Table of ContentsView AllTable of ContentsCausesWhen to See a Healthcare ProviderDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Causes
When to See a Healthcare Provider
Diagnosis
Treatment
Coping
Lower back pain when lying down is a symptom associated with several causes, from a common back sprain or strain to more chronic conditions like arthritis orsciatica.
Lower back pain can be mild, but it can also be severe enough to interfere with your sleep when dealing with nighttime back pain. It can lead to muscle stiffness and a limitedrange of motionthat affects your daily life.
This article examines some possiblecauses of lower back painwhen lying down. It also explains how the cause can be diagnosed and treated.
Verywell / Laura Porter
Causes of Lower Back Pain When Lying Down
Nighttime back pain usually isn’t a sign of a serious health condition. Note that there are two types of back pain:
Here are some of the most common causes of lower back pain when lying down.
Strains or Sprains
Lumbar(lower back)strain or sprainoccurs when muscles or ligaments are stretched too far. Injuries like these are very common.
A sprain or strain is usually considered acute rather than chronic, so the symptoms should last a few days or weeks.
Ankylosing Spondylitis
Ankylosing spondylitis(AS) is a rare form of arthritis. It causes persistent neck andback inflammation. Symptoms can be worse at night.People living with AS also appear to have a higher risk of spinal fractures.
It is known to occur in people also diagnosed withosteoporosis(thinning of bones) orpsoriasis, among other conditions. AS symptoms tend to get better withphysical therapy.
Spine Osteoarthritis
Osteoarthritis(OA) is a common cause of joint pain, often calleddegenerative, because it occurs due to the wear and tear on cartilage tissue across your lifetime. OA affects at least 32.5 million people in the United States.
The lower back is one of the most commonly affected sites with OA.Spine osteoarthritisdue to wear and tear on the spine may spur more intense pain at night. That could be because you’re less active.
Sciatica
Sciatica is nerve pain that often radiates from the back through the hip and down the leg.
Certain sleeping positions can aggravatethesciatic nerve, which runs from your spine to the foot on either side of your body. This can causepain that shoots down your legs.
Sciatica typically affects one side at a time but can occur on both sides of your body (bilateral). Sciatica pain usually flares up and resolves on its own within six weeks for about 80% of people.
Epidural Corticosteroid Injections for Sciatica
Spinal Tumor
People diagnosed with cancer of all types have difficulty sleeping at much higher rates than the general population. While tumors or growths on the spine are rare, they can cause worse pain when lying down if the growth puts pressure on the back.
Researchers who study spinal tumors find that compression on the spine results in pain that disrupts sleep, but surgery can lead to improvement.
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Spinal Stenosis
Spinal stenosisis a condition that leads to narrowing of the spinal column and compression of nerves. The stenosis can affect different parts of your back, with lumbar stenosis andthoracicstenosis affecting the lower back.
As the stenosis becomes more advanced, sitting or lying down does not help as much to relieve the pain. This chronic condition can sometimes lead to severe impacts, including paralysis.
Osteomyelitis
Osteomyelitisis a bone disease due to bacterial infection. TheStaphylococcus aureusbacteria is a common cause of these infections, which can spread throughout the body or recur at the same site.
Back pain is the most common symptom of osteomyelitis that affects the vertebral bones in the spine.You also may experience fever and other symptoms of an infection.Antibioticsand pain medication are used to treat osteomyelitis, but it can be difficult to manage.
Other Causes
Lower back pain when lying down can also be related to a condition that causes pain at other times of the day. Sometimes, we don’t notice pain when busy throughout the day, which becomes more apparent when we go to bed.
Other possible causes of nighttime back pain include:
Everybody handles pain differently. Still, it’s a good idea to talk to your healthcare provider right away if your pain:
Also, contact your healthcare provider if the pain feels severe or if signs of infection, like redness, warmth, swelling, or fever, are present. You may want to start with your primary care provider, who can treat or refer you to arheumatologistor other specialist.
