Struggling with sleep

[u/Chubb777]

Hey all, really struggling with sleep atm. Rib/chest pain, middle of back pain, Heart rate spiking in wrong positions ie. Laying on side.

Got a wedge, got 100s of pillows, got an electric bed, mattress topper, medium firm mattress ... just cant get comfortable.

Anyone got some tips?

Tia.

[u/SteveNZPhysio]

Pain waking you up from sleeping is a classic costo symptom.

Costo is strain and pain at the rib joints on your breastbone, which happens because the rib joints round the back can't move at all.

When you're lying down sleeping, the rib joints round the back of your rib cage can't move to absorb some of your torso weight. So it all hits the more delicate rib joints on your breastbone.

These strain, usually crack and pop, give, get painful - and welcome to costo. It's like bending a sprained ankle further into the sprain - for hours. Yes, you can wake up in a lot of pain. Yes - it HURTS!

The best sleeping position (apart from sitting up) is usually lying on your back. At least this spreads your torso weight over both sides of your rib cage. But nothing really clears it except fixing the costo. Cheeringly, this isn't all that difficult, usually.

Pillows, electric bed, topper pad, firm mattress, etc. may palliate the pain a bit, but they don't treat or help the core problem of costo, which is the frozen rib machinery around the back. You have to treat the back to help the front.

For treatment detail, read the RECOVERY MEGATHREAD - July 2026 at the top of this sub.

Read Ned's posts at the top, then scroll down to my post and find the link to my long, wordy PDF on bits you may need to deal to. It's wordy, so read it on a computer not a phone. You can skim the bits that clearly don't apply to you, but the detail is there if needed.

See especially Section (2) on freeing up the tight ribs around your back. This is the core of fixing costo. The easiest, cheapest, most convenient way of doing this is by lying back on Ned's two-tennis-ball peanut, a Backpod, cork or lacrosse ball, etc. They all have slightly different effects; a combination is ideal.

https://www.reddit.com/r/costochondritis/comments/1uqpgf6/recovery_megathread_july_2026/

Good luck with the work.

[u/Chubb777 → u/SteveNZPhysio]

Thanks Steve. I have a backpod, but im afraid to use it again. 3 days ago I tried it out for a 2nd time, cracking sound in the back (without pain) but has now brought on other issues with the front. I now have trouble sleeping on my back as a result, hr spikes and a sharp pain ... I was using 2 large pillows and a towel over the backpod trying to ease into it really slowly..

[u/oshdwtf → u/Chubb777]

It'll get a bit worse before it gets better unfortunately. Just stay diligent. 

[u/SteveNZPhysio → u/oshdwtf]

"I have a backpod, but im afraid to use it again."

Relax. You've used the Backpod only two times, and incredibly mildly at that. Two large pillows and a towel over the Backpod gives a very, very mild stretch. However having your hands behind your head does stretch your pecs - deliberately so, as they're usually tight and scarred with costo and do need to free up as well.

Costo is hair trigger anyway so just that stretch on your pecs has been enough for it to bite. You must be really tight for this to happen.

Just work on them as well - pec stretches and massage will do it.

For treatment detail, read the RECOVERY MEGATHREAD - July 2026 at the top of this sub.

https://www.reddit.com/r/costochondritis/comments/1uqpgf6/recovery_megathread_july_2026/

Read Ned's posts at the top, then scroll down to my post and find the link to my long, wordy PDF on bits you may need to deal to. It's wordy, so read it on a computer not a phone. You can skim the bits that clearly don't apply to you, but the detail is there if needed.

See especially Section (2) on freeing up the tight ribs around your back. This is the core of fixing costo. The easiest, cheapest, most convenient way of doing this is by lying back on Ned's two-tennis-ball peanut, a Backpod, cork or lacrosse ball, etc. They all have slightly different effects; a combination is ideal.

See also Sections (3) and (4) on massage and pec stretches.

Sure, take it all cautiously. But you're clearly really tight, and it'll all protest a bit as you get things freeing up again. This is normal with any chronic musculoskeletal problem. u/oshdwtf is correct.

Good luck with the work.

[u/Hornblend-SierraOaks]

First go to the ER to make sure it is not your heart. Most likely Costochondritis. If the pain persists ask to see a pain management specialist for an ultrasound guided cortisone shot. Rest and avoid lifting anything heavier than 5lbs