Lower Back Pain In The Morning
Experiencing lower back pain in the morning upon waking is a common issue. This type of pain may develop due to reduced blood flow while sleeping or stiffness after long periods of rest. Once an individual stands up and starts moving around, the symptoms may start to subside.
Some people experience irregular episodes of morning back pain, while for others, morning back pain is a chronic problem. Persistent lower back pain is associated with physical stress, poor posture, and underlying medical conditions. To properly address this issue it is important to identify the exact cause.
What Causes Morning Back Pain?
Lower back pain in the morning is often a symptom of inflammation or structural changes in the spine that developed due to the constriction of space around spinal discs or nerves. If the problem that is causing the pain is temporary or it is corrected, the pain may lessen when an individual wakes up and starts to move the body.
Poor Sleeping Position
Morning back pain that occurs every day, especially while lying down, may be linked to sleeping posture. A poor sleeping position can place pressure on the spine that causes the natural spinal curve to flatten. The uncomfortable pressure that is placed on muscles or ligaments in the lower back can also cause a back strain. Individuals who regularly sleep on the stomach may frequently experience back pain. The discomfort may even disrupt sleep.
Another reason that people may wake up with back pain is due to a spinal disc injury. This is because certain processes that take place while sleeping may further aggravate the outer layer of an injured disc. When a person is asleep, disc decompression occurs and the spinal discs also hydrate. Disc hydration leads to expansion that puts increased pressure on the outer layer of a previously injured disc, thereby causing pain that is felt upon waking. As an individual gets up and begins to move around, the disc loses some of its water content. This decreases the pressure that was being placed on the outer layer of the disc and subsequently reduces the lower back pain.
Changing sleep positions helps promote better spinal health and more restful sleep. In some cases, improving sleep posture can completely relieve morning back pain. A subtle change such as placing a supportive pillow around the body helps keep the spine correctly aligned while sleeping. For side sleepers, placing a pillow between the legs reduces lower back pain by aligning the spine and the hips. Similarly, a pillow should be placed underneath the knees if a person sleeps on their back. For those who are only comfortable when they are sleeping on the stomach, placing a pillow under the lower abdomen or pelvis provides extra support that targets back pain by taking pressure off of the spine.
Stretching before getting out of bed can lessen back pain in the morning as well. Here’s an easy technique to perform while lying down - stretch the arms over the head and then point them toward the feet. Hold this position for a few seconds, then lift the knees toward the chest. This type of stretch relieves tension or spinal compression (squeezing) that may have occurred during the night by relaxing muscles in the lower back.
Another simple stretch can be performed after sitting up in bed. Before standing up, plant the feet firmly on the floor, shoulder width apart. Reach up over the head and gently swing the body from side to side. This stretch incorporates basic movements from the McKenzie Method, which focuses on enhancing musculoskeletal health through self-treatment, when possible. In general, changing sleeping positions and stretching before getting out of bed helps relieve morning back pain.
An old mattress or one that does not provide proper back support can lead to poor sleeping posture as well as lower back pain in the morning. The lack of support causes excess pressure on the spine. It may also lead to frequent shifting of the body in an attempt to remain comfortable throughout the night.
It is recommended that a mattress be replaced at least every 10 years or sooner if there is visible damage, indentations, or sagging. This is because getting a newer, more supportive mattress can improve back pain and enhance sleep quality. Changing out an old mattress can even lower stress that is related to poor sleep quality or persistent pain. Before choosing a new mattress, it may be helpful to speak with a professional who can make recommendations based on preference and medical history.
Degenerative Disc Disease
Degenerative disc disease is an age-related condition that may gradually develop due to normal wear and tear on the body. It is not the result of an accident or injury, but instead occurs when the shock-absorbing spinal discs between the vertebrae (spinal bones) start to break down or shrink (degenerate) over time. The disc degeneration decreases the space between the vertebrae and this causes them to rub together. When this happens, intense lower back pain and discomfort may be experienced. For most people who have this condition, the pain is particularly worse in the morning. This is because the normal process of disc hydration that occurs during sleep, leads to expansion that increases pressure on the outer layer of the injured disc, thereby resulting in morning back pain. The constricted space (defined as stenosis) that develops as the discs degenerate also leads to spinal nerve irritation. Symptoms that typically occur due to this condition include:
- Muscle weakness in the legs or feet
- Tingling or numbness in the arms and legs
- Pain that worsens while bending backwards, standing, walking or lifting
- Pain that improves while bending forward, sitting, or changing positions
- Lower back pain that extends down the hips, thighs, and buttocks
Pain relievers or steroid injections are often recommended to treat the discomfort that is caused by disc degeneration. Physical therapy is also a beneficial approach.
Fibromyalgia is a chronic condition that is associated with widespread muscular and skeletal pain. Whole body pain is the hallmark of fibromyalgia, where even the sides hurt. The pain is accompanied by sleepiness, fatigue, restless sleep, memory problems, anxiety, depression, mood fluctuations, tension headaches, and gastrointestinal issues. It is believed that neurological (nerve-related) issues amplify pain sensations by altering the way the brain processes pain signals as well as signals that should not be painful.
