Low back pain when lying down: causes and treatment


Low back pain when lying down can be caused by a variety of reasons. Also called nocturnal or nocturnal back pain, some of the more common causes include injuries such as sprains and conditions such as arthritis or sciatica . The pain can range from mild to debilitating and is often described as dull, sharp, or stabbing.

Low back (lumbar) pain when lying down can make restful sleep difficult and can affect the way you move your lower back muscles, ligaments, and vertebrae during movement and daily activity.

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Possible reasons

Back pain at night is not always a sign of a serious health condition, especially if it occurs infrequently or for a short period of time. But when nighttime back pain is frequent and bothersome, it might be time to check it out.

Some of the more common causes of back pain when lying down include:

  • Stretch or stretch : The most common causes of low back pain are sprains and sprains in the lumbar spine, when the muscles or ligaments are overstretched.
  • Ankylosing Spondylitis (AS) : This rare form of arthritis, characterized by chronic inflammation in the back and neck, tends to get better with exercise and worse at night.
  • Spinal osteoarthritis : pain in the joints of the spine may be worse at night due to inactivity.
  • Sciatica : The vertebrae in the lower back can further irritate the sciatic nerve in certain sleeping positions, causing radiating pain in the lower body.
  • Swelling of the spine: Although uncommon, pain due to swelling or proliferation of the spine can be worse when lying down due to direct pressure on the area.

Other causes of low back pain when lying down include conditions such as spinal stenosis , narrowing of the spine.

Nighttime back pain can also be a symptom of kidney stones , endometriosis , certain cancers, pregnancy, and other forms of arthritis. Keep in mind that nighttime back pain is rarely caused by a tumor, infection, or AD.

When to contact a healthcare provider

Back pain at night that wakes you up or interferes with sleep is a sign that it's time to discuss the problem with your healthcare provider. Along with low back pain, you may also experience muscle stiffness and limited range of motion, especially if the cause is a sprain or strain.

It is also helpful to know how pain is usually classified:

  • Acute pain is short-term pain that lasts from several days to several weeks. This is usually associated with a specific injury or event.
  • Chronic pain is long-term pain that lasts for several months or longer. In many cases, this is not due to injury.

While everyone's situation and pain threshold will be different, there are some general guidelines to help you decide when your nighttime low back pain deserves to see a doctor.

Contact your doctor as soon as possible if your pain:

  • It started with a specific injury.
  • Lasts or worsens for more than a few days.
  • Feeling of heaviness or radiation to other parts of the body, such as the legs.
  • It is accompanied by signs of infection such as redness, warmth, swelling, or fever.
  • It is accompanied by weakness, numbness, or tingling in the lower body.

Talking to your healthcare professional or other front-line healthcare professional is a good start. They can treat you or refer you to another specialist if necessary.

For example, if your healthcare provider suspects that your back pain at night may be related to an inflammatory condition, you may be referred to a rheumatologist (who specializes in arthritis and conditions that affect the bones, muscles, and joints ) for further evaluation.

Get immediate medical attention if you have a history of cancer, unexplained weight loss or sudden bladder problems, or low back pain when lying down .


To understand the cause of your nighttime back pain, your healthcare provider will start with a physical exam and your medical history to identify or rule out any serious medical conditions.

Your healthcare provider will ask you about the characteristics of your discomfort and ask you to describe your pain. You should be prepared to talk in detail about when the pain started, what made it worse or better, its quality and intensity, and if you noticed any additional symptoms, such as numbness or tingling.

In addition to the basic exam, there are other tests that your healthcare provider may order to help with your diagnosis, including:

  • Neurological tests or movement tests measure the strength of the muscles to determine if the pain is related to the spine or the nervous system.
  • Imaging tests , such as an MRI or CT scan , can help rule out specific causes of pain, such as cancer, infection, or fracture.
  • Laboratory tests, such as a complete blood count, can be helpful if you have a possible infection or unexplained weight loss, which could indicate cancer or inflammatory arthritis such as AD.

Watch out

Treatment for nocturnal low back pain can vary depending on the exact diagnosis. In general, for the most common conditions, healthcare professionals generally recommend relieving discomfort at bedtime, such as:

  • Apply heat or ice
  • Take over-the-counter pain relievers
  • Light stretching or light exercise (not vigorous)
  • Physical therapy exercises to strengthen the main muscle groups that support the lower back.
  • Spinal injections, such as corticosteroids or epidurals.

Since low back pain occurs at night, your healthcare provider will likely recommend approaches to improve your sleep conditions as well, including a sleeping position, pillows, and a mattress.

Additional home remedies can also be included in your treatment plan.

This includes:

If the pain is severe and cannot be treated with non-invasive methods, your doctor may recommend surgery to treat certain conditions, such as low back pain, sciatica, spinal osteoarthritis, and sometimes ankylosing spondylitis.

If you've been diagnosed with cancer, a spinal tumor, or another serious medical condition, your doctor will discuss treatment options, which may include surgery, radiation therapy, or other immediate medical care.

Front facing

While not all conditions that cause low back pain at night are preventable, there are several strategies you can implement to keep your back healthy and pain free.

Many experts suggest the following to help prevent pain progression:

  • Keep a healthy weight.
  • Practice good posture.
  • Avoid moving or lifting heavy objects that can stretch your back.
  • Avoid smoking , as some studies show that it increases the risk of chronic back pain.
  • Whenever possible, use ergonomic chairs (furniture designed to minimize physical discomfort) at home and at work.
  • Change your sitting position and take frequent walking or stretching breaks throughout the day.
  • Wear comfortable, supportive, low-heeled shoes.

Be aware that there are also some risk factors that can increase the likelihood of low back pain. These include being overweight, being sedentary, lifting heavy objects, and repeatedly bending or twisting the lower back.

Quality sleep

Low back pain at night can make it difficult to get quality sleep, which is an important part of recovery in many conditions. To improve sleep during nighttime low back pain, experts recommend the following tips:

  • Find a sleeping position that supports your particular back condition.
  • Choose a mattress that keeps your spine straight.
  • Use a support pillow to support specific parts of your body, reducing pressure and stress on your lower back.

Get the word of drug information

Low back pain while lying down can be especially uncomfortable even after diagnosis. When pain prevents you from getting enough sleep to help your body repair itself, it opens the door to other health problems associated with sleep deprivation .

Any back pain that only occurs when you lie down or wake up regularly in the middle of the night should be seen by a doctor as soon as possible so that you can get back to the restful sleep your body deserves.

Frequently asked questions

  • Sciatica is a nerve pain that often radiates from the back through the thigh and down the leg. This type of pain usually gets worse and goes away on its own in six weeks in about 80% of people.

  • There are several forms of complementary therapy you can do at home to relieve back pain, including exercises such as yoga or tai chi, stress reduction programs, massage, and hydrotherapy. You may also consider visiting a chiropractor for additional relief.

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