Why Does My Back Hurt Worse in The Morning?

There are a lot of people who have some level of every day lower back pain. If you wake up in the morning, and your lower back hurts even worse, there are a few things you should check out.

Cause 1: Bad Mattress

The first thing that I would always recommend is to evaluate your mattress. I’m not telling you to go out and spend thousands of dollars on a new mattress, but there was a study that I read that said 68% of people after evaluation thought they needed a new mattress.

So, check to see if your mattress is giving you enough support. A lot of times you’ll travel to a hotel, and think, “Man, I haven’t slept that well in years!” Well, it’s, it’s obviously the mattress.

Sometimes, patients tell me, “I got down on the floor last night!” Well, that floor probably provided quite a bit of support. So, I would definitely evaluate your mattress.

What Kind of Mattress is Best?

I like a firm mattress and my wife and I just had an argument about this. We just purchased a new mattress a couple of weeks ago. The salesperson came over and said, “What can I help you guys with?” I said, “We need a new mattress.”

And he says, “What do you guys want?” And, simultaneously, I say, “Firm,” she says, “Soft.” He says, “This is a problem you guys need to work out on your own,” and just left us alone for a while.

But related to this type of pain, firm is always going to be better. We want something to provide plenty of support to the back. That’s why I’m starting to tell patients to get away from pillow tops. Those things break down. Two years into it, there’s almost like a crater in the top of the bed. I actually went with a memory foam, or Tempurpedic type mattress that we’ve really, really liked.

It’s really helped us out quite a bit. I just tell folks to get out there, do your research. Talk to your doctor, talk to your chiropractor, your physical therapist. Some salespeople, obviously are going to try to sell you one of the most expensive mattresses. But get on the mattress.

Many of these mattress stores will give you 90 days to take it back. Just figure out what you’re comfortable with because you’re going to be the one sleeping on it. And firm is always going to be a little bit better than soft when it comes to supporting your back.

Other Causes of Lower Back Pain in The Morning:

There are two other big issues that can come into play. I call them mechanical and chemical.

Cause 2: Mechanical Back Pain

By mechanical, I’m talking about the position you sleep in.

Typically, patients are sleeping on their stomachs, and it’s a big no-no. When you sleep on your stomach, you’re going to put your back into extension, increasing the pressure into your lower back and making you really uncomfortable.

So how should you sleep? Get on your back. Put a pillow, or something rolled up, underneath your, your knees. Get your knees bent to like a 45 degree angle. That will take some of the pressure off your back.

Or, lie on your side. Get your knees bent to a 45 degree angle. And maybe get something between your knees. Just stay off your stomach.

Cause 3: Chemical Back Pain

By chemical, I’m referring to some kind of pain generator. Typically, like a disk problem.

The disk is the spongy, jelly thing in between two of your vertebrae, in your backbone. And what happens is, when we sleep, that disk actually rehydrates.

It’s called hydrostatic pressure. And actually swells a little bit. So, if there is potentially a little bit of a disk problem we hear about hernia issues and bulges and protrusions, and the like.

If that thing has a tendency to swell or rehydrate when you sleep, you’re going to be fairly symptomatic or a little uncomfortable, first thing in the morning. So what I always tell patients to do is just be very, very careful of what they do first thing in the morning. Your margin for error is not as large.

It’s kind of shrunk down on you a little bit. So, be careful getting out of bed; pay attention to the way you’re getting out of bed. Don’t sit straight up. Sitting straight up is going to put a lot of pressure on that low back, which potentially could irritate that disk a little bit more.

Pay attention to how you roll out of the bed. Roll over on your side and use your side muscles to bring you up, which will help you.

And then most importantly, take it easy with bending, first thing in the morning. We’ve all heard people say, “I threw my back out putting my shoes and socks on!” What happens, is there’s increased pressure with that disk. We simply go down to put our shoes and socks on, and it aggravates it even more.

So get down, sit on your butt, bring your foot up to you to put your shoes and socks on. With women, I ask them to try not to bend over to shave their legs in the shower. Maybe get your leg up, and just really work into it. Let the low back get warmed up first.

So, the golden rule first thing in the morning is to just be very, very careful about bending and going into flexion.

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