Back pain upon waking up: advice from a physiotherapist

The back pain   is an inconvenience for many people.  Indeed, according to to   Statistics Canada  between 70% and 85% of people suffer from it to varying degrees, during their lifetime.  About 40% of these people see their daily activities disrupted, and about 10% have to stop their activities completely.

Back pain symptoms often appear when you wake up.  The first instinct is to blame your mattress.  However, usually the mattress or the sleeping posture, are only aggravating or triggering elements.  Physiotherapist Elaine Maher explains the possible causes of back pain upon waking up and offers some prevention tips.

People at risk

In general, people over 40 are more likely to experience back pain when they wake up.  This correlation is explained by the inactivity of people in this age group, the increased risk of symptoms caused by loss of joint mobility, and the stiffening of tissues associated with osteoarthritis 

However, a 65-year-old in very good physical shape may be less at risk than a 35-year-old who is less fit, less flexible, and with poor muscle tone.  This makes the association between back pain and age difficult, so it is better to focus on lifestyle habits.  Consequently, an active person at a healthy weight decreases their risk of suffering from back pain.

Main causes of back pain upon waking up

Back pain can be associated with several factors.  If back pain is present at night or upon waking up, it may be caused by poor lying posture, firm mattress, or other things related to sleep.  However, in the majority of cases and excluding cases of accidents, it is bad lifestyle habits and bad ways of moving that are the main causes of back pain.

For example, the factors below can cause pain upon waking up:

sedentary habits (lack of physical exercise);

long-term maintenance of poor posture;

lack of flexibility;

lack of mobility;

loss of muscle tone.

While the following examples can be aggravating factors (or triggers):

use of an inadequate mattress;

use of an inadequate pillow;

adopting an inappropriate sleeping posture.

Regarding the aggravating factors, Elaine Maheu specifies that they vary from one person to another.  While it is generally recommended to buy a semi-firm mattress, some people will be more comfortable on a mattress that is slightly softer or firmer depending on their weight or condition.

It is, therefore, essential to try out the different types of mattresses when shopping to determine what is most comfortable according to our own sleeping habits.

Sleeping positions: good and bad

Humans spend almost a third of their life lying down.  For a person living over 80, this figure represents about 250,000 hours.  For those at risk, adopting good bedtime habits is essential in preventing back pain.

Here are some examples of bad and good sleeping postures.

For those who sleep on their backs, it is suggested to place a pillow or cushion under the knees to avoid deepening the lower back.  Only the head should be resting on the pillow.  The size of the pillow should be enough to support the head well and keep the neck in a neutral position.

To find out if your pillow is right for you, check if your forehead and chin are the same height when your head is lying on the pillow.

 Besides sleeping positions, equipment can have an impact. Here are some general tips:

choose the right mattress for you.  Do not hesitate to try them in-store to find the one that suits you (medium-firm mattresses are recommended in most cases);

renew your mattress every 10 years (maximum);

change your pillow every 5 years (maximum), for both hygiene and efficiency reasons.

In reality, the formula differs for each person as evidenced by this article:   What position for good sleep? 

A night lying on the stomach is enough to trigger an episode of low back pain in some, while others will sleep well all their life without a problem.  The same goes for mattresses and pillows.  Elaine Maheu, therefore, suggests listening to your body and not waiting before making the necessary adjustments.

Some habits to adopt on a daily basis

Many people spend almost two-thirds of their day in a sitting position, either at work, in the car, during meals, or watching TV.  Depending on the surface you are sitting on or the support of your backrest, the spine is not always kept in a neutral position and some tissues may experience constant tension.

To help you maintain a better sitting position, you can use a lumbar roller or a rolled towel on the back of your chair that you place in the small of your back, at the top of your buttocks.

It is also advisable to get up every 30 minutes to stretch your back backward, to walk, or to move (the back).  This routine can last less than a minute and allows you to change the strain on your back and sit back in a good posture regularly.

Use an ergonomic chair at work.

Adopt a seated position where your lower back is supported. 

Regularly vary the position of the spine.

Back pain upon waking up: what is the role of physiotherapy?

To prevent and treat back pain, physiotherapy is definitely a frontline science.  Elaine Maheu explains the process of a consultation.