What can cause morning back pain?

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Back pain may be short term (acute) or can last for more than 12 weeks (chronic). Most back pain is acute and will improve after a few days with appropriate home care. If the pain persists, a person may need to contact a doctor to determine whether there is an underlying cause.

There are a number of reasons a person may experience back pain when they wake up. Some possibilities are outlined below.

Degenerative disc disease

As a person ages, natural wear and tear of the vertebrae and disks in the back can cause narrowing of the lumbar spinal canal. Doctors refer to this narrowing as spinal arthritis or degenerative disc disease (DDD).

DDD can compress the spinal nerves, resulting in pain, stiffness, and reduced mobility that typically affects the lower back or neck. The pain can range from mild to very severe, and it may radiate to other parts of the body. Symptoms can be worse in the morning and may even interfere with sleep.

Other possible symptoms of DDD include:

• leg muscle weakness or foot drop
• numbness and tingling in the arms and legs
• pain that may get worse with sitting, lifting, or bending
• pain that improves with walking, moving, or changing position

Treatment

Treatment options for DDD include:

• taking over-the-counter (OTC) pain relievers, such as ibuprofen, naproxen, or acetaminophen
• applying ice packs and heat packs
• temporarily wearing a back brace
• undergoing physical therapy
• trying alternative therapies, such as acupuncture, or chiropractic therapy

If a person’s symptoms are severe, their doctor may recommend surgical approaches, such as disc replacement or spinal fusion.

Fibromyalgia

Morning back pain and stiffness are common symptoms of fibromyalgia. This is a chronic disorder that can cause aches, pains, and tenderness in many parts of the body.

Other possible symptoms of fibromyalgia include:

• fatigue
• difficulty sleeping
• memory and concentration problems, which people sometimes refer to as “fibro fog”
• headaches
• irritable bowel syndrome
• numbness and tingling in the arms and legs

Treatment

The treatment for fibromyalgia depends on a person’s symptoms, but it typically involves:

• pain relievers
• anti-inflammatory medications
• lifestyle changes, such as:
  • exercising regularly
  • eating well
  • making appropriate changes to the work environment
• complementary therapies, which may include:
  • massage therapy
  • acupuncture
  • chiropractic treatments

Some steps that people with fibromyalgia can take to reduce morning back pain include:

• doing stretching exercises before getting out of bed, such as pulling the knees in toward the chest or reaching each arm in front of and across the body
• taking a warm shower immediately after getting out of bed to help promote circulation and release tight muscles
• ensuring that the bedroom is at a comfortable temperature
• using pillows to position the body in a way that minimizes strain on the back

Overdoing exercise the day before

Regular exercise can help strengthen the back and reduce back pain. However, overdoing it at the gym or while playing sports can lead to morning back pain and stiffness.

It is important for a person to pay attention to their posture during and after any intense physical activity. Properly warming up and cooling down can also help reduce back pain and muscle stiffness the following day.

Treatment

The following can help alleviate symptoms of exercise-related back pain:

• applying hot or cold packs to the affected area
• taking OTC anti-inflammatory drugs, such as ibuprofen and naproxen

Getting out of bed improperly

How a person gets out of bed can be vital to preventing early morning aches and pains. Even if a person is well-rested, rising too quickly or bending too far forward when getting out of bed can place a strain on the back.

To reduce the risk of morning back pain and stiffness, a person should follow these steps:

• Begin by moving slowly to the edge of the bed.
• Using the arms for leverage, transfer to a sitting position with the legs dangling off the side of the bed.
• After taking a few seconds to adjust to this position, slowly place the feet on the floor and stand up.

Improper sleeping posture

Some sleeping postures can place extra strain on the lower back, hips, and neck.

It is not always necessary for a person to completely alter their usual sleeping position in order to alleviate back pain. Instead, a person can place pillows around their body for extra support while they sleep in the position that they find most comfortable. For example:

• Back sleepers can try putting a pillow underneath their knees to align the spine better and reduce lower back pain.
• Side sleepers may benefit from placing a pillow between their legs to better align their hips and spine.
• Stomach sleepers can position a pillow underneath their lower abdomen to reduce curvature in the lower back.

If a person’s symptoms do not improve with the use of pillows, they should consider other potential causes of morning back pain.

Unsupportive mattress

Mattresses that do not fully support a person’s weight or body shape may lead to morning back pain.

Manufacturers generally recommend that people replace their mattresses every 10 years or so. Signs that a mattress needs replacing may include visible sagging or indentations that remain where a person has been sleeping.

When buying a new mattress, it is important to choose one that is both comfortable and fully supportive.

Some manufacturers offer an extended trial period that allows a person to return a mattress after several weeks or months if they are not fully satisfied with the product.

Pregnancy

Lower back pain is a common musculoskeletal complaint during pregnancy, and this can occur in the morning. The prevalence of lower back pain during pregnancy ranges between 30–78% in some parts of the world, including the United States.

There are many reasons for lower back pain during pregnancy, including:

• increased release of hormones, including relaxin and progesterone, which soften the pelvic ligaments and joints, potentially reducing back support
• the additional weight of the fetus requiring extra back support
• a person’s center of gravity shifting forward due to the growing fetus

Pregnancy-associated back pain usually goes away after giving birth. A 2019 study found that exercising may decrease the severity of back pain during pregnancy but does not decrease the likelihood of back pain during pregnancy.

Click here for more information about back pain during pregnancy.

If back pain does not improve on its own, a person may find relief using one or more of the methods below:

• OTC pain relief: A person can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
• Muscle relaxants: These prescription drugs relax tight muscles and may help ease muscular back pain. However, a 2021 study found that muscle relaxants are generally ineffective for chronic lower back pain and long-term use may increase the risk of side effects. A person considering muscle relaxants should discuss this with their doctor.
• Hot and cold therapy: Applying heat or ice packs to the lower back may reduce pain and inflammation as well as help improve movement.
• Gentle stretching: Gentle stretches may alleviate pain and improve mobility in the lower back. However, a person should discuss this first with their doctor to ensure that stretching does not worsen their symptoms.

A person should contact a doctor if their morning back pain does not improve with self-care measures. It is important to seek prompt medical treatment for severe pain that interferes with movement and everyday activities.

A person should also see a doctor as soon as possible if back pain occurs alongside any of the following symptoms:

• bowel or bladder problems
• numbness or weakness in the arms or legs
• shortness of breath

In order to make a diagnosis, the doctor will:

• ask about a person’s symptoms
• review the person’s medical history
• conduct a physical examination

In some cases, a doctor may recommend tests to help identify the underlying cause of back pain. These may include nerve conduction studies or imaging tests, such as X-rays or CT scans.

Waking up with back pain is often the result of sleeping habits or overstraining the body during physical activity. However, morning back pain can also be a symptom of certain medical conditions, such as fibromyalgia and DDD.

A person should speak with a doctor if back pain does not get better with self-care measures, such as trying a different sleeping position or a new mattress. It is also important to contact a doctor for severe back pain that limits movement or the ability to carry out everyday activities.