It’s a good idea to seek immediate medical care if you have low back pain and a personal history of cancer. Your pain may need urgent treatment if you also have unexplained weight loss or sudden bladder control issues.
To find the cause, your healthcare provider will start with a physical exam. Be prepared to talk about your medical history to help identify or rule out health conditions.
Your healthcare provider will ask you to describe your pain. You may want to note:
You may also need other tests to help with the diagnosis:
Your treatment will depend on what’s causing your pain. Healthcare providers often start with pain remedies such as:
Because the pain happens at night, your healthcare provider will probably want to improve your sleep environment. You may need to change your sleeping position, pillows, or mattress.
Your treatment plan could also include complementary remedies, like:
If your pain is severe or isn’t improving with these methods, your healthcare provider may recommend surgery. Surgery may be a good option fordegenerative disc disease, sciatica, and spinal osteoarthritis. It sometimes helps with AS.
If you have cancer, a spinal tumor, osteomyelitis, or another serious condition, your healthcare provider will discuss your options with you. You may need surgery, radiation therapy, or another speedy intervention.
Some risk factors increase the chance of having chronic low back pain. These include:
Getting Quality SleepNighttime back pain can be treated with OTC or steroid medications. Heat, ice, and stretches may help you heal, too. You may also need to change your sleep position or try a different mattress. A physical therapist can help you to fully recover, but the best treatment will depend on the cause of your pain.
Getting Quality Sleep
Nighttime back pain can be treated with OTC or steroid medications. Heat, ice, and stretches may help you heal, too. You may also need to change your sleep position or try a different mattress. A physical therapist can help you to fully recover, but the best treatment will depend on the cause of your pain.
Why Does My Back Hurt When Lying Down?
Summary
Back pain when you lie down can have a wide range of causes. Some are serious, and others are less so. It’s important to find the cause, especially if you experience lower back pain when lying down.
Muscle strains are the most common cause. Different types of arthritis, sciatica, and spinal changes can also lead to nighttime back pain.
Your back pain may respond to OTC pain medications, heat, ice, or gentle stretching. A new pillow or mattress may help, but your healthcare provider will need to diagnose and treat your pain if it continues.
A Word From VerywellFor lower back pain when lying down, I tell my patients to think about it in an A.B.C. format. “A” is for antecedent (what you did during the day before lying down), “B” is for behavior (what you are doing while lying down), and “C” is for consequence (the pain that is experienced). Antecedent examples include the activity or inactivity that occurs during the day, the position your body is in during work, and the firmness of your chair and mattress, while behavior may include sleep position and mental health. This way of thinking can help stimulate conversations with healthcare providers toward an individualized action plan for what is causing the pain, leading to a greater sense of control.—FOREST MILLER, OTR/L, MEDICAL EXPERT BOARD
A Word From Verywell
For lower back pain when lying down, I tell my patients to think about it in an A.B.C. format. “A” is for antecedent (what you did during the day before lying down), “B” is for behavior (what you are doing while lying down), and “C” is for consequence (the pain that is experienced). Antecedent examples include the activity or inactivity that occurs during the day, the position your body is in during work, and the firmness of your chair and mattress, while behavior may include sleep position and mental health. This way of thinking can help stimulate conversations with healthcare providers toward an individualized action plan for what is causing the pain, leading to a greater sense of control.—FOREST MILLER, OTR/L, MEDICAL EXPERT BOARD
For lower back pain when lying down, I tell my patients to think about it in an A.B.C. format. “A” is for antecedent (what you did during the day before lying down), “B” is for behavior (what you are doing while lying down), and “C” is for consequence (the pain that is experienced). Antecedent examples include the activity or inactivity that occurs during the day, the position your body is in during work, and the firmness of your chair and mattress, while behavior may include sleep position and mental health. This way of thinking can help stimulate conversations with healthcare providers toward an individualized action plan for what is causing the pain, leading to a greater sense of control.
—FOREST MILLER, OTR/L, MEDICAL EXPERT BOARD
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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