The good news is, if your back hurts after sleeping or you’ve been getting back pain during the night, there are some handy things you can try that might help.
From the different types of pain to symptoms and causes, as well as that all-important treatment, prevention and management – we’ll help you rediscover the way to a better night’s sleep.
While some pain is common, sometimes back pain can be a sign of a more serious medical condition. Be sure to contact your doctor if you’re concerned, or if symptoms suddenly get worse.
What Is Back Pain?
Back pain can range from short, sharp pain to more persistent aches and discomfort, especially in the lower back . It can become difficult to live with if it is more intense.
If you experience it – you’re not alone. In fact, it’s the second most common reason people visit healthcare providers in the USA - and an incredible 80-90% of people in the US will suffer back pain at some point in their lives1.
Most instances of back pain are manageable, and with enough rest and exercise, or professional medical attention, you may see an improvement within weeks.
Back pain at night is potentially more problematic, however. For many, back pain in bed can be very disruptive – as the pain gets worse when they lie down or may not even start until they do so. Often known as ‘nocturnal back pain’, it can sometimes indicate a serious issue, even leading to what some people have coined ‘painsomnia’.
Types of Back Pain
- Sciatica/pinched nerves – this is basically inflammation, irritation or compression of a nerve in the lower back. Commonly caused by a ‘slipped disk’, which puts pressure on the nerve root2
- Muscle strain – if you get an injury to a muscle that causes it to tear, you probably know all about this. One of the most common back injuries, particularly among athletes3
- Herniated disk – also known as a bulging, ruptured or slipped disk. This is when the cushions between the bones in your spine tear or leak4
- Fractures – if you impact your spine, in a fall for example, this can cause a crush in your vertebrae known as a compression fracture. When the entire vertebral column breaks, it’s called a burst fracture5
- Osteoporosis – this disease, often associated with increased age, weakens your bones, putting you at higher risk of unexpected fractures, especially in the hip or spine6
- Non-specific – sometimes, annoyingly, there’ll be no clear reason for your pain, but it could be arising from weak muscles that struggle when walking, bending and stretching7
- Arthritis – this is joint pain or disease which can also affect the lower back. It sometimes narrows the space around the spinal cord (spinal stenosis too)8
Symptoms of back pain may vary, but some common signs to watch out for include8:
- Aching muscles
- Shooting pain
- Burning sensation
- Stabbing sensation
- Radiating pain down legs
- Weakness, numbing or tingling
Causes Of Back Pain
If you’re experiencing back pain at night, or during the day, the cause may not always be clear. But the following may help explain the issue:
- Spine or other mechanical movement problems – most commonly a result of disk degeneration7
- Common injuries – such as sprains or fractures7
- Severe injuries – caused by car accidents or falls, for example7
- Scoliosis – which causes curvature of the spine7
- Spinal stenosis – narrowing of the spinal column7
- Kidney stones – hard deposits made of salts and minerals that form inside the kidneys7
- Pregnancy – pain can often occur when the pelvis meets the spine at the sacroiliac joint9
Treatment, Prevention And Management of Nighttime Back Pain
Although it can feel like back pain in bed will never go away, you can take steps to help manage your symptoms.
Best Ways To Sleep With Back Pain10
Three of the best sleeping positions for lower back pain, sciatica and back pain in general, are:
- Sleeping on your side – slightly draw your legs up towards your chest and place a pillow between your legs. A full-length body pillow can help
- Sleeping on your back – placing a pillow under your knees will help maintain your lower back’s normal curve. A rolled towel under the small of the back will provide additional support, and a pillow will do the same for your neck
- Sleeping on your stomach – this can be hard on your back, but if you’re struggling to sleep any other way, you can reduce the strain by putting a pillow under your lower abdomen and pelvis. If it doesn’t cause further strain, put a pillow under your head. Try sleeping without a pillow under your head if you feel the tension
Best Mattresses, Pillows and Beds For Back Pain
It’s worth evaluating whether your mattress or pillow may be contributing to your discomfort. If your mattress is too soft, your spine may fall out of alignment, and if it’s too firm, it could cause joint pressure in your hips.
The best mattresses for back pain tend to be those with added support that promote alignment11, while orthopedic pillows can also be helpful.
Stretches And Exercises For Back Pain12
- Knee-to-chest stretches – pulling your knees up to your chest from a lying position
- Shoulder blade squeezing – while sitting up straight, pulling shoulder blades together
- Lower back rotational stretching – rolling your bent legs to the side from a lying position; in the mornings, and at night
- ‘Bridge’ stretch – raising hips from a lying position and holding for several seconds
- ‘Cat’ stretch – arching one’s back from a ‘hands and knees’ stance. Stretch your chest, neck and shoulders and ‘wake up’ your spine!
- Seated lower back rotational stretch – increases mobility in your spine while stretching your shoulders, abdominals and neck
Please talk to your doctor before starting or changing any exercise regimen.
OTC Pain and Sleep Aids
Over-the-counter medication can also help ease back pain while sleeping, and get you closer to a good night’s sleep. Be sure to always read and follow the product label of the OTC pain reliever and talk to your doctor if you have any questions or concerns.
- Combined sleep aids/pain drugs – containing a pain reliever and nighttime sleep aid, TYLENOL® PM works to relieve minor aches and pains and helps you fall asleep. Tylenol® PM can be considered for those with an underlying condition.
- Other medications (both prescription and non-prescription) may also be helpful; talk to your doctor about options to consider.
Always consult a doctor or pharmacist before taking new medication. You can also see what might be able to help if you are experiencing leg pain at night as well.
When To See A Healthcare Provider
You should see a healthcare provider about back pain at night if it feels severe and/or it doesn’t improve after a few weeks.
Be sure to seek medical advice immediately if:
- Your legs feel weak
- There’s numbness or tingling in your legs, genitals, buttocks or anus
- You’re losing weight (without purposefully doing so)
- You have swelling in your back
- Pain spreads down your legs
Cancers that can cause back pain include:
- Spinal tumor
- Lung cancer
- Breast cancer
- Gastrointestinal tract
- Blood and tissue
Persistent lower back pain at night that doesn’t seem related to movement, goes away during the day, or remains after treatment, isn’t necessarily cancer. However, you should consider your symptoms and contact a doctor if you’re worried. It is important to remember that it is rare for back pain to indicate cancer.
The pancreas, kidneys, liver and gallbladder are sometimes associated with back pain, so these could be responsible.
Be sure to always read and follow the product label of the OTC pain reliever and talk to your doctor if you have any questions or concerns.
Again, while some pain is common, sometimes back pain can be a sign of a more serious medical condition. Be sure to contact your doctor if you’re concerned, or if symptoms suddenly get worse.
1. Back Pain. https://my.clevelandclinic.org/health/diseases/22325-back-pain
2. Sciatica. https://my.clevelandclinic.org/health/diseases/12792-sciatica
3. Muscle Strains. https://my.clevelandclinic.org/health/diseases/22336-muscle-strains
4. Herniated Disk (Slipped, Ruptured or Bulging Disk). https://my.clevelandclinic.org/health/diseases/12768-herniated-disk
5. Spinal Fractures. https://my.clevelandclinic.org/health/diseases/17498-spinal-fractures
6. Osteoporosis. https://my.clevelandclinic.org/health/diseases/4443-osteoporosis
7. Back Pain. https://www.niams.nih.gov/health-topics/back-pain
8. Back pain, Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
9. Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580107/
10. Slide show: Sleeping positions that reduce back pain. https://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452?s=2
11. Best Mattress for Back Pain. https://www.sleepfoundation.org/best-mattress/best-mattress-for-back-pain
12. Back exercises, Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265
13. Is My Lower Back Pain Cancer? https://www.verywellhealth.com/is-my-lower-back-pain-cancer-5101068
14. Kidney Pain. https://my.clevelandclinic.org/health/symptoms/17688-kidney-pain
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