Introduction
Have you ever found yourself wrestling with back pain – as you try to find the perfect sleeping position? The mysterious phenomenon of nighttime back pain is an all-too-familiar struggle for many. In this blog, we look at why your back aches when the lights go out, I share my clinical and personal experiences treating back pain. Can the way you sleep, or perhaps your daytime habits, be the culprit? Join me to decode the reasons and find solutions to your nighttime back pain.
What is causing your nighttime back pain?
Sleeping Positions
Your preferred sleep posture can significantly impact nighttime back pain. Rethinking your position could help reduce your pain.
Daytime Stressors
Activities like lifting heavy objects, an afternoon spent gardening or prolonged sitting may contribute to nightly back pain. Simple adjustments in your daily routine can make a significant difference.
Evening Stressors
What you do in the hours leading up to bed could positively and negatively impact your lower back pain at night.
Age-Related Factors
Ageing often brings changes in spinal structures, namely arthritis. However, this does not mean it is a foregone conclusion that you will always have pain or that there is nothing you can do to improve things. If you get your back moving well and build strength, then you can reduce, if not eliminate your pain even if you have also got age-related changes.
Poor Functioning Back
If your back is not functioning well during the day, it will often tell you about it at night. The key is to improve how your back, a strong dependable mobile back will rarely ache on a night.
Minimal distractions
During the day, plenty is going on to distract you from your painful back. However, when you go to bed it’s just you, your thoughts and your aching back.

If you need help with Back Pain I have a FREE video guide and PDF here.
How to treat nighttime back pain
Ultimately the key is to identify the problems and then take steps to change them.
Lifestyle Adjustments
Modifying daily activities
Think about what is aggravating your back and then try to reduce these aggravating activities. Certain activities and movements put more strain on your back, common triggers are sitting, lifting, leaning, pushing, and twisting. All backs are different not all of these will be a problem for you. If anything is aggravating your back, look at reducing these in the short term, once your back is happier, start to reintroduce these activities.
Evening routine
Do you like to spend a few hours before bed watching TV or reading a book? These can be classic triggers as they promote poor posture and long periods with no movement. If you think this could be an issue, get up regularly so you are moving more and take a look at your posture, are you slumped, or do you sit looking at the TV in a twisted position? Or is it worse in the evenings after you have been to that exercise class? Consider your activities tonight and keeping a note of your activities and pain can help you to spot triggers as well as activities that may ease pain.
Ergonomic Considerations
Invest in a supportive mattress or a mattress topper and pillows, to help you gain a nice position in bed. Before you buy, try the other beds in the house, you may find one your back likes.
Sleeping Positions
Changing your position could have a big impact on your pain.
Try these tried and tested positions and see if they help – good sleep positions.
Posture awareness
Maintain good posture during daily activities. Small adjustments can lead to significant improvements in back health. I have a FREE posture masterclass that would be a great place to start, click to learn more.

Physical Therapy and Exercise:
Engaging In Targeted Exercises & Physical Therapy
To strengthen the muscles around the back and improve movement, providing support and alleviating pain. Build exercise into your daily routine – your back will thank you.
My Pain Free Back Program has all the exercises you need to upgrade your back.
Or join me on my FREE Masterclass where I teach you how to manage your back pain like a professional.
Incorporate Daily Low To Moderate Exercise
Simple exercise, such as walking. Your back may not like this initially, but look at adding it to your day as and when pain allows. Take a look at your step counter – is your pain better on days when you are on your feet a lot or days when you are more sedentary? Use your findings to your advantage.
1 to 1 Support And Treatment
It may be helpful to find a Chartered Physiotherapist near you for 1 to 1 support and treatment. http://painfreestart.comFind out how I can support you here.
Join me in my FREE masterclass and learn exactly how to manage your back pain, together we formulate an action plan for your back.
Stretching
For some Simple Stretches check out this blog.
TOP TIP – Avoid holding stretches for too long as these can aggravate an irritable back.
Positions of ease in bed
- In my personal and professional experience, when your back is sore, it tends to be happier in certain positions.
- Take a look at this blog, Finding Comfort in the Night – where I look at these in greater detail and give you ideas to try. Or this blog Sleeping Well With Pain – Proven Strategies For a Restful Night
Ice or heat:
- The use of heat and ice can be very beneficial in easing pain and encouraging relaxation. Unless you have an acute injury, the heat is probably your best option.
- A warm bath or shower before bed, an electric blanket or a hot water bottle could help you sleep more comfortably.
Medication:
- Chat with your Dr or Pharmacist regarding this, It is common for people to take more pain relief at night than during the day.
Good Sleep Hygiene And Mental Health:
- There are lots of elements that affect our sleep, not just pain. If you are sleeping badly for other reasons, then you will wake up more and be aware of your pain. Poor sleep also makes it harder to cope with pain. It can become a vicious circle, one that needs breaking.
- Take steps to sleep better. Have a look at this NHS site for tips to help sleep better.
- Mental health can also impact the way that we experience pain. For ideas on where to start with this have a look at this NHS website for practical ideas to improve your mental health.
Consulting a Healthcare Professional:
- If you’re experiencing persistent back pain, it’s essential to consult a healthcare professional, especially if it is worse at night. They can conduct thorough assessments, ruling things out and hopefully pinpointing the root cause, allowing more effective treatment.
Conclusion
Together we have explored the mysteries of nighttime back pain and explored some practical solutions. By understanding the reasons behind our back’s nocturnal discomfort, we can take proactive steps to ensure restful nights and wake up feeling refreshed. What steps will you take to confront the nighttime struggle with back pain? Don’t just read this – I challenge you to try at least one of these tonight, maybe try a few stretches or have a hot bath. Don’t forget to join me in my FREE video lesson. You will be an expert in no time. Sleep well.
Take care, Helen
Helen Manders BSc (Hons) MCSP HCPC
Chartered Physiotherapist Since 2001
