Why Do I Have Lower Back Pain After Sleeping?

Lower back pain is the most common type of musculoskeletal pain. It affects up to 84% of adults worldwide. Waking up to back pain is not unusual, and some people experience mild pain and stiffness after being in one position for many hours. 

If you continue to feel pain after getting out of bed and moving around or if you frequently wake up to back pain, your back pain might be due to an underlying condition. Determining and treating the cause of morning back pain can help you get better sleep and a better start to your day.

This article will cover potential causes of lower back pain after sleeping, tips to relieve pain, and when to contact your healthcare provider. 

Causes of Lower Back Pain After Sleeping

Back pain tends to be most severe in the morning, lasts a few hours, and then subsides during the day with activity.

While most people have morning back pain occasionally, some people experience chronic pain.

Chronic, persistent may be caused by the following: 

• Sleep position
• An old or unsupportive mattress
• Getting out of bed improperly
• Overexercising 
• Disc degeneration
• Fibromyalgia 
• Arthritis conditions 

Sleeping Positions

Sleep posture refers to your position you sleep in. Maintaining the spine's natural shape while you are inactive and lying in bed helps promote good sleep quality and allows you to wake up refreshed. 

Poor sleep posture can lead to back pain or aggravate existing back pain because it puts stress on the spine. Some sleep positions might lead to lower or upper back pain, while others may reduce the potential for back pain.

According to the Sleep Foundation, the best sleep position promotes healthy alignment from the head to the hips. Sleeping on your back or side is better than stomach sleeping, and side sleeping can help prevent back pain. 

Your sleep quality can also affect your back health. Delayed sleep onset, nighttime awakenings, increased wake time, and poor sleep continuity are all signs of poor sleep quality. If you experience any of these, you are more likely to awaken to back pain.

Mattress Condition

An old or unsupportive mattress can cause you to awaken to back pain. This might include mattresses over 10 years old that do not support your body weight or shape or that sag or have indentations. 

Research suggests that medium to firm mattresses offer advantages for nonspecific low back pain (back pain with no known cause). These mattresses have been found to improve sleep quality and reduce the risk of developing low back pain. 

Getting Out of Bed Improperly

How you get out of bed in the morning can reduce back strain or add to it. Rising too fast or bending or twisting incorrectly or swiftly can strain your back and lead to pain and stiffness.

When you are ready to get out of bed, move slowly to the edge of the bed. Use your arms to give you leverage, and move to a sitting position in which your legs are dangling on the side of the bed. Take at least 10 seconds to rest in this position, and then slowly put your feet on the floor and stand.

Overexercising 

If you are regularly exercising and stretching, your back pain and stiffness can improve. However, if you do too much during the day, you might wake up with back pain. 

It is essential to properly warm up before exercising and cool down to help prevent muscle pain and stiffness and to help you sleep better at night.

Pregnancy

It is not unusual to experience back pain while pregnant. About 70% of pregnant people will have lower back pain during pregnancy, and for many, pain severity can affect the ability to manage daily activities.

Several factors contribute to back pain in pregnancy, including: 

• Hormone influxes that lead to the softening of pelvic ligaments and joint pain
• Additional weight from the fetus and placenta can affect joints and ligaments in the lower back
• A center of gravity that shifts the body forward 

Back pain from pregnancy usually resolves once the pregnant person gives birth. Exercising and stretching may help to decrease back pain and stiffness during pregnancy. 

Disc Degeneration

Disc degeneration refers to changes in the spinal discs leading to back pain. It happens over time due to aging, injuries, and daily activities that strain the spinal discs. 

Disc degeneration can cause lower back pain that can be severe at times, especially in the morning. Pain might be caused by lying down on your back or side for an extended period while the inflamed (swollen) disc presses on a nerve root or causes nerve inflammation. 

Fibromyalgia

Back pain is a common symptom of fibromyalgia, a musculoskeletal condition that causes widespread pain. Fibromyalgia can also cause chronic fatigue, sleep troubles, mood disturbances, and cognitive difficulties. 

Back pain from fibromyalgia can be felt deep and may include achiness, stiffness, and tenderness. It is not unusual to wake up to back pain and stiffness in the morning if you have fibromyalgia.

Arthritis 

Various arthritic conditions can cause morning back pain, including osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). If you have one of these conditions, you might experience back pain when not moving for extended periods, such as while sleeping.

OA is wear and tear arthritis that causes cartilage (the cushioning at the end of joints) to gradually break down. This same process can lead to pain and stiffness in the lower back. People with OA often have mechanical back pain that worsens with bending and twisting. OA might also cause you to awaken to back pain if you move around frequently at night to find a comfortable sleep position.

RA is an autoimmune disease that develops because the immune system malfunctions and attacks healthy tissues—mainly the synovial linings of joints. According to a 2015 Oxford Academic report, severe lower back prevalence is high in people with RA and is often associated with a more severe disease.

RA primarily affects peripheral joints, such as hands, feet, and knees, but it can also cause inflammation (swelling and redness) of the joints of the lumbar spine. It may cause you to wake up feeling sore and stiff in your lower back. Symptoms may resolve with movement, but if there is inflammation, the pain may not resolve without treatment. 

Like RA, AS is an autoimmune disease. It causes joint inflammation, pain, and stiffness in the lower back and sacroiliac (SI) joints on each side of the spine in the pelvis. AS back and hip pain occurs after periods of activity—often upon waking in the morning. 

Tips to Relieve Lower Back Pain After Sleeping

It is possible to sleep better and not wake up to back pain. Your healthcare provider can recommend exercises and treatments to manage and reduce pain.

