If you are suffering from chronic back pain, you’ve probably asked yourself a multitude of questions to get to the bottom of what’s causing it and searched high and low for ways to alleviate it. But you may not have asked yourself the one question that may be able to help: Are you sleeping all wrong?

When you spend up to eight (or more, if you’re lucky) hours a night in bed, you want the sleep to be therapeutic, or at least refreshing, but, for many people with ongoing back pain, that’s not happening.

“Back pain sends more patients to doctors than any condition other than the common cold,” said Prevention. “In fact, it’s the fifth most common reason for hospitalizations and the third most common cause of surgery. And 56% of people with lower-back aches say symptoms disrupt their daily routines, including sleep.”

The way you sleep—the position you’re in, how long you’re in bed, how still you are, and what you’re lying on—can also affect your back, which is one more key reason to pay attention to this important health issue.

• The Right Amount of Sleep

Suffering from insomnia or interrupted sleep? It could be causing—or worsening—your back pain.

According to a study in the Asian Spine Journal, “More than 32 percent of those with low back pain suffered from sleep disturbances as a result of their back pain, waking at least twice during the night,” said Everyday Health. “Researchers also found that the worst time for back pain was between 7 p.m. and midnight, and that the worse the pain, the more sleep was affected.”

The catch-22 of back pain and sleep is that not getting enough rest can actually make back pain worse because the body isn’t able to regenerate itself.

“The inability to get a good night’s sleep hurts – literally,” said WebMD. “Chronic back pain prevents you from sleeping well. You can wake up hurting even more. What’s worse, studies have shown that not getting enough sleep may actually make you more sensitive to pain. It’s a vicious cycle. Back pain can make it harder to sleep — and when you can’t sleep, your back pain may be worse.”

• The Right Position

Numerous studies have been done on sleep position, looking at what it says about your personality and your relationship, among other things. But your sleep position is most critical to your back health. It could be that the way you’re sleeping is what’s causing your back pain or that it’s worsening an existing injury.

Many experts recommend side sleeping because it causes the least amount of strain on the back.

“By making simple changes in your sleeping position, you can take strain off your back,” said the Mayo Clinic. “If you sleep on your side, draw your legs up slightly toward your chest and put a pillow between your legs. Use a full-length body pillow if you prefer.”

Alternating sides can also help. “Some evidence suggests that habitually sleeping on one side on an ill-fitting mattress may contribute to muscle imbalance, pain, and in some cases, scoliosis,” said the Cleveland Clinic. “Always sleeping on the same side suspends the middle of your body between your hips and shoulders, the broadest parts of the trunk.”

Back sleepers don’t necessarily need to switch to sleeping on their side. A pillow placed under the knees can provide support, especially when combined with “a small, rolled towel under the small of your back,” according to the Mayo Clinic.

Many experts caution those who sleep on their stomach because it can create back strain. “Stomach sleepers may need to rethink their sleep stance because this position is a common offender,” said Everyday Health.

• The Right Bed

Maybe it’s not the way you’re sleeping that’s the problem, but what you’re sleeping on. An old bed could be creating new problems.

“Can’t remember the last time you replaced (your bed)? Your back may be in trouble,” said Prevention. “A good mattress lasts 9 to 10 years, according to the National Sleep Foundation, but consider replacing yours every 5 to 7 years if you don’t sleep well or your back throbs. A study at Oklahoma State University found that most people who switched to new bedding after five years slept significantly better and had less back pain.” Choosing the right bed can be challenging for anyone, but especially someone who is dealing with back pain. Prevention recommends taking a “Goldilocks approach: Pick one that’s not too squishy or too hard.” A mattress that’s too firm could potentially increase spinal pressure and pain, while one that is too soft may not provide the right support.

• The Right Treatment

If you have been living with chronic back pain, have changed your sleeping position and/or your bed and have already tried everything from over-the-counter medicine to stretching and yoga, it might be time to seek treatment, find a back specialist, and learn more about minimally invasive procedures.

Advancements in minimally invasive surgical procedures have changed the game for those who suffer from chronic back pain. Long surgeries and recoveries associated with traditional procedures can now be a thing of the past. Minimally invasive back surgery cuts back on the length of the operation, the size of the incision, the time spent in the hospital, and the time spent recovering. Many minimally invasive surgical procedures can also be done on an outpatient basis with complete recovery in a few weeks.

For more information, contact DISC Spine Institute, experts in minimally invasive treatments, the most effective medical procedures to treat and eliminate chronic back pain.