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Nighttime Back Pain

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What Causes Nocturnal Pain?

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.

Can Nocturnal Back Pain Be a Sign of Something Serious?

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:

  • Back pain that spreads down one or both legs
  • Weakness, numbness, or tingling in legs
  • New problems with bowel or bladder control
  • Pain or throbbing in your abdomen
  • Fever
  • Spots warm to the touch
  • Unexplained weight loss
  • History of cancer
  • History of a suppressed immune system
  • History of trauma

If one or more of these symptoms accompanies back pain -- especially if you have a history of cancer -- contact your doctor for further evaluation. 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. In the study in the U.K., for instance, no serious spinal disease was found in any of the participants who had nighttime back pain. And in another study, only 0.66% of patients (less than one in 100) being evaluated for lower back pain in a primary care setting were found to have cancer.

WebMD Medical Reference

Reviewed by Kimball Johnson, MD on September 26, 2012
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