Why does my lower back hurt more in bed?

So you get more lower back pain or sciatica when you’re lying in bed…  It gets worse as the night goes on, and is typically really stiff and sore in the mornings.  This is fairly common and can be due to a number of factors, but before I dive into those, let’s do a little safety check.  It’s worth mentioning that pain that is worse at night, particularly a constant (rather than intermittent) pain can be a sign of something more serious.  Check out our “safety questions” to be sure we’re talking about a mechanical back problem and not something that you need to be going to see your doctor about.  Briefly, if you have more pain at night, and you’ve lost weight unexpectedly, or have night-sweats, or feel unwell, or have a history of cancer, then please contact your doctor.


Regardless of what the injured tissue is (bone, muscle, tendon, disc etc.), if it’s inflamed the inflammation will tend to build up when you are still, whether sitting or lying.  Consequently the longer you lie still the stiffer and more sore your back – and potentially your sciatica – is likely to get.  TIP: Try ice-packing before turning the light out.

Disc related pain

If you have a bulge in one of your discs, it’ll probably be inflamed and – as described above – that’ll get worse the longer you stay still.  However, your discs also absorb fluid when you are off-weight bearing i.e. lying down.  When they absorb fluid any bulge in the disc gets bigger, so the bulge will be biggest first thing in the morning.  IF that bulge is compressing or irritating a spinal nerve, this pain will be worse in the morning too.

Muscle fatigue

It may seem strange to say that your muscles will fatigue when you are lying relaxing, however if your muscles are very tense and you’re lying in a position in which these muscles have to do some work to support your back, they will fatigue as the night goes on.

Movement-related pain

Many lower back pains spasm when you try to turn over in bed.  This is simply because you’re putting strain on the sore bits and the pain is warning you not to.  TIP: Try bracing your abdominal muscles before initiating the movement and keep them braced until you’ve completed the movement (there’s more on this in the lower back pain online course).

If you’d like help specifically for your pain, you can arrange a consultation by booking online here, or emailing info@active-x.co.uk, or sample our lower back pain / sciatica online course here.


About the Author:

Clinic Director and Osteopath. Gavin graduated as a Gold Medallist in 1991 and is now a Vice Patron of the British School of Osteopathy. Co-author of “The Back Book” with Gavin Hastings OBE in 1996, and author of "active X backs - an effective solution for lower back pain"; he has an MSc in The Clinical Management of Pain from the University of Edinburgh. He's passionate about helping to move people as far from illness and pain as possible, and in January 2015 set himself the target of helping a million people get a better back.

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