2002-11-23 / Columnists

Eye On Physical Therapy

By Tim Rorhs

By Tim Rohrs

Timothy Rohrs, P.T. is a NYS Licensed Physical Therapist, Director Sands Point Physical Therapy and is currently working towards a clinical doctorate degree at S.U.N.Y. Stony- Brook. Rohrs will be writing a monthly column for The Wave.

One of the most frequent questions I am asked as a physical therapist is, "Is there a certain mattress or pillow I should use to help with my back or neck pain. How many pillows should I be using? Should I keep pillows between my legs. Can I keep my legs elevated at night for comfort?" The answer is both simple and complex. Not one mattress, firmness or brand is good for everyone. Some people need greater support through firmer mattresses and others not. I usually recommend that patients note mattress firmness while away on vacation and compare to their home mattress and see if a better or worse nights sleep was attained because of it. An hour in a store is not sufficient time to judge the comfort for a full night's sleep. That's the complex and evasive sounding answer. The simple answer is... get the best night sleep possible. Sleep time is not the time to correct spinal asymmetries or muscle imbalances. Sleep time is exactly that; time to rest. People in pain, whether knee, back, neck or hip pain perceive pain greater than it actually is because of sleep disturbances. If you need 3 pillows under your head and one between the legs to get the best nights sleep possible then use them. Getting a good night sleep is the single most important thing you can do to perceive less pain. Dr. Martha Lentz and colleagues studied pain thresholds and reported the findings in the Journal of Rheumatology, 1999 26(7): 1586-92. They found that when slow wave sleep was disturbed, subjects showed a 24% decrease in pain threshold. Pain thresholds are a threshold at which a stimulus is needed to excite the pain nociceptor. The take home message is that it takes less stimulus to get these pain nerves to fire (increased pain) because of a disturbance in sleep. So, get the best nights sleep possible and let your physical therapist worry about correcting postural and movement impairments.

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