Physical therapists have years of training and advanced degrees, but they’re not superhuman — like most people, even they deal with morning back pain from time to time. 

By some estimates, around 80% of adults will experience back pain in their lives, so there’s a whole lot of ouch out there. Curious how Hinge Health PTs cope with their own aches and stiffness — and what they do to prevent pain from setting in during the night? 

Read on to learn about the causes of morning back pain, and get expert advice on the best ways to ease morning back pain so it doesn’t derail the rest of your day. 

Why Back Pain Can Be Worse in the Morning

There are a couple of reasons you might feel achy when you wake up. “One issue is that when you sleep, you're less likely to move — and our bodies don’t like being in one position for too long. When you wake up you may have discomfort,” says Hinge Health physical therapist Samantha Stewart, PT, DPT. “It’s your body’s way of greeting you in the morning and saying, ‘Alright, let’s move!’”

It’s the same thing when you sit for a long time and feel like you need to shift to a more comfortable position because you’re getting tight and sore, says Dr. Stewart, who tends to get bouts of back pain that can come and go. “Except that when you’re asleep you obviously can’t check in with your body and make adjustments.” 

Plus, during the night as you sleep, you could wind up in positions that your body’s not used to — twisting or curling your back, for example. And that can annoy your muscles, leading to some temporary stiffness and spasms after the alarm clock goes off. 

What PTs Want You to Know About Back Pain

Waking up with occasional back pain is normal — and usually not something to worry about. “I can have back pain in the morning because I've gotten stiff throughout the night, and it's often a sign that I need to stretch to be more comfortable,” says Dr. Stewart. “Pain is your body’s way of communicating with you.” One thing Hinge Health physical therapists try not to do when they wake up with back pain: worry too much about it. 

"It's not pleasant to wake up in pain, and it's totally understandable to be upset about how it may limit what you need to do, or feel anxious about how long the discomfort will last," says Dr. Stewart. “But we physical therapists know that it's important to feel like you have tools to cope with pain flares. These tools usually include movement and exercises, other coping strategies like heating pads or over-the-counter-medication, and mindset adjustments, like feeling hopeful and confident that the pain will pass with treatment." 

For many people, doing some morning stretches (see PTs’ favorites below) can help them get moving to start their day despite having some pain. Continuing to move — with some activity modifications as needed — should help you start feeling better over the next few days. If the pain doesn’t start to improve or starts getting worse, it’s a good idea to talk to your healthcare provider or physical therapist to see what might be contributing.

Here are the strategies Hinge Health physical therapists rely on when they have a case of morning back kinks. Please, by all means, steal them for yourself. 

PT-Approved Ways to Ease Morning Back Pain

Stretch in Bed

“Before getting out of bed, I like doing knee rocks — where you lie on your back with your knees bent and feet on the bed, then gently rock your knees from side to side. Another good movement is the single knee-to-chest exercise — pulling one knee at a time in toward the chest and holding it for a good stretch. It loosens up your glutes and lower back. They help prime your body for movement, and ease the stiffness that can occur overnight. ” — Samantha Stewart, PT, DPT

Get Blood Flowing to Your Back Muscles

“One move I recommend — and perform myself — is a standing backbend. Do several of them when you first stand up in the morning to increase blood flow to the spine and get things moving.” — Nicole Stavale, PT, DPT, OCS

Bring the Heat

“I prefer heat therapy over cold for morning stiffness because the warmth tends to loosen you up. I recommend applying a heat pack in the morning. You can make your own by sewing dried rice or dried beans into an old sock and microwaving it. It can help to take a warm shower or bath in the morning. Even better if you can do a little gentle stretching while you’re in there.” — Mary Kimbrough, PT, DPT

Try a Hip-Opening Yoga Move

“I like a good Malasana squat, also called Garland Pose. It’s a yoga exercise where you stand with your feet more than shoulder width apart and turned out slightly. You bend your knees and squat down, chest lifted and spine straight, then press your upper arms against the inside of your knees as you bring your hands together in a prayer position. Hold the stretch. It opens up your hips and stretches your back, particularly the muscles in your lumbar spine”  — Scott Loving, PT, DPT

Visualize Less Pain

“Research shows that mental practices can produce physical results — meaning that if your brain believes you’re okay to move, it can translate to less pain and discomfort in your body, even if your actual back pain hasn’t gotten a lot better. So imagine starting your day with ease and try to move through your planned activities. Use your ‘movement sweet spot’ to gauge how much activity your body can handle.” — Hannah Hargis, PT, DPT

How to Prevent Morning Back Pain

Adjust Your Sleep 

“Lying on your back can be one of the best positions for relieving pain because it more evenly distributes your weight compared to stomach or side sleeping. You can reduce the pressure on your low-back even more by placing a pillow under your knees. Can’t sleep on your back? Another good option is to lie on your side holding a body pillow for support.” — Jillian Aeder, PT, DPT, ATC

Breathe Before You Turn In

“I really like adding some breathing exercises to settle things down before bedtime. [See the how-to below.] They can reduce sensitivity in the nervous system so you sleep with less pain and feel better in the morning.” — Julianne Payton, PT, DPT

Limber Up before Bed

“Prep your body for sleep with some gentle nighttime back exercises, such as cat cow, pigeon pose, and the figure four stretch. They’re calming, and they ease muscle tension in your hips and back so you can sleep more comfortably and wake up with less stiffness and soreness.” — Carissa Lane, PT, DPT

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Casiano, V. & Nikhilesh D. (2020). Back Pain. PubMed, StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538173/

2. Louw, A., et al. (2017). A Clinical Perspective on a Pain Neuroscience Education Approach to Manual Therapy. Journal of Manual & Manipulative Therapy, vol. 25, no. 3, pp. 160–168. doi:10.1080/10669817.2017.1323699

3. Low Back Pain – Causes, Diagnosis and Treatment.  (n.d.). American Academy of Neurological Surgeons. Retrieved from https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain