How to Treat Back Pain in the Morning

Get your day off to a great start!

Back pain is a common problem, with 16 million adults in the U.S. dealing with regular or constant back pain. For many, mornings are when the pain is worst. Fortunately, you have a lot of options for easing those morning backaches.

A woman clutches her back in pain while sitting on her bed.

Yuttana Jaowattana / EyeEm / Getty Images

Causes of Morning Back Pain

Sometimes, morning back pain is just the result of sleep itself. When you move, the fluid that lubricates your joints (called synovial fluid) circulates and keeps things moving smoothly. Movement also increases blood flow, which gets oxygen and nutrients to your joints, muscles, and connective tissues.

When you lie still for several hours, that doesn't happen, so it's normal for you to feel a little stiff when first waking up. This may be the only time you have back pain, or your existing back pain may be especially bad in the mornings.

If you have morning back pain that is severe or persistent, it could be caused by an undiagnosed medical condition. Some common medical causes of morning back pain include:

It may also be due to a vitamin or mineral deficiency (such as vitamin D or calcium), chronic overuse, stress, poor posture, or a current illness.

At-Home Treatments

You can try a lot of things on your own to see if they improve your morning back pain. Some things that might help include:

  • A new mattress
  • A new pillow
  • A change in sleeping position
  • Over-the-counter pain medication
  • Increasing your exercise
  • Morning stretches

New Mattress

A new mattress can be expensive but is often worth it. In a review of studies on the type of mattresses that best relieve back pain and improve spinal alignment, the most effective mattresses were considered medium-firm and custom inflated (such as the Sleep Number bed).

However, no one bed is best for everyone. Look for one that feels like it supports the natural curves of your spine—so your spine stays as straight as possible—and feels most comfortable to you.

When buying a new mattress, be sure to take advantage of return periods and in-home trials, which are often 30 days but can be even longer. You will have to go through an adjustment period during which your pain may increase, but this often goes away after a few weeks. If it doesn't, you may want to return that model and try something else.

If you can't afford a new mattress, you might want to try a mattress topper. Many of them are available in different materials and thicknesses.

A New Pillow

A young Black woman sleeps on a fluffy pillow.

LaylaBird / Getty Images

You may not realize how important your pillow is for a proper sleep position, but the right one can eliminate pain not just in your neck and shoulders, but in your entire back.

You want to use a pillow that supports your neck well and keeps it in a straight line with the rest of your spine. You can also use body pillows or towel rolls to support places that don't feel well supported by your mattress. If you sleep on your back, try a pillow under your knees to relieve lower-back strain. For side sleepers, a pillow between your knees can help, too.

Look for pillows made for the position you sleep in most often, since that makes a big difference in how thick or firm they are. A lot of specialty pillows are available, as well, if conventional ones don't work well for you.

Pillows break down over time, so some experts recommend replacing them once a year.

Fluffing Up Your Pillow

If your pillow is feeling flat, try putting it in the dryer on air fluff for about twenty minutes, and add a tennis ball or wool laundry balls. That'll increase the loft and help make them comfortable again.

Sleeping Position

No matter what position you sleep in, you want your ears, shoulders, and hips to be in alignment with each other. The best sleep position is usually thought to be on your back, because that's the easiest way to keep your spine in its natural position.

If you're a side sleeper, bending your knees and pulling them up toward your chest may help ease the stress on your lower back. Experts also recommend switching sides frequently, as the side you sleep on may develop pain after a while.

Sleeping on your stomach is considered the worst for contributing to back pain. If this is your preferred position, try putting a pillow under your pelvis or lower abdomen to help keep your spine properly aligned.

Over-the-Counter Pain Medication

While not considered a long-term solution due to potential side effects, over-the-counter (OTC) pain relievers can help alleviate occasional morning back pain. The main OTC pain medicines are:

Tylenol is often the first drug doctors recommend because it's least likely to cause side effects. However, overuse of Tylenol can severely damage your liver. Be sure to follow the dosing recommendations and check any other drugs you take to see if they also contain acetaminophen—a huge number of products do, including cold and flu formulations.

If Tylenol isn't effective for your back pain, the next step is to try Advil, Aleve, or aspirin, which are all non-steroidal anti-inflammatory drugs (NSAIDs). These medications can have long-term negative effects on your health, so they shouldn't be used for longer than a week at a time without your doctor's knowledge.

Monitoring & Regular Use

If you take any OTC pain relievers on a regular basis, your doctor may want to periodically monitor your liver and kidney function.


Exercise

The beneficial effects of exercise on your joints shouldn't be overlooked when you're trying to alleviate morning back pain. It doesn't necessarily have to be in the morning, either.

