We’ve Got Your Back: Possible Culprits and Resolutions for That Post-Sleep Back Ache

There are several potential causes of post-sleep back pain.
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Back pain is as common as it gets. If you're like some people who wake up with backside pain, from dull aches to sharp stabs, you might be wondering what's causing that pain in your back. According to experts in pain medicine, there can be several causes for your back pain after catching zzzs.

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Read more:How to Alleviate Back Pain in 11 Simple Moves


Aligning the Cause

Having backaches after you rise and shine for the day suggests that a number of factors could be at play, says Richmond, Virginia-based David Drake, MD, medical director of the Interventional Pain Clinic at the Hunter Holmes McGuire Veterans Affairs Medical Center.

Some potential causes of your back pain after sleeping, according to Dr. Drake, could be bone-related (think: arthritis) or muscle-related.

"When you look at back pain, there are different layers, with the outer layer being the fascia, which is a covering over the muscle with a lot of nerves in it. The next layer is the muscle, and the layer after that is where the bones are located — that would be the facet joints," he explains. "If you go down deeper than that, then we're talking about the nerves and the discs."


According to Dr. Drake, pain in the fascia, or the overlying tissue on muscle, is involved in the majority of cases of back pain after sleeping. Shoulder and neck pain are also common pain areas after sleep, whereas the midback is not often a cause of sleep-related back pain, he adds.

To get to the root of post-sleep back pain in his patients, Dr. Drake asks them what sleep position they gravitate toward and which one they avoid. If your back pain is worse when your spine is straight, such as when you are lying flat on your stomach or standing, your facet joints may be the culprits, he says.


If sleeping in a curled position aggravates your back pain, the cause may be disc- or nerve-related, adds Dr. Drake. And if you tend to sleep on one side because the other side of your back bothers you, it could be a muscular issue, he notes.

If your back pain is affecting you during and after sleep, Dr. Drake says it's important to talk to your doctor to correctly determine the cause.

Position Yourself to Alleviate Pain

Beyond your sleep position being potentially indicative of the cause of your back pain, it can actually become the remedy of your back pain if you make some changes, according to the Cleveland Clinic.


However, if your go-to sleep position is contributing to your back pain, changing this tendency is not as easy as it may seem. "We develop patterns over time, and people often become a back sleeper, side sleeper, etc.," Dr. Drake says. "Changing that position after it's become a habit is really a challenge."

To help stave off your sleep-related back pain, the Cleveland Clinic recommends you snooze on your back with your spine in a neutral position. Sleeping on your back, explains the Cleveland Clinic, helps evenly distribute your weight, reduce pressure points and ensure correct alignment of your organs.

If you tend to snooze on your side, curling your legs slightly toward your chest and sleeping with a pillow between your legs can help reduce back pain, the Mayo Clinic says. And if you happen to be a side sleeper with pain in your shoulder region, custom pillows and wedges offered by therapists could help, Dr. Drake notes.

As far as positions to avoid, sleeping on your stomach is often a no-no if you have back pain, cautions the Mayo Clinic, because it can put strain on your back. But, if you enjoy sleeping on your stomach and have trouble changing your sleep position, the Mayo Clinic suggests sleeping with a pillow beneath your lower abdomen and pelvis (with or without a pillow under your head, depending on what's most comfortable to you).

Read more:6 Exercises That Can Help With Back Pain for People Over 50


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If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker.