Waking up with lower back pain can often indicate a problem with a person's sleeping posture, mattress, or pillows. However, morning back pain can sometimes be a symptom of a medical condition.

Waking up with lower back pain can make for a slow start to a person's day. Determining the cause of the pain can help them identify ways to manage the problem and wake up to more pain-free mornings.

In this article, we describe some of the possible causes of waking up with lower back pain and their treatment options. We also cover when to see a doctor.

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A person with degenerative disc disease may wake up with lower back pain.

As a person ages, natural wear and tear of the discs in the spinal cord can lead to the narrowing of the lumbar spinal canal. Doctors refer to this narrowing as spinal arthritis or degenerative disc disease.

Degenerative disc disease 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 symptoms of degenerative disc disease can 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 degenerative disc disease include:

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

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

Morning back pain and stiffness are symptoms that people with fibromyalgia commonly experience. Fibromyalgia is a chronic disorder that can cause aches, pains, and tenderness in many different parts of the body.

Other symptoms of fibromyalgia can include:

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, and adjusting the work station as necessary
  • complementary therapies, which may include massage therapy, acupuncture, and chiropractic treatments

Some of the 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

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:

  • First, move 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

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A person should pay attention to their posture during and after physical activity.

Regular exercise can help strengthen the back and reduce back pain, but overdoing it at the gym or on the playing field 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, such as a gym workout or playing sports. Properly warming up and cooling down can also help reduce back pain and muscle stiffness the next day.

For exercise-related back pain, applying hot or cold packs to the affected area and taking OTC anti-inflammatory drugs, such as ibuprofen and naproxen, can help reduce discomfort.

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

However, it is not always necessary for a person to completely alter their usual sleeping position. Instead, they can try placing pillows around the body to better support it 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 the curvature in the lower back

If a person's symptoms do not improve with the use of pillows, they may wish to consider other potential causes of morning back pain.

Mattresses that do not fully support a person's weight or body shape can lead to them waking up with back pain.

Manufacturers generally recommend that people replace their mattress 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 research suggests that a mattress of medium firmness may be best for people with chronic lower back pain.

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.

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A person should see a doctor if they have lower back pain alongside shortness of breath.

People with morning back pain that does not improve with self-care measures should speak to a doctor. It is important to seek prompt medical treatment for severe pain that makes movement and everyday activities difficult.

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
  • loss of feeling or weakness in the arms or legs
  • shortness of breath

A doctor will typically review a person's medical history and symptoms and conduct a physical examination. They may sometimes also recommend nerve conduction studies or imaging tests, such as X-rays or CT scans, to help identify the underlying cause.

Waking up with lower 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, including fibromyalgia and degenerative disc disease.

A person should speak to 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 see a doctor for severe back pain that limits movement or the ability to carry out everyday activities.