Healthier joints are less prone to getting stiff and sore while you sleep, so choose the time of day that's best for you. (Don't exercise close to bedtime, though, if it interferes with your sleep.) Some experts recommend about 30 minutes of exercise five days a week to keep your joints healthy and lubricated.

Especially when you're first getting started with an exercise regimen, take it easy and increase the duration and intensity of your workouts gradually.

What's Right for You?

Be sure to talk to your doctor about what types of exercise are most appropriate for you, given your age, fitness level, and overall health.

Morning Stretches

Knees to chest stretch

PhotoAlto / Frederic Cirou / Alto Agency RF Collections / Getty Images

Morning back stretches are another great way to loosen up your stiff joints in the morning and get rid of that back pain. Here are a few you can even do before you get out of bed and without any special equipment.

Knees-to-Chest Stretch

A knees-to-chest stretch is a good way to start.

  1. Lie on your back and bring one knee up toward your chest.
  2. Then bring up the other leg.
  3. Grasp your lower legs just below the knees and pull them further in.
  4. Hold for between 5 and 15 seconds and then release.

You might follow this up with an opposite movement that targets the mid-back:

  1. Keeping the grasp just below your knees, press your knees into your hands, away from the front of your body.
  2. Hold for 5 to 15 seconds and relax back into the start position.

Prone Position

  1. Lie prone (on your stomach).
  2. Place a flat pillow or folded towel lengthwise under your trunk (this allows your head and neck to relax down toward the bed. Turn your head to one side, if that's comfortable, and place your arms where they're most comfortable.
  3. To support the low back and engage the abdominal muscles, arch your lower back, pressing your tailbone toward the back of your thighs.
  4. Hold for up to a minute.

Lengthen Your Spine

In this more active version of the previous stretch, you'll remove the pillow under your trunk. Without that support, you'll need to add more "oomph" to the effort by contracting the muscles at the sides of your hips, as well. These muscles (the hip abductors) provide stabilization and support to the pelvis, which in turn, may help support your spine.

  1. Depending on which is most comfortable, either rest your forehead on the mattress or place a pillow crosswise under your forehead.
  2. Bring your arms down by your side and straighten the elbows, but don't lock them.
  3. Continue picking up the front of the pelvis, which activates the abdominals.
  4. Elongate your spine.
  5. Hold the position for about 30 seconds and then relax.

Back Extension

A back exercise taken from the yoga cobra pose may help improve pain related to disc problems. This gentle back extension exercise also lengthens the spine and may help counter an excessive curvature in the upper back (kyphosis).

Back extension may need to be avoided if you have facet joint problems, spondylolysis, spinal arthritis, or spinal stenosis. This is because the position you'll be in may irritate already compromised areas. If you're unsure as to whether it's right for you given your condition, ask your doctor or physical therapist before proceeding.

  1. Lie on your stomach and place your forearms on the bed, elbows bent and directly under your shoulders. Relax your shoulders as best you can.
  2. Press up a short way. Be sure to keep the movement in a pain-free zone; in other words, don't go so far up as to feel a "kink" in your low back. Keep your abs engaged.
  3. Hold for a few seconds, then gently bring yourself down and rest. Repeat up to three times.

Spine Stretch

You'll be on your back for this one. You might want to try placing a small pillow or rolled towel under your low back for support. If your shoulder or arm muscles are tight, or if your shoulder range of motion is limited, you can use pillows to support them, as well. Just be sure the resulting position is comfortable.

You can also modify the position by placing big pillows under your knees. This may help keep your knees and hips supported in a flexed position. Another variation is to lie on the floor with your knees bent and lower legs resting on an ottoman or chair for support.

  1. Lie on your back in your chosen position.
  2. Move your arms out until they make a "V" shape above your head.
  3. Reach with your arms and feel the stretch in your upper back. Relax.

When to See a Doctor

If you have morning back pain that is severe, gets increasingly common or is present every morning, or is accompanied by other symptoms, be sure to see your doctor. They'll want to look for possible causes of your pain including injury, illness, or another medical problem.

Some conditions, including fibromyalgia and lupus, may cause periodic bouts of back pain that clears up in between, so also report any back pain that comes and goes—especially if you experience fatigue, rashes, or cognitive dysfunction ("brain fog") at the same time.

Back pain that radiates down your leg(s) may be due to a herniated disc or sciatica (compression of the sciatic nerve).

Be sure to tell your doctor about the intensity, nature, frequency, and duration of your pain as well as any symptoms that appear to be related to it.

A Word From Verywell

Even if your back pain isn't severe or accompanied by other symptoms, just the fact that it's a regular part of your life warrants a conversation with your doctor—especially if you try several at-home treatments without relief.

Contrary to popular opinion, aches and pains are not just a normal part of growing older. With the proper diagnosis and treatment, and a focus on living a healthy lifestyle, you should be able to reduce or eliminate your morning back pain.

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Article Sources
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