Waking up occasionally with a stiff neck or some minor back pain may not be a pleasant way to start your day. However, it’s usually nothing serious to worry about. If you’ve reached a point where waking up with spine-related aches and pains is your new normal, it’s time to find out what’s going on with your backbone and the various parts that support it. To give you a better idea of what you may be facing, here are four possible causes of morning back pain.
1. Spondyloarthritis
Also referred to as inflammatory back pain (IBP), spondyloarthritis is a general term for inflammation-based diseases often associated with arthritis. It’s not known why IBP sometimes results in morning back pain, other than the fact that it’s just the way the inflammation process sometimes works in the human body. In one study, 82 percent of people with chronic back pain reported experiencing morning stiffness or pain. However, only 11 percent had IBP, so not all instances of morning back pain can be attributed to IBP. Signs, symptoms, and risk factors specifically associated with IBP include:
• Inflammation in areas other than the spine (e.g. supporting tendons in the arms, legs, toes, or fingers)
• A family history of autoimmune diseases
• Having an infection prior to experiencing recurring morning back pain
• Being older or being male*
*Spondyloarthritis occurs more in males and tends to become more severe with age.
2. Chronic, Low-Grade Inflammation
Normally, inflammation is something the body temporarily produces in response to tissue or nerve irritation, but some people develop chronic, low-grade inflammation that’s always present (inflammaging). Chronic inflammation can be related to poor lifestyle habits (e.g. diet, exercise, excess weight, stress). Inflammaging, on the other hand, can affect adults 40 and over regardless of their physical health or lifestyle. One theory as to why it sometimes causes morning pain is because the brain produces a special protein (cryptochrome) while sleeping that naturally suppresses inflammation. However, the effects of cryptochrome wear off when you start to wake. Therefore, you experience morning back pain. Inflammaging isn’t entirely preventable, but you may be able to ease inflammation-related back pain by:
• Staying active – Getting some form of regular exercise stimulates the production of chemicals in the body with natural pain-relief properties and strengthens the muscles that support the spine in some way.
• Eating healthy foods – Green, leafy veggies, oily fish, berries, and whole grains are among the foods that can help the body fight inflammation. Sugary snacks and processed foods, on the other hand, can contribute to it.
• Getting plenty of sleep and easing stress – Regular sleep is needed to give the tissues in and around the spine time to naturally heal.
• Easing stress – Being overly anxious or stressed can make spine-supporting muscles tense.
3. Myofascial Pain Syndrome/Fibromyalgia
With myofascial pain syndrome (MPS), sensitive points in muscles are stimulated enough to cause discomfort in various parts of the body, including the back. Only affecting 1-2 percent of the population, fibromyalgia is a chronic condition characterized by widespread muscle pain. It can also affect sleep and contribute to general fatigue. While these conditions are unrelated, both fibromyalgia and MPS may contribute to morning back pain.
Multiple studies show that nearly half of all people with fibromyalgia have back pain, likely because muscles that support the spine can be affected. During the day, staying active with things like walking, cooking, or work-related duties may ease discomfort or distract you from your pain. When you first wake, you get the full brunt of your discomfort until you get active again, which is a possible explanation for the link to morning back pain.
Myofascial pain syndrome affects muscles in a way that knots develop and form various trigger points. While these knotted trigger points commonly present in people with MPS can cause pain at any time, back pain is more common in the morning for people with this condition. One possible reason is because muscles are less active at night, which leads to reduced circulation. It’s also possible that tossing and turning during the night can place added stress on trigger points. Morning back pain associated with fibromyalgia and MPS may be minimized with:
• Therapeutic massages
• Heat therapy
• Regular exercise targeting core muscle groups
• Better sleep habits
4. Improper/Poor Sleeping Posture
It’s good to get plenty of sleep. However, it’s just as important to make an effort to be as mindful of your sleep posture as possible. Poor sleep posture is one of the most common causes of morning back pain, especially the kind that’s only experienced now and then. Normally, the body naturally shifts positions while sleeping to maintain healthy circulation. However, there are times when the body works itself into awkward positions that place too much pressure on certain parts of the spine or throw off alignment.
You don’t necessarily have to end up twisted like a pretzel as you sleep to wake up with back pain. Even a slight misalignment or awkward position could affect your spine or its supporting muscles if you stay in the same position long enough. With sleep positions, side and back sleeping tend to be better for the spine. However, if you’re a diehard stomach sleeper, attempting to a switch to a more neutral sleep position may help. Sleep posture may also be improved by:
• Placing a pillow between your knees to minimize excessive rolling
• Using a lower pillow under your head to avoid throwing off your head-neck alignment
• Switching to a mattress that provides better support and weight distribution
One trick that might help you reduce instances of morning back pain is to purposely wake yourself a few times during the night to get up and move around or apply some heat or ice to the sore part of your spine. If this doesn’t help, see your doctor or a Beverly Hills spine surgeon to determine if there’s a reason for your recurring morning discomfort that may be correctable with physical therapy, medication, or a minimally invasive spine procedure.
For those who are experiencing recurring back pain and want to know about minimally invasive back surgery and spinal fusion alternatives, Beverly Hills residents can get in touch with Dr. Hyun Bae at The Spine Institute. Dr. Bae can determine the best course of action to help you find relief for your pain. Call 310-828-7757 today to schedule an appointment.