It’s a vicious cycle: Nagging back pain interrupts your sleep, and the lack of restorative sleep makes back pain feel even worse. But identifying specific causes of nighttime back pain—and taking steps to ameliorate them—can lead to better zzz’s, according to Kaliq Chang, MD, interventional pain management specialist with Atlantic Spine Center.
“Whether you’re having trouble falling asleep, staying asleep, or waking up earlier than you’d like, pain is widely considered to be among the top causes of insomnia,” Chang says in a release. “So it’s wise to aim at the pain—not just medicate the inability to sleep well. Fortunately, there are a variety of proactive ways to tackle nighttime back pain.”
Contributors to Nighttime Back Pain
What are some of the most prominent causes of back pain, and why might they worsen when lying down or sleeping? Most likely, your nighttime back pain isn’t just occurring after the sun drops—it’s an extension of occasional or chronic back pain you’re also feeling during daytime hours.
Many patients tell Chang their symptoms increase if they lie in a particular position, like on one side of their body or another, or on their backs. That’s why it’s so important to obtain a proper diagnosis from a physician about the cause of your back pain—especially to rule out serious conditions such as spinal tumors or bone infections.
The most common causes of nocturnal back pain include:
- Disc degeneration, meaning the spongy material between spinal vertebrae is breaking down (usually due to age)
- Injuries, such as fractures or sprains
- Scoliosis, a gradually progressing curvature of the spine
- Spinal stenosis, a narrowing of the spinal column that pinches surrounding nerves
- Kidney stones
“Simply put, laying in a position that pushes or pinches the damaged part of your spinal area, or aggravates other pain triggers, will make it hurt more,” he says. “Also, because inflammation increases at night due to our slowing circulation and metabolism, inflammatory pain also tends to rise.”
Tips for Relief
Chang suggests these tips to relieve back pain at bedtime:
- Take tub time: Taking a bath or shower helps relax muscles that have tightened during the day. Massaging shower heads can pinpoint problem areas even better.
- Stretch: Since muscle tightness is a big contributor to back pain, taking time to gently stretch helps prepare the body for sleep.
- Adjust sleep positions: It may seem obvious to change a problematic sleep position that results in back pain, but many of us are deeply attached to our favorite positions, Chang notes. Stomach or side sleepers are actually more likely to experience back pain because these positions cause unnatural curvature of the spine. “It may feel odd at first, but try changing up the position in which you fall asleep,” he suggests.
- Add enhancements: If you’re married to your preferred sleep position, or find you keep waking up in the same position despite altering it, try softening the stress on your spine. “Place a pillow between your legs if you’re a side sleeper,” Chang recommends, “or under your pelvis if you’re a stomach sleeper. If you’re a back sleeper, place a pillow under your knees to lessen stress on your lower back.” A strategically placed hot water bottle can also ease pain.
- Spring for a new mattress: If your mattress is more than 10 years old, it may be past its prime in properly supporting your spine, particularly as age and injury add to the mix. “If you’ve tried other measures, and your doctor has weighed in with a diagnosis and corrective measures, think about getting a new mattress,” Chang says. “You can always try out different versions at the store and see how they feel on your back first.”
Kaliq Chang, MD, is a board-certified physician who is fellowship-trained in pain management at Atlantic Spine Center.