Back Pain At Night And Ankylosing Spondylitis
There are two main categories of back pain: mechanical and inflammatory. Mechanical back pain results from problems with the way the different components of your spine work together. Mechanical back pain, such as from overuse injuries, poor posture, or a herniated disc, is the reason for the vast, vast majority of back pain cases.
On the other hand, inflammatory back pain occurs because theres a problem with your immune system attacking the joints in your spine, sacroiliac joints , and the entheses .
Back pain that wakes you up in the second half of the night is one of a few key signs that your back pain could be inflammatory and due to a disease like ankylosing spondylitis.
Patients often experience stiffness and pain that awakens them in the early morning, a distinctive symptom not generally found in patients with mechanical back pain, reports Medscape.
Its not common to have back pain so bad in the middle of the night that you cant go back to sleep, says Fardina Malik, MD, a rheumatologist at NYU Langone in New York City who frequently treats patients with ankylosing spondylitis.
Mechanical back pain generally feels better when you rest or sleep. You might have discomfort, but you should be able to sleep through the night.
Stop Your Activity And Find Immediate Rest
This may already make sense, but many of us prefer to keep moving. Some professionals actually recommend that you stay in motion, but if you are the unfortunate one to have a disc or nerve problem, then that is poor advice. You may end up visiting them for that instead.
Dont try to actively work or move until you know the source of the injury.
A very common reaction is to keep moving but MAY be dangerous. Although this might feel helpful, it is important to determine whether your pain is more than just muscular in nature.
Why you should NOT move:
Moving when you have any of these injuries can cause further injury, intensifying the pain.
If you have a history of ANY of these injuries or suspect that your lifestyle may contribute to it , then rest is a better than simply muscling through it with medication.
Lastly with this first tip, you should know that you should also apply this caution to not just your back but also to your hips, knees and neck.
Forcing yourself to move when these areas are injured can be very risky. Make sure that you arent adding to the pain. The wrong movement can set you behind.
The Role Of Your Mattress
We spend one-third of each day in bed, meaning your mattress and how you sleep is just as important as focusing on posture in the daytime hours. Since sleep is a time for healing and renewal, it may arguably be even more important.
Its an important, often-asked question. But, there is no single right answer. When it comes to picking a bed, there are no hard and fast rules that will apply for every person, every time. Essentially, the best mattress is the one that you feel gives you good, refreshing sleep with minimal pain and stiffness.
While we all have different preferences and needs that are important to consider, research and studies can shed some insight on different mattress traits and how they may interact with back pain.
The Two Basics of Beds
At their most basic, beds do two things: provide support and comfort.
Support comes from the core of the mattress, typically a sturdy foam layer or innersprings depending on the type of bed. A supportive mattress will have enough firmness to keep your spine aligned, meaning your heavier areas like hips and shoulders wont sink too far into the bed. On the other hand, it shouldnt be so firm that it forces hips and shoulders up at an awkward angle either.
Now, comfort is pretty easy to identify, but how do you know if a mattress is providing adequate support? Essentially, your spine should maintain an even, natural posture , with whichever sleep position you prefer.
Nocturnal Leg Cramps Vs Restless Legs Syndrome
Nocturnal leg cramps are a distinct condition, but they are often misdiagnosed as restless legs syndrome because both disorders involve uncomfortable sensations in the legs. Although symptoms are similar, there are some key differences between these disorders.
- Calf or foot cramps during the night
- Cramping that causes intense pain
- Sharp pain lasting less than 10 minutes
- Soreness lingering for hours or days
- Sleep disruption as a result of cramping
- Feeling distress around falling asleep
Even though restless legs syndrome also involves leg discomfort at night, its symptoms vary from those found in nocturnal leg cramps. RLS is characterized by the desire or urge to move your legs in the evening. Other symptoms can include:
- Unpleasant or painful sensations in the legs
- Discomfort that worsens in the evening or night
- Relief found by walking or stretching
- Sensations that worsen with lack of exercise or rest
Symptoms of nocturnal leg cramps and RLS often present in similar ways. Therefore, nocturnal leg cramps might be difficult for your doctor to diagnose. To help your doctor figure out what issue is causing your leg discomfort, track your symptoms and bring detailed notes with you to your appointment.
Lack Of Sleep Makes Pain Worse
It can be easy to get stuck in a cycle where you cant sleep because of knee pain. That lack of sleep can actually make your pain worse. Sleep is vital for healing and rejuvenation. Without sleep, you have less energy to expend on healing as you need to focus your bodily processes on staying alert and awake.If nighttime knee pain causes you to toss and turn, you may end up accidentally further straining your knee by sleeping in an uncomfortable position.
