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Low Back Pain Upon Waking Up? Try These 3 Things!

July 4, 2023 · In: Back, Body Region Support, Science-Backed Education

A common complaint I hear in the clinic revolves around low back pain when first waking up in the morning. This blog post addresses a few common ways to help provide relief by addressing three different parts: sleeping positions with added support, stretching before getting up, and a technique to get out of bed to make sure you are reducing stress to your low back.

**This is not medical advice. Please consult your medical provider for more information.

Low back pain when getting up

Sleeping Positions

We all know that sleep is important for recovery. But what happens when you’re waking up with low back pain? The act that is supposed to be restorative to the body doesn’t feel like it’s helping as it should. It can almost feel more detrimental than helpful.

Oftentimes, sleeping positions can lead to low back pain upon waking up. As we know that sitting or standing in one position for too long can lead to some aches and pains, the same thing can happen with sleeping. The best thing you can do is to set yourself up in an optimal position with better support to reduce the risk of waking up with these aches and pains in your back.

Back Sleeper

Why does my lower back hurt in the morning

If you are a back sleeper, try placing a pillow under your knees to help relieve some of the tension that may be pulling on your back muscles. You are providing relief by giving some support to the legs.

Side sleeper

Low back pain on awakening

If you are a side sleeper like me, use a body pillow to support the knee and arm of your side facing up. If you don’t have a body pillow, use a smaller pillow to support the knee of your top leg. This prevents your knee from dropping down towards the bed and creating rotation through your low back. You can also place a pillow under your side to give your back a little extra support.

Stomach Sleeper

Middle back pain in the morning that goes away

If you’re a stomach sleeper, give a little extra support to your hips. Lay a thin pillow under your hips to allow them to raise slightly. Angle your leg out to the side with support from the pillow too if this position suits you.

Perform Gentle Stretches Before Getting Up

Try performing some gentle stretches to help get your blood flowing to your muscles before actually getting out of bed. Start on your back with your knees bent and gently rock your knees side to side. Grab behind one of your knees and extend your leg out, feeling a stretch in the back of your thigh. Then repeat on the other side. Get your ankles moving by performing ankle pumps or ankle circles.

This morning flow is about slowly waking the body up, gently restoring some mobility, and getting your blood flowing before actually getting up to start your day. Find a flow that feels good and right for you.

Use the Log Roll Technique When Getting Up

The log roll technique is a common practice taught in physical and occupational therapies as it provides a means of functional movement with reducing stress to various parts of the body, including the low back. This technique focuses on preventing rotational forces through the spine.

Start on your back with your knees bent. Roll towards the side of the bed you will be getting up out of. Ensure that when you are rolling, you keep your shoulder and hip moving together as one. In other words, don’t allow your hips or your shoulders to roll forward too quickly as this is what creates twisting in your low back. Use your arm on the side that is rolling to reach over and grab the side of the bed if you need assistance with rolling on your side.

Once on your side, you will use your elbow on the side that is on the bed and your hand of your opposite arm to help push your upper body up. At the same time, your legs will drop down off the side of the bed acting as a counterbalance as you lift yourself up to a seated position. This movement should feel quite effortless. If not, practice it over time and you’ll get the hang of it.

TL;DR

If you are experiencing low back pain upon waking up, check to make sure your body is supported by pillows depending on your sleeping position. Perform a couple gentle stretches prior to getting up to loosen up areas that might have gotten stiff from being still throughout the night. And finally, don’t force yourself up through a sit up! Get up using the log roll techniques to prevent twisting through the supine and placing undo stress through your lumbar spine.

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Tera Sandona
Tera Sandona

Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.

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By: Tera Sandona · In: Back, Body Region Support, Science-Backed Education · Tagged: daily habits, pain flares, posture and positioning

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I'm a practicing physical therapist based out of sunny SoCal who loves to educate others and share information and knowledge. You can typically find me hard at work trying to manage normal life or cuddled up under a blanket enjoying coffee or desserts I can never seem to get away from!

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I hear this one on repeat. It started in your shou I hear this one on repeat. It started in your shoulder, now it’s crept into your shoulder blade, and maybe down toward your mid back. And the first thought is always the same: something new is wrong now or something else is breaking down.

But that’s not usually what’s happening. Pain that spreads to the region right next door isn’t a new injury announcing itself (unless you legitimately injured yourself again).

