Back Pain in the Morning: 5 Possible Causes

Written by Leon Mao
Physiotherapist, University of Melbourne
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on June 20, 2022

Woman suffering from morning back pain

Waking up with back pain in the morning can be frustrating. This is not an unusual occurrence for many Australians.[1] The symptoms may only last for a couple minutes after walking around for a bit, or may continue throughout the rest of the day. In some cases, low back pain may occur every morning.

Back pain in the morning can be a sign of poor sleeping posture or an unsupportive mattress.[2] However, morning back pain can also be a symptom of an underlying medication condition and may need to be assessed by a doctor.

What are the symptoms of morning back pain?

The symptoms of morning back pain may include:

  • Stiffness

  • Muscle aches

  • Reduced flexibility

  • Pain with movement, such as walking

  • Fatigue.

What causes morning back pain?

Evaluating the cause of the pain can help determine ways to manage and resolve the symptoms for a pain-free morning.

1. Awkward sleeping posture

Back pain in the morning can be caused by an awkward sleeping posture. Prolonged positions can put extra strain on the joints and muscles in the body and spine. Stomach sleepers may experience this more frequently.

A doctor may recommend a visit to a sleep clinic to assess and evaluate sleeping posture, and make suggestions to get a better night’s sleep. This may include sleeping with a pillow between the knees to better align the hips and pelvis, or using a pillow to support the pelvis or lower spine.

2. Old mattress or pillow

An old mattress or pillow may be the culprit for back pain in the morning. Mattresses degrade over time and with use. There are some suggestions that a mattress should be replaced every 5-10 years. Once the mattress starts sagging or loses tension, it may need to be replaced.

Changing to a new mattress can provide better support to the spine, and reduce the incidence of back pain in the morning. However, before choosing a mattress, it is a good idea to do some research and ask lots of questions to work out which is the best one.

3. Muscle aches and pain

In some cases, overdoing exercise the previous day can cause back pain the next morning. This is particularly common after a new sport or activity. Overloading the spine and muscles beyond usual activity levels can stress these structures and result in muscle aches or pain.

The symptoms are usually short-term, and may even resolve after a short period of moving around or walking. It is important to increase any exercise gradually, and complete a proper warm-up and cool-down for exercise.

4. Degenerative disc disease

Degenerative disc disease is a chronic condition that develops over time with age or injury. It is progressive and occurs when the cartilage and discs in the lumbar spine stiffen and degrade over time. These vertebral joints and discs are important for absorbing load and enabling movement.

Some people may not experience any symptoms at all. However, for others degenerative disc disease can cause pain and stiffness in the morning. Degenerative disc disease needs to be monitored over time, and a combination of treatments is often needed to help manage any symptoms.

5. Fibromyalgia

Fibromyalgia is a term that describes widespread pain in the body. Other symptoms may include soreness, sensitivity, fatigue, and mental fog.

There is no specific treatment for fibromyalgia. Instead, a doctor may recommend a combination of treatments to help improve sleep and reduce any painful symptoms. This may include physiotherapy or counselling to help develop ways to manage the symptoms and improve quality of life.

Other causes of morning back pain

Other causes of morning back pain can include:

  • Arthritis

  • Spinal stenosis

  • Pregnancy

  • Herniated disc

  • Infection

  • Tumour

  • Gut disturbances

  • Kidney stones

When to see a doctor?

It is also possible that morning back pain is caused by an underlying medical condition. If the pain causes frequent waking in the night, it could be a sign of a medical issue.

A doctor should be consulted immediately if there are symptoms including the following:

  • Persistent or severe pain

  • Bladder or bowel incontinence

  • Sudden weakness or numbness

  • Difficulty walking or weight bearing

  • Shortness of breath

  • Dizziness or loss of consciousness

  • Nausea or vomiting

  • Fever or chills.

Treatment for morning back pain

Treatment depends on the location, cause, and severity of the symptoms. Back pain in the morning can be helped with a combination of treatments.

The following are some common strategies to alleviate symptoms:

  • Changing an old mattress for a more supportive one

  • Addressing any awkward sleeping positions

  • Avoiding pets in the bed that may disturb sleeping patterns

  • Ice or heat therapy

  • Regular walks throughout the day

  • Avoiding prolonged periods of sitting

  • Use an ergonomic or standing desk

  • Warm-up and cool-downs, particularly before a new activity

  • Over-the-counter pain relief.


A physiotherapist may recommend certain stretches or exercises to stretch and relax the structures in back. These exercises may be particularly helpful just before bed. Common exercises include gentle knee bends, rocking, or mini-extensions.

A regular exercise program is also important to keep the muscles and body strong, and functioning optimally throughout the day. A physiotherapist may suggest a walking program, which is a low-impact exercise that can help condition the body.

Medical treatments

A doctor may also recommend the following:

  • Topical remedies: Topical medications applied to the skin may help reduce any inflammation and provide pain relief.

  • Prescription medications: A doctor can prescribe medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), to alleviate pain or discomfort

  • Corticosteroid injections: If the pain is severe or persistent, a doctor may suggest a steroid injection to provide local pain relief to the affected area.

In rare cases, morning back pain may be caused by an underlying medical condition. In these situations, a doctor may recommend a review with a neurology clinic to assess the pain and discuss alternative treatment options.

Key takeaways

Back pain in the morning can be caused by an old mattress or awkward sleeping position. It typically resolves on its own, however there are some strategies that can help reduce symptoms.

However, if the pain is persistent and occurs every morning alongside other unexplained symptoms, it’s important to consult a doctor to rule out any serious medical conditions.

Written by Leon Mao
Physiotherapist, University of Melbourne
Published on June 20, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on June 20, 2022
Medical reviewers
Last medically reviewed on June 20, 2022 has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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