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How To Reduce Leg Cramps At Night
Although the exact cause of nocturnal leg cramps is unknown, there are ways to reduce the likelihood that you will experience them. Typically, leg cramps do not indicate a serious health problem. However, if you are experiencing frequent leg cramping, you should reach out to your doctor. You may be able to reduce the likelihood of experiencing leg cramps through:
Hydration: Staying consistently hydrated throughout the day may help reduce the frequency of muscle cramps, since dehydration can cause cramps. Though some research suggests that nocturnal leg cramps are not caused by dehydration, it may help to drink water during long periods of outdoor activity or strenuous activity. There is also research to suggest that drinking pickle juice during a cramping episode helps inhibit the cramp quickly.
Stretching: Doing some stretching or yoga before bed may help you reduce both the frequency and intensity of nocturnal leg cramps. Research suggests that engaging in a stretching routine before bed helps reduce cramps and leg pain after about six weeks.
Baths: Some people claim that taking a bath helps relieve their nighttime cramps, though further research is needed. An epsom salt bath in particular could help reduce muscle pain. Epsom salt contains magnesium sulfate. An epsom salt bath could increase your magnesium levels, which may help relieve leg cramping.
Could Upper Back Pain Mean Something More Serious
There is always a chance that your upper back pain could be caused by a much bigger problem. Degenerative Disc Disease , a herniated disc, and osteoarthritis are possible underlying problems causing your upper back pain. Shapiro cautions that while pain should never be ignored, normal muscle soreness from exercising is nothing to be concerned about. He warns, however, that you should question intense pain that doesnt go away over time. If you notice symptoms like fever, chills, tingling in your chest or stomach along with your upper back pain you should see your doctor.
Sharp, shooting, radiating, severe, unexplained acute pain or chronic pain lasting more than a few days could be your body’s way of telling you that something more serious is going on, Shapiro says.
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When You Should See A Doctor About Back Pain At Night
While its common to experience back pain every now and again, it should not affect your daily life and interfere with your everyday routine.
If you’re finding that you can’t sit at work, arent able to ride a bike as you normally would, or the pain is changing the way you live your life, I would say that’s a good point to go see a medical professional for further advice, says Marcus.
Listening to your body is the best tell-tale sign of when to see a doctor. If you feel abnormally high pain and dont know whats causing ityour body is sending you a signal to seek further advice.
w& h thanks Hollie Maskell, physiotherapist and fitness expert for Meglio, , consultant physiotherapist and clinical Pilates instructor specializing in injury rehabilitation and prevention, and Jasmine Marcus, a physical therapist and certified strength and conditioning specialist.
Here Are A Few Other Tips That Might Make It Easier For You To Get Through The Day:
- Morning Stretching: Wake up your muscles and joints by gently stretching before you get out of bed. Bring your knees to your chest to get a lower-back stretch. Also, stretch your arms above your head and reach your feet in the opposite direction. Pay attention to the tight areas of your body, then talk to a physical therapist or doctor about the stretches that could help your situation.
- Core Strength: Building the muscles in your core can improve your overall body structure, helping to reduce the back pain you are experiencing. No, were not talking about hundreds of crunches each day because certain ab exercises can exacerbate the problem. A physical therapist can provide personalized recommendations, which might include planks, stretching, gentle cardio, and other tips to support the overall structure of your body.
- Medications: When the pain is intense, then medication can provide immediate relief to dull the discomfort. Talk to your doctor about over-the-counter medications such as NSAIDs or acetaminophen. For severe back pain, prescription medications can sometimes be used. But you need to be careful to avoid dependence on these pain relievers. Medication should be used as a short-term strategy until you can address the root problem.
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Poor Posture While Sleeping
If you find theres nothing wrong with the mattress, scrutinize your sleeping posture. These are the ideal positions for sleeping. Are you adopting these when you sleep?
- Sleeping on your back: Tuck a firm pillow under your knees to maintain the natural curve of your lower back and to support the spine. The natural curve of your neck and the alignment of your shoulders, neck, and head should be supported by the pillow under your head.
- Sleeping on your stomach: Keep the spine better aligned by placing a flat pillow under the stomach and the pelvic area. Use a flat pillow to support your head or do not use one at all.
- Sleep on your sides: Tuck a firm pillow between the knees so that your upper leg doesnt move your spine out of alignment. This way, the stress on the spine is reduced, too. Also, pull your bent knees slightly toward the chest.
If you are already suffering from back pain, fill the gaps between your body and the bed while lying down by inserting small pillows in the gaps. When you turn to a different position in bed, move the entire body as one unit and do not turn or twist from the hips.2
How To Relieve Nighttime Back Pain
Does your aching back keep you tossing and turning all night? Try these simple tips to help ease your back and get better sleep.
