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.
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The Scariest Type Of Morning Back Pain: Inflammatory Back Pain
The closest thing to back pain that is truly prominent in the morning is inflammatory back pain , or spondyloarthritis.3 Although IBP is well known to medical science, it often eludes diagnosis, its biology is mysterious, and morning symptoms specifically are a stumper, as unexplained as joints that ache before a storm. Its just something IBP does.
But dont panic! Although studies have confirmed that morning is a common time for inflammatory back pain to flare up, they have also shown that the connection is not strong or exclusive.4 In fact, most morning stiffness and pain is not pathologically inflammatory. Its just that IBP is the only official morning back pain culprit.
The pain of IBP tends to be quite severe. If its not actually waking you up, its probably not IBP, or its a minor case.
When should you consider the possibility of IBP? Basically if your morning back is particularly bad: nasty and very consistent morning symptoms. The diagnosis is also more likely if you have other signs of this kind of back pain. Heres a good inflammatory back pain quiz, and heres my own quick checklist of reasons to ask your doctor about spondyloarthritis:5
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Preventing Back Pain In Children
Back pain in secondary-school-age children has been linked to heavy schoolbags and ill-fitting classroom seating. Nearly half of all teenagers in the UK have experienced occasional backache from poor posture, carrying overloaded bags, and an unhealthy lifestyle.
The best schoolbag for your child is a well designed backpack. This should be worn over both shoulders to balance out the weight. A heavy satchel or shoulder bag can put stress on your childs spine.
Encourage your child to exercise regularly, or plan joint activities, such as a walk in the countryside or a trip to a swimming pool.
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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The Solution Is In Correcting The Muscle Imbalances
Many people immediately react in disbelief because they believe that they have tried this method without success. However, due to the complexity and layers of imbalances, it is not possible to correct them as easily as one would want. Quick fixes do not work. You cannot fix this problem with a few quick stretches or movements and break the cycle. This approach has failed too many people.
It is very hard to accept, but many specific movements and stretches are needed to return this balance. They must be performed in a specific order, number of repetitions and length of time in order to be successful. This is about reconditioning the muscle and joint to it proper state and alignment.
Specific known culprits include the iliopsoas, iliacus, abdominals, rectus femoris, quadriceps, hamstrings, deep intrinsic muscles supporting the spine and more. They all must operate in a specific fashion and sequence to protect the spine and themselves from injury and harm. It is from the lack of adequate conditioning and use of these muscles. Any imbalances from these muscles lead to disc bulge, nerve impingement, back spasms, guarding, muscle strain, muscle fatigue, excessive pelvic tilt, hip & knee pain and more.
Is Your Back Pain Getting Worse At Night
Have you noticed that your back pain usually gets worse at night when youre trying to sleep? Or maybe you wake up the next morning all achy and stiff? Well it turns out there are a number of factors that can worsen your back pain at night but dont worry, as I explain, theres plenty you can do to ensure that you get a good nights rest!
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I Didnt Need Exercise Before And I Dont Now
The problems with your symptoms are not obvious until long after some injury has occurred to you. There is a good chance that earlier warning signs such as sudden spasm, stiffness, soreness, tightness and aches are sometimes seen as unrelated or to be treated simply with rest or medication.
But when you are not able to care for yourself because of these warning signs, they may progress into the morning. Sudden and gradual changes to your level of activity or lifestyle do have an impact on any changes to the overall health of your back.
Dont regard exercise as something new to add to your recovery. Rather, it should be seen as what your body naturally requires to maintain optimal health and protection of your spine. The type of exercises for your relief that are beneficial are actually composed of movements and stretches to improve your mobility and eliminate weaknesses.
Is Lower Right Or Left Back Pain Worrisome
Pain on one side of the back is not particularly more worrisome than central pain. There are three main kinds of one-sided back pain:
Most of the anatomy of the low back and abdomen is symmetrical. Some of the guts are not symmetrical, and only some of those is a plausible cause of back pain on one side. Heres some of the key anatomy to consider:
The side of the pain on its own doesnt tell us much, and most of the one-sided sources of pain are viscera that usually cause abdominal pain instead of back pain, or in addition to it. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other red flags or significant non-back symptoms.
