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The Mystery of Morning Back Pain

July 19, 2019

No one wants to start the day with low back pain, but sadly, many of us do. One 1990 study ranked low back pain as the sixth most problematic health condition, and by 2010, back pain had moved up to third, just behind heart disease and chronic obstructive pulmonary disease (COPD). When we wake up with low back pain that doesn’t subside after we’re up and moving around, we can think about how we are sleeping as well as the type and condition of our mattress when we’re trying to solve the mystery of that morning back pain.

Impacts On Life

Impacts On Life

Sleeping Position


While experts like physical therapist Marleen Caldwell at the Cleveland Clinic recommend sleeping on your back, preferably with a pillow or bolster under the knees, we recognize that this isn’t going to happen for most of us. Thankfully, there are ways to help spinal alignment if you are a side sleeper or a stomach sleeper.


  • Side Sleeping: Make sure you are switching sides rather than sticking with just one side, and place a pillow or a rolled towel or blanket between your knees so that your hips don’t sink forward, and instead, your spine stays in alignment.


  • Stomach Sleeping: This sleep position puts the most strain on your spine, but putting a pillow under your pelvis can help. You also might think about sleeping without a pillow under your head or maybe switching to a very thin pillow.

Mattress Type & Condition


Men and women may differ in the firmness of the mattress needed to properly align the spine. For women (whose hips are typically wider than their waist), having a softer mattress allows the hips to sink in and keeps the spine straight, but for men whose hips and waist tend to be somewhat straight, having a firmer mattress might be a better option. Some researchers suggest that the degree of firmness of the mattress might depend more on body weight, but most recent research concurs that an overly firm mattress is not the best choice, despite the fact that many orthopedic surgeons routinely recommend hard mattresses to relieve back pain.


One study shows that medium-firm mattresses might be a better alternative. Researchers studied the sleep quality of 59 men and women who had reported back pain upon waking in their own beds for almost a month, and then researchers replaced the participants’ beds with new, medium-firm, innerspring mattresses and had them report their experience with back pain for the next 28 days. Most of the participants’ original mattresses were average in pricing and were over nine years old. The study results showed that back pain was reduced in participants by almost 50 percent. Some researchers suggest that this reduction in back pain might be the result of a placebo effect from having new bedding; however, any placebo effect would have waned after a week or two. In this study, the participants’ back pain continued to improve over the 28-day study period.


The mystery of morning back pain might be solved by something simple. If you wake up with low back pain, consider your sleep position and your mattress. If your low back pain continues or grows in intensity, Doctorpedia recommends checking with your physician to help put you on the road to being pain-free!

Doctor Profile

Nan Kuhlman


Nan Kuhlman is an author, freelance writer, and part-time university professor based in Los Angeles, CA. She currently works full-time as a technical writer in Los Angeles and part-time as an online adjunct writing instructor. She has written for scholarly publications like the University of California, Davis Writing on the Edge and Chapman University’s Anastamos Interdisciplinary Journal, among others.

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