While selecting a bed due importance should be given to posture and spinal anatomy. Most people are not aware of these considerations. In fact, with affluence and luxurious living, things are changing for the worse rather than the better. Cotton mattresses are being replaced by foam mattresses. The thickness and number of pillows used by an individual are increasing. Springs are often added beneath these foam mattresses. A comfortable bed is considered to be one into which you sink in. Is that correct? Very definitely not!
It is important to keep the spine as straight as possible while sitting, standing or doing any job. Equally important is to help the spine to remain as straight as possible while lying in bed, and even more so when you are suffering from back pain or neck pain. Let us consider what a soft bed does to your spine. When you lie on a soft bed the heavier part of the body sinks deeper into the bed, and the lighter part of your body stays up in bed, thus increasing the curvatures of the spine and putting a lot of undesired strain on it. Thick pillows worsen this situation. The thicker the pillows, the more you flex your cervical spine, which is again an unnatural strain,.
The body has a great capacity to compensate. It compensates wrong posture for a long time. It does not complain till prolonged excesses are committed. However continuous prolonged excesses are committed. However continuous prolonged strain gradually weakens the ligaments, leads to minor displacements in the intervertebral joints, and it is at this stage that the mechanism of the body, to compensate for undue strain, breaks down and we start feeling the pain.
The brahmachari or the pupil who went to his teacher and stayed with him in an ashram till he acquired sufficient knowledge and made himself fit for family life, was advised to sleep on the floor with a kush or rug made of grass. In gurukuls and even in the Banaras Hindu University founded by Madan Mohan Malaviya, students were provided with a wooden plank to sleep on.
A relaxation posture in yoga called Shava asana or Corpse pose is done by lying flat with the back on the floor with only a mat intervening. This asana is done to attain maximum relaxation of all parts of the body. Similarly hardness of the bed helps to maintain a straighter posture of the spine which is the normal posture – a posture of maximum relaxation and greater relief. This should be given due consideration while recommending a hard bed to a patient with back pain. Resting in bed with a soft mattress does not help such patients.
The lumbar curvature is best maintained when a patient lies on a hard bed – that is, a wooden plank with a mat or blanket and a sheet. Lordosis is maintained due to the structural peculiarity of the lumbar spine. Sleeping on a soft mattress disturbs this lordosis and so deprives the patient of maximum relief. Exercises are prescribed for patients with low back pain when their lumbar lordosis is obliterated. The lumbar curve can be compared to the arch of the foot, which is maintained by the peculiarity of the construction of the bones of the foot joint. This arch gives resilience of the foot and, due to the construction of the foot bones and the arches, provides it with strength and a springing action. The weight of the body is well distributed on the foot in order to bear the weight of the whole body and maintain its mobility.
The same is true about the construction of the lumbar and cervical vertebrae. When one lies flat on the floor without a mattress, the cervical and lumbar lordosis is in a posture of maximum relief and should be maintained in patients suffering from back pain and neck pain. Compare the quick fatigue you feel when you walk barefoot on the sand and the sand hampers the effective action of the foot arches. The same is true when you sleep on a thick mattress; it does not allow the lumbar lordosis to be maintained in a position of maximum comfort.
The best remedy for your tired back after a whole day’s work is to lie down just for a few minutes with your back flat on the ground and you will feel relaxed. Buddhists in ancient India lived in a monastery which consisted of a large hall with small rooms all around in the monastery. These rooms were often made by digging into big rocks, and stand to this date. Beds were also made by cutting into the rocks; these were for meditation and for the monks to sleep on.
There is an interesting shloka in Bhav Prakash by Rajeshwar Dutt Sashtri. This is one of the most authentic books on ancient Ayurveda.
To sleep on a proper bed stimulates the heart; a person gets good sleep, develops better patience, and his health improves. Sleeping on a bad bed has the opposite effect. Sleeping on a khat (a bed on four legs with tightened string top) helps rheumatism and a cough. He who sleeps on the bare earth will be more virile and strong. A wooden bed produces vatal, one of the dosas. He who sleeps on a wooden plank will be cured of all his aches and pains.
Ayurveda considers that all pains and aches are caused by vata, the energy which can get stuck in any part of the body and cause pain. Charaka, a famous teacher of Ayurveda, mentioned thast ‘the person who feels lazy due to discomforts in the body, and wants to sleep, should sleep on a somewhat hard bed’ (asukha shaiyya).
When a person changes from a soft to a hard bed, he feels a little discomfort and slight stiffness in the beginning, but this phase passes off quickly and he later feels comfortable and relaxed. A person who is healthy and does not have any back problem should have a bed with a solid base and a comfortable mattress, two to three inches thick. It can even be a foam mattress which is one inch thick. If there is a spring in the mattress, a wooden board should be placed on top of it and then a thin mattress. A patient with a spinal disc problem should be provided with a harder bed.
If pain and stiffness are felt after a night’s sleep, it is an indication that the bed is faulty. Dyuring sleep, the muscles are relaxed and all the strainb is tolerated by the ligaments. When these ligaments are stretched for a long time they start aching. This indicates that the bed is wrongly constructed and in spite of relaxing the spinal ligaments, it makes them taut, and pain is felt due to stretching of these ligaments. Correcting Your Sitting Posture
Pain over the dorsal spine is very rarely due to a slipped disc. It is mostly due to the searing strain on the posterior ligaments of the spine, following a wrong posture. Due to the chronic habit of standing or sitting with a forward stoop, the patient develops a round back. This long-standing strain on the back weakens the spinal muscles. As the muscles are not able to take the strain, the strain passes on to the ligaments; and as the ligaments are continuously stretched for s long period, the body’s compensation breaks and you start having back pain. When a patient has dorsal kyphosis, the site of the vertebrae placed at the summit of the dorsal curve feels most painful after fatigue. This pain may also radiate to the chest, shoulder and back. The cartilage of the disc is insensitive since it has no nerve supply and, therefore, the first sign of disc damage is due to the stretching of the supporting ligaments.
The prolapsed disc may bulge and stretch the posterior ligament. A thin disc leads to narrowing of the space between the adjacent vertebrae of facets, with aconsequent strain on the ligament which causes pain. Have you observed the statues and paintings of Buddha at Ajanta and Ellora? Buddha is always shown sitting in yoga mudra with is spine straight. Yoga mudra is the sitting posture for meditation. This posutre frees the body from any strain on the spine so that it does not hurt and divert the attention of the person who is meditating. This posture has to be maintained for hours and therefore, it shoyuld be comfortable , and free of any pain or strain.
Yoga asanas called posture exercises were developed in India in ancient times, and were practised for generations. Asanas are taught by Yoga teachers to patients suffering from back pain; they take the form of back extension exercises. A simple set of exercises of dand baithak practised in the villages of India has a beneficial effect on the spine. It takes off the strain from the spine and makes it fit to fight the other strains on the spine caused by the adoption of an erect posture.
To sit slumping in a low chair puts considerable strain on the lower back. If the posture of sitting is not correct any measure to relieve the low back pain will not be effective. The patient should sit right at the back of the seat and then rest against the back of the chair. An ordinary office chair is much better than a sofa. If the cushion is not of a proper design, a small pillow may be placed behind the small of the back.
While designing furniture – be it a bed, kitchen shelves, or cupboards – keeping in mind the right posture is important. As an osteopath, I remember being paid a big fee for designing the chairs for the British Airways aircraft.