Getting through the day with back pain can be tough enough, but when the pain revs up at night as youre trying to sleep, that might be the last straw. It’s no surprise that the National Sleep Foundation reports that the majority of people who have chronic pain dont sleep well and neither do those with acute back pain.
So how can you get a good nights sleep if back pain is keeping you awake? Discovering back pain relief thats effective for you may take some trial and error. In some cases, it might be as simple as getting a new mattress, or adding or changing pillows so that youre sleeping in a more comfortable position.
Find the Right Formula for Relief
Here are some ideas for getting better sleep with back pain:
1. Try a body pillow. Malton A. Schexneider, PT, MMSc, a clinical specialist in orthopaedic physical therapy in Lafayette, Louisiana, says that many people with back pain do well with a body pillow for support. Use a body pillow, about 5 to 6 feet in length, but use it effectively,” he says. “Place it between your knees, allowing it to rest along your trunk so youre in a semi-sidelined position. This will take some pressure off your back.
Discover What Works for You
Practice Good “Sleep Hygiene”
If sleep is still elusive, you should talk with your primary care doctor about other approaches to back pain relief.
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Consciously Try To Relax Your Muscles With Slow Deep Breaths
Seriously, I know this much easier said than done, but you NEED to do it.
If you learn to breathe the right way, it wont hurt so easily. Breathing poorly will move your rib cage too erratically and might trigger your back muscles again.
Try to relax your muscles when they are in spasm with slow, deep and controlled breaths. Its pretty painful to breathe deeply when you have a full attack, but it will get you to focus more.
We tend to breathe very quickly and shallow when we are in pain. Shallow breaths or even holding your breath is a natural reaction, but will only add to the discomfort.
Dont Skimp On Your Mattress
If you scour the internet, you will discover all sorts of suggestions to extend the life of a sagging mattress. These include methods like sliding plywood under your mattress and ditching your box spring. While these tricks may work for some, the best approach is usually to replace a worn-out mattress.
It is important not to neglect your mattress because, for some people, a sagging mattress can exacerbate lower back pain by placing additional stress and strain on your spinal structures. In turn, this can make it harder to fall asleep at night.
When it comes to sleeping with lower back pain, the most expensive mattress is not always best. Instead, the best mattress for you is ultimately the one that provides the best nights sleep. With this in mind, here are a few mattress guidelines to help get you started in your search:
- Your mattress needs to support the natural curvature of your spine. This means your spine should look similar when you are lying on your back or side as when youre standing with good posture.
- Visit your local mattress store and try out various types of mattresses. After 15 minutes on a mattress, you will have a general idea if it is a good fit for you. Dont be afraid to take your time.
- If you sleep with a partner, consider a larger-sized mattress. This will allow you both room to sleep without startling one another awake at night.
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How Are Sleep And Lower Back Pain Related
Researchers have long seen an association between lower back pain and sleeping problems, and growing evidence points a two-way relationship in which they can be mutually reinforcing.
Discomfort from pain can be a major barrier to sleep. Lower back pain makes it hard to get comfortable enough to fall asleep or may provoke nighttime awakenings when pain surges.
At the same time, people with sleep problems are more likely to start having pain or to have pain get worse. Experts arent certain why this happens, but there are several potential explanations. Sleep deprivation may impair healing, affect mood in a way that heightens pain sensitivity, or disrupt chemicals in the brain that are involved in how we experience pain.
How To Exercise To Relieve Back Pain
In the morning and evening, it is beneficial to warm up and warm down. To achieve this:
- Some gentle stretching will help in general, but particularly for pain in the lower back.
- For the neck and lower back, gentle stretching in all vectors of movement will help, ensuring you engage the core muscles at all times to strengthen them and stretch the other muscles.
- Tight hamstrings can place stress on your lower back. To stretch your hamstrings, place one leg up on the bed and gently stretch forward until you feel the tension down the back of the leg. This will help, particularly if you have been sat down all day as the hamstrings will have been contracted and shortened for that whole period, they deserve a stretch!
Any exercise that strengthens your core will help prevent back pain in the future, so consider hitting the gym or park more often, or taking up a yoga class or similar.
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Secure Your Back While Lifting
Lifting is an usual reason for reduced pain in the back. Typical day-to-day tasks, such as dumping grocery bags from the cars and truck or raising your kid, can bring about decrease back troubles.
Raising with your back bent, or raising while twisting, might cause an abrupt injury to your lower back or repeated injury over an amount of time, bring about chronic cells damages.
Bend at your knees, not at your reduced back a totally bent back can be very at risk to a ligament or disc injury.
Pivot your feet and also hips, as opposed to twisting your lower back.
Hold the things close to your upper body while aligning your spinal column.
While lifting is a part of everyday tasks, having a job that consists of heavy training might increase your risk of developing reduced back troubles.