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Myofascial Pain Syndrome And/or Fibromyalgia
There are two common causes for widespread moderate body pain, both somewhat mysterious and controversial, both known for affecting the back more than other areas, and both known for their morning hijinks:
Theres likely lots of overlap between these conditions. Fibromyalgia isnt really an explanatory diagnosis it just labels a common pattern of symptoms that could have several different causes. MPS is a hypothetical problem with muscle tissue that is a possile explanation for some body pain, and that type of pain is extremely common in fibromyalgia patients.
Fibromyalgia is associated with morning back pain because:
Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
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When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
It Could Be Your Sorry Old Pillows Fault
If your pillow is too thin or soft, your back will bend downward at an awkward angle. Conversely, if its too thick, your spine might bend unnaturally upward. Both situations can cause pain.
If your head is supported at the correct level, the muscles in your neck and back will be able to to completely relax. Pressure on your discs and muscles will be diminished and, as a result, your back pain reduced.
Most of us westerners are acclimated to traditional soft pillows containing down or polyester fibers. Traditional soft pillows will collapse under pressure and can not support your head consistently throughout the night. In fact, many find themselves using two pillows or folding their pillow in half in an attempt to support their head at the proper level. Fiddling with pillows in the middle of the night is not conducive to good sleep!
We are huge fans of buckwheat pillows due to their adjustable and malleable nature. The buckwheat hull fill is really uniqueit will perfectly conform to the space between your head and the mattress eliminating potentially pain-causing pressure points in your neck and back. Most buckwheat pillows are adjustable you can add or remove fill to dial in the loft so that your spine is straight rather than bent upwards or downwards.
Your old pillow is probably pretty gross anyway! Toss it out and treat yourself to a new one.
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Can Sleeping On My Stomach Cause Back Pain
The simple answer is yes. Stomach sleeping is infamous for causing back pain problems, which makes sense when you think about it.
Most of your body weight will be dispersed around your middle so the natural curve of your spine will be flattened and placed under unnecessary strain in an awkward position. Since the spine is a hub for your nerves this pain can spread throughout your entire body, not just your lower back!
Then theres your neck to consider. Unless youve miraculously developed the ability to breath with a pillow stuffed in your face, the chances are that you have to turn your neck to the side in order to breathe peacefully through the night.
This can cause problems because its not a natural angle for your neck to be twisted at imagine sitting all day with your head turned to the side! It puts your head out of alignment with your spine which eventually will cause you some discomfort and in a worst case scenario it can cause some real health problems such as a herniated disk!
Mattress And Pillow Changes And Upgrades
Mattresses are touted as both cause and cure of morning back pain. As a cause, they allegedly constitute a significant source of postural stress basically, the idea is that you have poor sleeping posture because of a mattress. This is all a more specific version of the topic of posture, but it is the most significant and popular version.
I have no doubt that there are mattress that are bad enough to cause trouble. What I doubt is that there are mattresses that basically seem fine, and yet still cause this serious chronic symptom. In other words, if the problem is the mattress, its probably obvious that the mattress is uncomfortable and if the mattress isnt obviously uncomfortable, its probably not causing significant morning back pain. I doubt theres a large ambiguous sweet spot between those, where large numbers of people are being plagued enough for it to be a problem, but not enough that its obvious why.
The world is stuffed with claims about better mattresses and pillows, and you can even find the extreme opinion that we should get rid of them entirely and sleep on the ground, naturally paleo sleeping!25 But even the tamest of these claims are wishful thinking.
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Whats New In This Article
Fourteen updates have been logged for this article since publication . All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreWhens the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are fine print, but more meaningful than most of the comments that most Internet pages waste pixels on. I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.See the Whats New? page for updates to all recent site updates.
2020 Minor science update, added a citation to a cancer case study.
2020 Added information about back pain as a symptom of COVID-19.
2018 Cited Premkumar et al on red flag reliability .
Why Does My Lower Back And Hip Hurt
Your lower back and hip are codependent structures. A problem in one of these structures can cause dysfunction and pain in the other. 1
- If you have chronic lower back pain, the movements in your hip may be reduced and the muscles surrounding your hip joint can become tense and painful.2,3
- If theres an abnormality in your hip function, the mechanics of your lower back may be altered, causing pain in both regions.4
The lower back and hip share many groups of muscles. When a specific muscle is affected, it may lead to compensatory movements, fatigue, and pain in the other surrounding muscles.1
Read on to learn how lower back and hip pain can occur together. While some conditions may affect one side of your lower back and hip, others can cause pain on both sides at the same time.
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