Why does my back hurt in the morning?

We get asked this question multiple times a day…

“Why would my back be hurting from 4am, if all I’ve been doing all night, is lying down?”

Let’s clear out some of the immediate suspicions we hear:

• No, you don’t need a new mattress or pillow.

• No, it’s not because you sit on your wallet.

• No, it’s not because of your posture or because you cross your legs.

• No, it’s not because you sleep like a pretzel.

Just like most answers in healthcare, “it depends” - and that is the most ‘correct’ answer.

So, now that we have the ‘most correct answer’ out of the way, we want to share the 3 most common things we discuss with our patients in helping them understand their morning back pain.

1. There is an active disc injury process

2. You’ve overloaded a compressed joint

3. You have history of back pain and you’re in a ‘sensitised state’

Disc injuries
When you aren’t weight bearing, your discs have the opportunity to receive more nutrients and blood supply.

If there’s a small irritation on the lining of the disc, then the disc receiving these nutrients will likely cause a stretching of the nerve endings that reside on the disc lining.

That aches.

These tend to get better once you get out of bed, have a shower and by about mid morning, you’re pretty much not feeling it anymore.

Overload/Compression
Imagine bending a finger back a little and holding it for an hour… how long before it starts to hurt?

So if you tend to hold your lower back in extension or flexion, you’re creating sustained compression throughout the day.

Nothing is injured or hurt, but you might be feeling some sensitivity through the joint due to the overload.

You feel it in the morning as this is when we start to receive more signals as we start to become more conscious again after deep sleep - ultimately we are receiving the initial array of signals and we perceive them more in the morning as there are less competing signals to perceive.

History of back pain and currently in a ‘sensitised state’
A history of back pain means that you’ve hurt your back or had back pain before.

A sensitised state means that your nervous system is in a state that is more exciteable than usual - ultimately it takes less stimulus to fire off signals.

The most influential factor that causes this is stress.

Suppressing negative emotions, clenching your teeth, breathing shallowly, sitting all day (not moving) and pretending like ‘everything is fine’ would be the perfect recipe to put yourself in a sensitised state.

When you’re in this state, your body will feel like it’s on a knife edge.

Need help? leave us your details to receive a free call from one of our health professionals

How we can help…

1. Get to know you:
   Understand whether the problem is due to behaviour or trauma and relate the problem to a particular pattern in movement or in life.
   

2. Find the cause:
   Is the problem due to an injury that needs a diagnosis or is it something movement related that needs to be assessed and identified?
   

3. Make a plan:
   Agree on what the problem is, what the goals are, the way we’re going to achieve the goals and over an agreed timeframe.
   

4. Follow up:
   Check in with you along the way and have an open line of communication to ensure you’re on te right track.