Back Pain After Sleep: Causes, Chiropractic Care, and Other Remedies

Back hurts after sleeping: Common causes

Poor sleep habits and an unsupportive sleep environment are common culprits behind back pain after sleep (5, 6). However, underlying medical conditions like arthritis, disc herniation, and fibromyalgia can contribute to the condition. 

Here’s a look at the common causes. 

Poor sleeping position

Sleeping on your stomach can force your spine out of alignment, putting excessive strain on the muscles and ligaments in your back (2). This strain can lead to pain and stiffness, particularly in the lower back and neck. 

Similarly, sleeping in a curled-up position on your side or with your neck twisted can cause misalignment and back pain (2).

Unsupportive mattress or pillow

If your mattress doesn’t conform to your body shape and provide proper pressure relief, your spine won’t rest comfortably (6). This can lead to muscle tension and pain throughout your back.

Likewise, an old or unsupportive pillow can cause the misalignment in your neck, contributing to upper back pain and headaches.

Stress and tension

When we’re stressed or tense, our muscles tend to tighten up (7). This tension can build in the muscles of the upper back and neck, leading to stiffness and pain when we wake up.

Arthritis

When it comes to back pain, osteoarthritis, the most common form of arthritis, can affect facet joints in the spine (8). These facet joints help stabilize the vertebrae and allow for movement in your back. 

Over time, the cartilage that cushions these joints can wear down, leading to inflammation, stiffness, and pain, especially in the lower back (8). The pain might be worse in the morning after sleep due to inactivity and stiffness, but may improve with movement.

Disc herniation

A disc herniation happens when a soft cushion between your spine bones bulges (9, 10). This can irritate nearby nerves, causing pain, numbness, weakness, or tingling that may radiate down one or both legs (9). 

Pain from a disc herniation can sometimes worsen with certain positions, which may explain why back pain disrupts sleep.

Fibromyalgia

Fibromyalgia causes pain and tenderness throughout the body, affecting the muscles and surrounding the joints.

Apart from feeling back pain, people with fibromyalgia often experience fatigue, sleep disturbances, headaches, and difficulty concentrating (3, 11). 

The exact cause of fibromyalgia is unknown, but it’s thought to be related to abnormal processing of pain signals in the brain and spinal cord. 

Pain associated with fibromyalgia can affect the back and may be worse while waking because of sleep disturbances and lack of movement.

Kidney disease

When kidney function is compromised, waste products can build up, causing inflammation and pain that may radiate to the lower back (3). Conditions like kidney stones or enlarged cysts in the kidneys can irritate nearby nerves, leading to backache.

Endometriosis

This condition involves the growth of uterine tissue outside the uterus. Endometriosis often manifests as pelvic pain, but back pain can also be a significant symptom (3). 

The displaced endometrial tissue can irritate nerves in the lower back, causing pain that may worsen during menstruation or with certain positions (3).

Tumors

Tumors in the spine or surrounding tissues can cause back pain (3). The location and type of tumor determine the specific symptoms, but back pain, weakness, and numbness in the legs are some potential signs. 

Pregnancy

Hormonal changes, weight gain, and altered center of gravity during pregnancy can strain the lower back, leading to pain and discomfort (3).

This pain typically improves after childbirth, but a history of pregnancy-related back pain is a risk factor for back problems later in life.

Psychological conditions

Stress, anxiety, and depression can manifest as physical symptoms, including back pain (3). These psychological conditions can heighten pain perception and contribute to muscle tension that worsens backache.

Infection

While less common, spine or surrounding tissue infections can cause back pain. These infections can arise from bacteria entering the bloodstream or spreading from a nearby infection (3). 

Early diagnosis and treatment with antibiotics are essential to prevent complications like permanent nerve damage.

How chiropractic adjustment helps

Chiropractic care focuses on the musculoskeletal system and the spine’s alignment (12). A chiropractic adjustment involves manual spine manipulation to improve joint function and alignment.

Research suggests that chiropractic care can be effective for some musculoskeletal complaints, including low back pain, and can complement conventional medicine (13). 

A visit to a chiropractor can (12): 

• Restore mobility
• Alleviate pain
• Reduce muscle tightness
• Allow tissues to heal

What to expect

If you decide to explore chiropractic care for your back pain, here’s what to expect throughout the process (13):

Initial consultation

• Discussion: The chiropractor will ask detailed questions about your medical history, current symptoms, and past injuries. 
• Physical examination: The chiropractor will examine your spine, checking for joint mobility, muscle tension, and any postural imbalances. They may also assess your reflexes and range of motion.
• Diagnostic tests: The chiropractor may recommend X-rays or other imaging tests to rule out underlying conditions like arthritis or disc herniation.

 Possible treatment

• Manual adjustment: This is the most common chiropractic technique. The chiropractor uses controlled, quick thrusts to manipulate specific joints in your spine. The goal is to improve joint mobility and restore proper alignment. 
• Massage therapy: Many chiropractors incorporate massage therapy into their treatment plans. Massage can help relax tight muscles, improve circulation, and reduce pain.