Due to improper pain signaling, individuals who have fibromyalgia may experience intense lower back pain in the morning upon waking. Pain medication helps relieve various symptoms, including back pain. It supports better sleep as well. Unfortunately, there is no cure for fibromyalgia, however, physical therapy may be recommended to help individuals cope with the condition and improve their quality of life.
Lower back pain is commonly associated with pregnancy. Some women report that their sides hurt in the morning as well as their backs. The pain may begin as early as eight weeks, although it typically develops between the fifth and seventh month. As the baby grows and the body gradually changes to accommodate the pregnancy, the lower back muscles can become strained. In addition, back pain may be worse in the morning, especially after sleeping for a long period due to muscle tightness and stiffness.
Placing a pillow around the body or between the legs helps reduce discomfort. Stretching the legs and standing up occasionally decreases the pressure on the back as well. Warm compresses on the back also help alleviate lower back pain.
Given that there are a vast number of issues that can lead to lower back pain in the morning, determining the exact source of the pain involves assessing a lot of different factors. For some people, simple postural changes help target morning back pain, while others may benefit from physical therapy. Carefully implemented pain management therapies can relieve back pain long enough for some people to make long-term lifestyle changes that promote a healthier spine.
Morning Back Pain Treatment
The following strategies and exercises are beneficial toward reducing, and in some cases, completely alleviating lower back pain that is experienced in the morning.
Over-The-Counter Pain Relievers
Intense morning back pain that can disrupt an entire day often necessitates rapid relief. For chronic back pain, a physician may suggest taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin. These types of pain relievers also target inflammation that may be contributing to the discomfort. Acetaminophen, better known as Tylenol, is another effective option for occasional morning back pain if NSAIDs cannot be taken.
Topical ointments also offer temporary pain relief. This includes creams that contain anti-inflammatory ingredients or even essential oils such as peppermint or turmeric. However, these types of oils need to be diluted in carrier oils such as olive, jojoba, or almond oil to avoid skin irritation.
Exercising regularly is one of the keys to experiencing long-term improvement from lower back pain. An optimal exercise is walking. This simple activity strengthens the back, boosts blood circulation, and supports healthy muscles throughout the body, including the back. People who have office jobs or positions that involve sitting for long hours should stand up frequently to avoid muscle stiffness. Standing up every 20 to 30 minutes and stretching relaxes the ligaments and muscles in the back, which helps relieve tension that may develop at night. Using a standing desk also reduces pressure on the back during the day to help prevent back pain the next morning. Combining an ergonomic floor mat with a standing or regular desk also provides ideal back support.
Planks are another form of exercise that engages the entire body, but particularly the core muscles. As the back and abdominal muscles get stronger, back strains become less likely. Doing planks can also relieve minor lower back pain.
To perform a plank, start by lying face down on the ground. Gently lift your body off the floor, supporting yourself on your elbows and toes. Make sure that your body remains straight, and that your hip area is not sagging down or sticking up in the air. Hold the plank position for about 30 seconds, crunching the abs tightly as if bracing the abdomen for a stomach punch. The muscles in the thighs as well as the buttock muscles, called glutes, also need to be contracted during the plank stance. This exercise can be repeated if it is desired.
If the combination of over-the-counter pain relievers and at-home exercises does not provide significant relief, an individual with back pain should schedule an evaluation with a Physical Therapist.
Physical therapy is a non-surgical treatment approach that involves the use of physical, manual, and soft tissue manipulation (mobilization) for the treatment of acute or chronic pain. It may be recommended for a certain amount of time (e.g., 4 to 6 weeks) to fully resolve the symptoms and to prevent further recurrences. The therapeutic strategies that are used aim at decreasing pain (e.g., back pain), restoring muscle function, improving mobility, and increasing range of motion. In addition to targeting pain, physical therapy also involves teaching maintenance strategies that reduce the risk of future back problems.
Lower back pain in the morning is a frustrating issue that can make it hard to get out of bed. It can also ruin the day before it begins. Morning back pain is usually an indication that abnormal pressure was placed on the spine during the night. However, certain conditions such as degenerative disc disease and fibromyalgia are associated with increased back pain in the morning due to stiffness that develops while sleeping.
Certain lifestyle changes such as choosing a different sleeping position, using supportive pillows, and getting a newer mattress can reduce lower back pain in the morning. Furthermore, physical therapy can help target morning back pain through the use of therapeutic techniques to reduce pain and improve mobility and back exercises that strengthen the spine. A physical therapist may even be able to demonstrate sleeping, standing, walking, and lifting positions that reduce the amount of strain that is placed on the back. The combination of these strategies may completely relieve back pain for some individuals.
The physical therapists at FYZICAL would love to help you address your lower back pain.
FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!
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