Causes Of Back Pain At Night

back pain at night

As you prepare to hit the sack after a day of hectic work, does a mild pain in the back nag you? You’re not alone in this. In fact, thank your stars that the pain is only mild. Some people attribute many sleepless nights to acute back pain. If you wonder why this nagging pain strikes only in the night, there are many reasons—from mild to serious—behind this. Read on to know more.

Why Do You Get Back Pain At Night?

Maybe You’re Sleeping On A Hard Or Uneven Surface

If you find your back aching every time you wake up in the middle of the night, your mattress might be the culprit. Does it have a deep depression in the shape of your body? Or does it feel like a bed of bricks? A mattress that is too soft and one that is too firm can prove problematic.


Your spine is often at the receiving end of your long hours of sitting or standing or other activities like lifting or driving through the day. Sleeping on a firm mattress helps your spinal cord assume the right posture while at rest. Research has found that a firm mattress reduces pain among patients with chronic non-specific lower back pain, that is back pain that cannot be attributed to any disease.1

But if the mattress is too hard or uneven, it could result in back pain through the night. Sleeping with poor support leaves the body at an unnatural angle and prevents the tense muscles from relaxing, which increases the pain.


Maybe Your Sleeping Style Is All Wrong

If you find there’s nothing wrong with the mattress, scrutinize your sleeping posture. These are the ideal positions for sleeping. Do you do them well?

  • If you are used to sleeping on your back, tuck a firm pillow under your knees to maintain the natural curve of your lower back and to support the spine. The natural curve of your neck and the alignment of your shoulders, neck, and head should be supported by the pillow under your head.
  • If you prefer sleeping on your stomach to any other style, the spine can be kept at a better alignment by placing a flat pillow under the stomach and the pelvic area. Use a flat pillow to support your head or do not use one at all if you are sleeping on your stomach.
  • For those who like to sleep on their sides, a firm pillow between the knees is a good idea just so your upper leg doesn’t move your spine out of alignment. This way, the stress on the spine is reduced, too. Also, pull your bent knees slightly toward the chest.
  • If you are already suffering from back pain, fill the gaps between your body and the bed while lying down by inserting small pillows in the gaps.
  • When you turn to a different position in bed, move the entire body as one unit and not turn or twist from the hips.2

Maybe You’ve Been Slouching All Day At Work

Do you slouch while working at your desk? Slouching results in a tilt of your pelvis, which has a direct impact on the curvature of your spine. When you repeat poor posture daily, your body’s structure slowly changes and adapts to it, leading to misalignment and pain. If your pelvis is in a neutral position, it is easy for your spine to hold itself upright. Proper sitting posture relieves the back of any pain.3


Try these postural changes to alleviate back pain and avoid it in the future:4

  • Sit on a chair with a firm back and move it close to the desk to maintain contact between the chair back and your back. This will also relieve pressure on your back and shoulders and maintain the natural, inward curve of the spine.
  • Ensure that the upper back is straight, shoulders are relaxed, and your knees are slightly higher than your hips.
  • Keep your feet flat on the floor.
  • Avoid sitting for a long time at a stretch. Stand up and move around every one hour to stretch tight muscles and give them a chance to relax.

Maybe It’s More Serious Than You Think

If you can rule out all the causes mentioned so far, you might want to consult a doctor to detect an underlying condition that is causing back pain in the night. Here are some of them for you to consider.


Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a type of arthritis that affects the spine and sometimes, other joints. It causes inflammation between the bones of your spine and in the joints between the spine and the pelvis. The symptoms include pain and stiffness in the lower back and buttocks and the pain can be so severe that it can keep you up all night.5 The symptoms of AS are usually dull and diffuse, with the pain and stiffness worse in the mornings and in the night.6

Spinal Tumors

Back pain is the presenting symptom in 90 percent of patients with spinal tumors, which can affect any of the structures of the spine or the spinal column. The common symptoms of spinal cord tumors include pain in the lower or middle back that worsens when you lie down. The pain is often present at night and gets worse with physical activity.7 8


Kidney Stones

Kidney stones are hard deposits of calcium, minerals, and acid salts formed in concentrated urine in the urinary tract. These cause pain when they lodge in the ureter and obstruct the urine flow. The pain is usually bad at night or in the early morning possibly because of the low urine output during these times.9

Visceral Cancer

Low back pain, which cannot be located precisely, can be due to visceral cancer or cancers of the internal organs, such as pancreas, duodenum, colon, uterus, cervix, and ovary. The symptoms include back pain, which is not relieved with rest and can be the most intense at night. This non-mechanical back pain, which progresses persistently in spite of medication and activity modifications, should raise the suspicion of cancer.10


Women May Have Other Reasons

If you’re a woman suffering from back pain in the night, here are some more reasons to consider.

High Heels

After a night of partying and dancing on high heels, do you feel a dull, persisting back pain as you get ready to hit the bed? Walking on high heels is a common cause for back pain because high heels pull muscles and joints of the body out of alignment. In addition, the plantar fascia ligament in the foot connects to the calf muscle, which in turn connects to the hamstring. The hamstring attaches to the pelvis. Walking on high heels shifts your center of gravity forward, forcing you to arch your back, which eventually leads to back pain later in the day or at night.11



Endometriosis is another condition that can cause back pain in women, which often gets worse in the night while sleeping. Endometriosis is a disease in which tissues that normally grow inside the uterus grow outside of it, leading to infertility. Pain occurs in the abdomen, lower back, or pelvic areas, which gets worse at night.12


If you are pregnant, you can safely attribute your back pain at night to the changes happening to your body. In a survey conducted among 200 women within 24 to 36 hours of their giving birth, it was found that 56 percent of the women suffered from low back pain during pregnancy. It is also notable that one-third of the pain increased during the night and disturbed their sleep.

This pain is due to the enlargement of the pelvic veins and the expansion of uterus, which presses the vena cava, the large vein carrying deoxygenated blood into the heart, particularly at night when the woman is lying down.13

Remember, a back pain that doesn’t get better with postural changes merits a prompt consultation with the doctor.