Treatment frequency and duration

The frequency and duration of treatment will depend on the severity of your condition and your individual response. For acute back pain, you might visit the chiropractor two to three times a week for a few weeks, then gradually decrease the frequency as your pain improves. 

If you’re experiencing chronic back pain, a longer-term treatment plan might be recommended. 

Self-care and lifestyle modifications

Your chiropractor will likely recommend self care practices to complement the adjustments and support your healing. This might include:

• Stretching and exercises: Specific exercises tailored to strengthen your core and improve flexibility in your back muscles will likely be prescribed.
• Nutrition advice: The chiropractor might offer diet tips to help alleviate your condition.

Results and timeline

There’s no one-size-fits-all timeframe for getting results from chiropractic care. Some people feel immediate relief after an adjustment, while others may take several sessions to notice a significant improvement. 

Factors that can influence how quickly you see results include:

• The severity of your condition: Acute pain generally responds faster to treatment than chronic pain.
• Overall health: Your general health and fitness level can influence your body’s healing process.
• Treatment adherence: Following the chiropractor’s recommendations for self care and lifestyle modifications greatly optimizes the results.

Potential side effects

Chiropractic care is generally considered safe, but some people may experience mild soreness or discomfort after adjustments (14). 

These side effects are usually temporary and resolve within a day or two. If you experience any concerning side effects, communicate them to your chiropractor.

How often should you try chiropractic care?

Depending on the severity of the pain and your individual needs, you might need to undergo chiropractic care two to three times a week (13, 15).

It’s important to discuss your individual situation and goals with your chiropractor. These professionals can develop a personalized treatment plan based on your specific needs and track your progress over time to adjust the frequency of adjustments as needed.

If you’re experiencing a sudden onset of back pain (acute pain), you might benefit from more frequent chiropractic adjustments in the initial stages, perhaps two to three times a week for a few weeks (15). 

This can help reduce inflammation and facilitate healing. As your pain improves, the frequency of adjustments can gradually decrease.

Who shouldn’t try chiropractic adjustment?

Chiropractic care can be a safe and effective treatment option for many people with back pain. However, if you are pregnant, have osteoporosis, arthritis, or certain neurological conditions, consult your doctor before seeking chiropractic care (16, 17). They can advise you on whether chiropractic adjustments are safe for you.

Other ways to relieve back pain after sleep

To manage back pain, you can try several self care strategies at home, such as stretching, meditation, and exercise.

Gentle stretching

As soon as you wake up, perform gentle stretches to loosen tight muscles and improve flexibility (18, 19). 

Focus on stretches that target your lower back, hamstrings, and glutes. Hold each stretch for 5 to 10 seconds and repeat a few times.

Mindfulness meditation

Studies have shown that mindfulness meditation can be a powerful tool for managing chronic pain, including back pain (20). 

Mindfulness practices help you focus on the present moment and accept your pain sensations without judgment (20). In the long term, this process can improve your pain tolerance.  

Breathing techniques

Deep breathing exercises can help manage stress and tension, which can contribute to back pain (21). 

Focus on slow, diaphragmatic breaths, inhaling through your nose and exhaling slowly through your mouth (21). Practice deep breathing for a few minutes before bed and throughout the day to help manage stress and promote relaxation.

Massage therapy

Massage can help relax muscles, improve circulation, and reduce pain (22). Consider a professional massage or learn self-massage techniques to target your back muscles.

Stay active

Low-impact exercises like walking, swimming, or yoga can help promote flexibility, strengthen core muscles, and improve overall well-being (23).

New findings

Chiropractic care remains a viable option. However, the future of back pain treatment seems to lie in a more holistic approach. 

Traditional medicine practices like herbalism, along with integrative therapies that combine different approaches, are showing promise for long-term back pain management. 

Here’s a glimpse into some exciting recent findings.

Herbal medicine

New research suggests that herbal medicine could be a helpful way to ease different types of pain. 

For example, the traditional Chinese medicine Xue-Fu-Zhu-Yu-Tang (XFZYT) has been used successfully for chest pain and headaches (24). 

Indian long pepper (Piper longum L.) has shown potential in treating osteoarthritis by reducing inflammation and protecting cartilage in lab and animal studies (24). 

Yoga and meditation

Research suggests that yoga might be a helpful addition to other treatments for back pain (25). 

Yoga poses can improve your balance, flexibility, and muscle strength, which can be beneficial to your back. 

Newer studies even suggest that yoga poses with meditation might help increase certain chemicals in your brain that promote relaxation and reduce stress, which can be linked to back pain (25). 

Sleeping on a firm floor

Traditional Asian beliefs promote sleeping on a firm floor for back health. However, recent research suggests that a medium-firm mattress with good pressure point distribution is more beneficial for most people (6). 

An overly firm mattress may not relieve enough pressure and can worsen back pain.