When pain spreads without a new injury behind it, it’s been part of the picture for a while, and showed up out of nowhere, it’s usually the same alarm system that’s been running in the background. It’s now been ringing long enough that the areas nearby started picking up the signal too.

Think of it less like a break and more like a smoke detector that won’t stop going off until the whole hallway of detectors starts sounding along with it. Nothing new caught fire. The system’s just been on for a long time.

If you’ve already had this checked and nothing new turned up to explain it, pay attention to that. It’s usually your best clue that this is your nervous system spreading the pain to a new area, not a new injury needing its own workup.

Comment “MINE DID THIS” if pain has crept into the area right next to where it started. I’ll send you my blog post I wrote on this exact topic that goes more in depth on what’s actually going on.
But here’s what’s actually true. You’ve probably But here’s what’s actually true.

You’ve probably been told for years that any movement counts as building strength, and in the very beginning, it kind of does. If you’re coming from little to no activity, walking, Pilates, biking, or yoga will strengthen you…at first. Your body is adapting to a demand it hasn’t had to meet before.

But that adaptation has a ceiling. Once your body reaches its load tolerance for that amount of activity, doing more of the same thing doesn’t build you past it. You’re not getting stronger anymore. You’re just maintaining the level you already reached.

This is where cardiovascular and endurance work split from strength work. Walking and biking stay focused on the cardiovascular system. They’re not increasing the load on your muscles. You’re training your heart and lungs instead.

Pilates and yoga work your muscles through holds, which builds muscular endurance and helps your muscles sustain a position under fatigue. That’s a real adaptation. It’s just not the same one as strength.

Real strength requires loading a specific muscle heavy enough, and consistently enough, that it has a reason to adapt again.

If you keep exposing your body to the exact same stimulus, no further change happens. The muscle already met that demand. It has nothing left to respond to.

Comment “MAXED OUT” if you just realized you’ve been maintaining instead of building for a while now.
Everyone sees you making it through the day just f Everyone sees you making it through the day just fine. They don’t see what it’s costing you to get there or what happens once you finally stop.

You show up. You answer the emails, sit through the meetings, keep your voice even when it needs to be, and nobody watching would ever guess anything is off.

They don’t see how tirelessly you work the second you walk back in the door, taking care of everyone else before you’ve had a single second to take care of yourself. They don’t see whatever you’re quietly carrying right now…the thing nobody’s asked about because you never said it out loud.

But your nervous system has been working the entire time to keep you looking like that. Holding the line through every part of the day you couldn’t afford to fall apart in.

And by evening, when nothing else is asking anything of you, it finally stops pretending. Not a dramatic collapse, just a flatness. It’s in the plans you cancel, the conversation you can’t hold, the two hours you lose staring at nothingwhen there’s nothing left keeping the performance up.

Nobody sees the discipline it takes to hold that together all day. They only see the version of you that’s left once it’s finally safe to stop.

If this is you, let the plans stay cancelled tonight. That’s not falling behind. You’ve already asked enough of yourself today.

Send this to someone who’s fine all day and disappears the second it’s finally safe to stop.
It’s Friday night. The week is finally behind you. It’s Friday night. The week is finally behind you. And you still don’t feel like you got anything back.

You’re not lazy. You’re using the wrong tool for the kind of tired you’re actually experiencing.

I know why you think something’s off. You slept enough. You even took the whole day off. And your mind still felt like it never turned off, replaying the week, running tomorrow’s list, and staying half on alert even while lying still.

The only explanation that makes sense is that you’re bad at resting, or too wound up to relax, or just built wrong.

But here’s the truth: physical stillness only covers one kind of exhaustion. If your eyes, ears, and screen never got a break, that’s sensory depletion still running underneath you. If you spent the day holding everything together for everyone else, that’s emotional depletion still running. If your brain never stopped making decisions, that’s mental depletion still running.

You didn’t fail at resting. You used the right tool on the wrong job…the screwdriver when you needed scissors.

So if you want to try this differently tonight, here’s where to start:

First, name which kind you’re actually short on (sensory, emotional, or mental) instead of defaulting to more sleep.

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You’re not lazy. You’ve just been resting the wrong thing.

Save this so you know which kind of rest to reach for tonight.
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