Senin, 05 Januari 2009

Low back pain: the effects of hard and soft mattresses

03 Apr 2008

A study in the April 1 issue of Spine reports that for patients with low back pain, sleeping on softer types of beds that conform to the body may lead to improvements in pain and sleep. Contrary to what many people think, sleeping on a hard mattress may actually make pain worse, according to the new report by Dr. Kim Bergholdt and colleagues of Backcenter Funen in Ringe, Denmark.

One hundred sixty patients with chronic low back pain were randomly assigned to sleep on one of three different types of beds for one month: a waterbed, a body-conforming foam mattress, or a firm futon mattress (without springs).

Patients who slept on the waterbed or body-conforming foam mattress had small but significant reductions in back pain scores. Total sleep time was also better for patients assigned to the softer mattresses. Again, the differences were small—sleep time increased by less than an hour in both the waterbed and foam mattress groups.

In contrast, patients who slept on the firm futon mattress tended to have increased pain scores and decreased sleep time. This result was difficult to interpret, however, because several patients assigned to the firm mattress group dropped out of the study early. At least some of these patients thought the mattress was making their back pain worse.

Another complicating factor was that several patients dropped out of the study after learning they had been assigned to the waterbed group. Most of these patients had negative opinions about waterbeds despite never having tried one. None dropped out because they knew the waterbed would make their back pain worse.

Patients with increased sleep time tended to have reduced pain scores. It was unclear whether reduced pain led to increased sleep time or vice-versa.

Mattresses are often mentioned among the factors that may affect low back pain, especially for patients whose pain is worse in the morning. Only a few studies have addressed the effects of mattresses on back pain, with inconclusive results.

There are reasons to suspect that either a soft or firm mattresses might be better for patients with back pain. For example, a soft mattress might help to avoid stress on the spine by keeping the back in a neutral position, while a hard mattress might reduce twisting of the back.

The new results suggest that the waterbed and foam mattress do reduce pain and improve sleep for patients with chronic low back pain. The results are consistent with another recent study, which also found beneficial effects of softer mattresses.

The authors emphasize that the two soft mattresses studied conform to natural body curvatures. They bring the joints into intermediate positions, rather than just letting the body parts sink, which may put the joints into awkward or twisted positions. "Thus, body-conforming soft mattresses seem to have an advantage over hard mattresses," the researchers conclude.

"Probably they are also better than soft, worn-out spring mattresses, hammocks, and other soft types that do not conform to natural, intermediary positioned body curvatures."

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