Stretches in Bed

Some simple exercises while you are still in bed can help relieve back pain. For example, you can do a side-to-side rocking stretch. With this stretch, you grab your knees and pull them into your chest. While wrapping your arms around your knees, gently rock from side to side. 

Or you can do a basic stretch lying on your back and stretching your arms above your head. Stretch your arms and hands as far as possible, and hold for a few seconds. Repeat two to three times. Do the same with your legs and feet.

Planks

A plank is a core strength exercise in which you hold your body in a push-up-like position. Doing planks might ease minor lower back pain. 

To do this exercise, get facedown on the floor. Push yourself up onto your forearms and toes. Keep your elbows under your shoulders and your forearms and elbows aligned with your wrists.

While looking down, keep your neck aligned with your spine. You'll want to keep your spine straight without your stomach sinking down or up. Hold the pose for at least 30 seconds. Complete two to three sets.

You can do the plank on your knees if you have severe back pain or back problems. If you have knee problems, do it by standing and leaning against a counter, keeping your body at a 45-degree angle.

Mini Cobra

Research shows that yoga is as effective as physical therapy for managing lower back pain. Various poses and exercises can help manage your lower back pain. The mini-cobra, for example, is a basic yoga pose that can help without overstretching the lower back. 

To do the mini cobra, lie on your stomach with your palms down and aligned with the sides of the head. The elbows and forearms should also be in line with your palms. Slowly push your palms and forearms to lift your chest upward as if about to do a push-up. Keep your head forward and your head straight. Hold the pose for at least ten seconds and repeat up to five times.

Knee Bends

Stretching your knees and glutes might help relieve your back pain. You can do this with an exercise called knee bends. 

To do a knee band, you squat as if trying to sit in a chair. Keep your knees bent at 90 degrees. Exhale as you squat down, and inhale as you come back up. Do up to 10 repetitions. 

Exercise Throughout the Day

Being active throughout the day can help ease your back and even help you sleep comfortably at night. Any exercise, even something as simple as walking, can manage pain and help you sleep more soundly and comfortably.

If you work a sedentary job (such as computer work), ensure you get up every 30 minutes to stand, stretch, or walk around. Make sure your office chair is supportive. Adding a pillow or towel rolled behind your back might offer further back support. 

Hot and Cold Therapy

Both heat and ice can help manage morning lower back pain. Heat can help reduce pain by relaxing and loosening stiff muscles. Ice can numb pain and reduce inflammation. 

Options for heat therapy include dry heat such as a heating pad or moist heat like that of a warm shower or bath. Apply heat for 20 minutes up to three times a day. You can use an ice pack or a bag of frozen vegetables in a cloth and apply it to the painful area for 20 minutes at a time a few times a day. 

You can also alternate between ice and heat. Apply one therapy for 20 minutes and wait a few hours to use the second therapy. You can manage inflammation and loosen stiff muscles by rotating heat and cold.

OTC Medications

You can take over-the-counter (OTC) oral pain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or Advil (ibuprofen), or Tylenol (acetaminophen). NSAIDs can help relieve inflammation and pain, while Tylenol can help manage mechanical back pain. 

Topical Remedies

Topical pain relief medicines are an option for managing back pain. These products are available as creams, lotions, gels, and patches you apply to the skin.

Examples of topical pain relief options for lower back pain include: 

• Topical medicines containing menthol, methyl salicylate, and camphor
• Capsaicin creams
• Lidocaine patches and creams
• Voltaren gel (diclofenac)
  

When to Contact a Healthcare Provider

If you often wake up with back pain, if the pain is severe, or if it interferes with your daily life, you should contact a healthcare provider. They can determine if your back pain is mechanical or related to an underlying condition. 

Your healthcare provider can recommend OTC pain-relief options and prescribe stronger pain relievers when needed. They may also prescribe a muscle relaxant to ease tight muscles and back pain. 

Some medical conditions that cause lower back pain, including fibromyalgia, RA, and AS, need additional treatments. This is because to manage back pain, you will need to manage the underlying cause. There is no cure for these conditions, but they are treatable and manageable. 

A variety of medicines are available to manage the symptoms of fibromyalgia. For example, OTC aspirin, ibuprofen, Aleve (naproxen sodium), or a prescription pain reliever can help manage musculoskeletal pain. Antidepressants and anticonvulsants can treat severe fibromyalgia pain and fatigue. Physical therapy and gentle exercise can help you to manage symptoms. 

Because RA and AS are both autoimmune diseases, they are treated similarly. RA is treated with traditional disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs to reduce pain and inflammation and slow down or stop the underlying processes that lead to systemic (whole-body) inflammation.

AS is also treated with biologic DMARDs. If RA or AS flare up (symptoms worsen), your healthcare provider might prescribe a corticosteroid, which can be given as an oral pill or as an injection. While rare, some people may need surgery to repair joint damage caused by RA or AS, including damage to the spine.

Summary

A good night's sleep is crucial for your overall health and well-being. But your sleep might be interrupted or unrefreshed if you wake up to back pain. 

Causes of morning lower back pain include sleep position, overactivity, or an old, uncomfortable mattress. Back can also result from a health condition like disc disease, fibromyalgia, or arthritis.

Managing your lower back pain can help you to sleep better and reduce future episodes of back pain. Mechanical lower back pain can typically be managed with stretching, exercise, heat and cold therapy, getting a new mattress, and OTC oral and topical pain relievers.

Back pain caused by an underlying health condition might require you to contact your healthcare provider. Conditions like fibromyalgia, rheumatoid arthritis, and ankylosing spondylitis also cause back pain and are manageable and treatable with medication and other therapies. 

Contact your healthcare provider if you frequently wake up with back pain, if the pain is severe, doesn't improve with self-care, or if it affects the performance of daily activities. They can examine your back and request tests to determine the cause of symptoms.