Nighttime Back Pain

Medically Reviewed by Dany Paul Baby, MD on April 22, 2022
Written by Joseph Saling
3 min read

Nighttime back pain is a special type of lower back pain that could indicate a serious problem with your spine.

In the U.S., up to 80% of the population experiences some form of low back pain at some time in their lives. It's the second most common reason people see their doctor. But as debilitating as back pain can be, most instances of it are manageable, and people who get adequate rest and proper exercise often see improvement within a matter of weeks.

With nighttime back pain, however, people can't get the rest they need because they can't get relief from their pain.

The majority of people with back pain are able to adjust how they sleep to get relief from the pain they experience during the day. But with nighttime back pain -- also called nocturnal back pain -- the hurting doesn't stop when a person lies down, no matter what adjustments they make. For some, the pain actually gets worse. And for others, the pain doesn't even start until they lie down.

A person can actually go through a day virtually pain-free. But then at night, they might find it nearly impossible to get a full night's sleep.

Just as with normal back pain, the cause of nighttime back pain isn't always clear. Among other things, back pain can be caused by any of the following:

  • Problems with the way the spine moves or other mechanical problems, the most common of which is disc degeneration. Discs are tissue between the vertebrae that function as a type of shock absorber; the discs can break down with age.
  • Injuries such as sprains or fractures or more severe injuries such as a fall or an auto accident.
  • Diseases and conditions, such as scoliosis, a curvature of the spine, or spinal stenosis, a narrowing of the spinal column. Kidney stones, pregnancy, endometriosis, certain cancers, and various forms of arthritis can all lead to back pain.

A large number of the participants in the British study suffered disc degeneration.

Sometimes the cause of back pain might not be determined.

Guidelines for discovering serious spinal health problems list a number of "red flags," among them nocturnal back pain.

Nocturnal back pain can be a symptom of spinal tumors. It could be a primary tumor, one that originates in the spine, or it could be a metastatic tumor, one that results from cancer that started elsewhere in the body and then spread to the spine.

Nocturnal back pain is also a symptom of spinal bone infection (osteomyelitis) and ankylosing spondylitis (AS), a condition that can cause the spine to fuse in a fixed, immobile position.

Other "red flags" include:

If one or more of these symptoms accompanies back pain -- especially if you have a history of cancer -- see your doctor right away. It's also important to call the doctor if your back pain is the result of a recent injury.

It's important to note that it's rare that nighttime back pain is caused by a tumor, infection, or AS.