleeping on my back is uncomfortable, so I prefer to sleep on my side.
This type of symptom has occurred occasionally in the past, but previously, after a few nights of sleeping on my back, the pain would subside when I returned to side sleeping (I usually perform some stretching exercises before bed).
The treatment plan includes physical therapy, which needs to be evaluated.
Wishing you peace and health.
Sincerely, Dr.
Li Wei-Chiang, Director of the Rehabilitation Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/06/28

More Info

When it comes to upper back pain associated with side sleeping, particularly on the left side, there are several factors to consider. Your description of the pain, which feels like a muscle strain and is exacerbated by breathing, suggests that it may be related to muscle tension or strain rather than a serious underlying condition. However, it's essential to explore the potential causes and solutions to alleviate your discomfort.

Potential Causes
1. Sleeping Position: Side sleeping can place significant pressure on the muscles and joints of the upper back, especially if the pillow is not providing adequate support. If your head is positioned too high or too low, it can lead to misalignment of the spine, resulting in muscle strain.

2. Mattress Quality: An unsupportive mattress can contribute to poor sleeping posture. If the mattress is too soft or too firm, it may not provide the necessary support for your spine, leading to discomfort in the back and neck.

3. Muscle Tension: Chronic muscle tension in the upper back can be exacerbated by poor posture during the day, stress, or lack of physical activity. This tension can lead to pain that becomes more noticeable after sleeping in a certain position.

4. Pre-existing Conditions: You mentioned having issues with your lumbar spine. If you have a history of back problems, this could contribute to the pain you're experiencing, as compensatory mechanisms may lead to strain in the upper back.

Solutions
1. Adjust Your Pillow: Ensure that your pillow supports your neck and keeps your spine aligned. A contour pillow or one that is adjustable in height may help maintain proper alignment while side sleeping.

2. Evaluate Your Mattress: Consider whether your mattress is providing adequate support. A medium-firm mattress is often recommended for side sleepers, as it can help maintain spinal alignment.

3. Stretching and Strengthening Exercises: Incorporate gentle stretching and strengthening exercises for your upper back and neck into your routine. Focus on stretches that target the thoracic spine and shoulder area. Yoga or Pilates can also be beneficial for improving flexibility and strength.

4. Heat Therapy: Applying heat to the affected area can help relax tense muscles and alleviate pain. A warm compress or heating pad can be effective.

5. Physical Therapy: If the pain persists, consider consulting a physical therapist. They can provide a tailored exercise program and manual therapy techniques to address your specific issues.

6. Postural Awareness: Pay attention to your posture during the day. Ensure that your workstation is ergonomically set up to reduce strain on your back and neck.

7. Consult a Healthcare Professional: If the pain continues or worsens, it may be wise to consult a healthcare professional. They can perform a thorough evaluation to rule out any underlying conditions and recommend appropriate treatment options.

Conclusion
Upper back pain associated with side sleeping can often be managed through adjustments in sleep posture, mattress quality, and incorporating stretching and strengthening exercises. While it’s common for such pain to resolve after a few hours, persistent or severe symptoms warrant a professional evaluation to ensure there are no underlying issues. By taking proactive steps, you can improve your sleep quality and reduce discomfort, allowing for a more restful night’s sleep.

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