Daily life with a disc herniation: how to sleep and how to sit

Placing a pillow between the knees when lying on your side prevents the pelvis rotating and keeps the lumbar spine neutral. This single adjustment makes a clear difference for a substantial proportion of patients with night pain.

For those who prefer lying on their back, a pillow under the knees reduces tension in the lumbar curve. Lying face down forces the back into extension and is uncomfortable for most; where the habit cannot be changed, a thin pillow under the abdomen helps.

There is no single correct mattress firmness. Very soft mattresses give insufficient support and very firm ones create pressure at the shoulder and hip; medium firmness is well tolerated by most people.

Sitting increases pressure on the disc compared with standing. Uninterrupted sitting time therefore matters more than the sitting posture itself, and standing every 30–40 minutes is the single most effective measure.

A lumbar support preserves the curve; a folded towel works where a purpose-made support is not available. Seat depth is set so the knees sit level with or slightly below the hips.

On long drives the backrest is reclined slightly and a lumbar support used. Stopping hourly and walking for a few minutes markedly reduces the stiffness that appears on arrival.

What matters in lifting is less the weight itself than its distance from the body. The same load carried away from the trunk multiplies the force through the lower back.

The movement is initiated from the hip rather than the back: knees and hips bend, the back stays neutral, the load is kept close. Turning is done by moving the feet; rotating the trunk while loaded is the riskiest pattern.

Distributing shopping bags evenly between both hands, rather than carrying them in one, removes asymmetric loading.