Back stiffness after sleeping is one of the most common problems. It causes backache or back pain in most of the people.(1) Back stiffness arises in the back muscles from increased tension in the muscle tissue. Stiff back after sleeping may occur in the upper back and/or the lower back (lumbar) region. It can range from mild constant ache to a sudden sharp pain. The increased muscle tension results from trauma, overuse and poor posture. Generally, back stiffness after sleeping is not caused by a serious condition and it disappears within few days or weeks.
Symptoms of Back Stiffness after Sleeping
Back stiffness occurs with recurring symptoms, such as tightness, stiffness, etc. There can be dull or sharp pain. Further the patient experiences reduced flexibility and inability to sleep comfortably. The back stiffness reduces as the day progresses and is fine prior to the bedtime. It recurs again after sleeping. These are some of the common variations observed in case of back stiffness:
- Constant stiffness anywhere along the spine from the base of the neck to the tail bone.
- Chronic ache in the middle or lower back, especially after sitting or standing for prolonged duration.
- Pain in lower back associated with numbness and tingling sensation that affects one leg which may be a symptom of sciatica or slip disc.
- Joint pain which leads to stiffness experienced as first thing in the morning and is symptom of arthritis.
Causes of Back Stiffness after Sleeping
Although most back stiffness after sleeping are muscular in nature, however some are caused by joint, disc or nerve problems. The cause of back stiffness or lower back pain is difficult to diagnose and can be due to various reasons:
- Back Stiffness after Sleeping Due to Mattress: The mattress used for sleeping should be of foam and should not be too firm or too soft. When a person lays down to rest, he should feel comfortable and should awake up fresh the next morning without any back-stiffness. In addition, the pillow used should be of appropriate height such that a person sleeping should not feel that it’s too high or too low.
- Sleeping Posture Can Cause Back Stiffness after Sleeping: The position of sleeping is of utmost importance. Lying on belly all night makes lower back tight. Sleeping on back for some time and on one side with rolled up blanket and pillow between knees is highly recommended to avoid back stiffness after sleeping. A poor sleeping posture, in an incorrect position for hours, leads to reduced blood flow to local muscles and results in build-up of lactic acid causing stiffness. Moreover, being in bad posture such as constant standing or sitting with hunched back (in front of the computer) or bending for a long time while gardening and then returning back to the normal posture leads to back stiffness. This happens since some muscles are overworked while others are underworked, leading to an imbalance. Further lifting of heavy objects inappropriately or regularly carrying a heavy backpack too adds to the back problems. When muscles do not get sufficient time to recover, they get tired (fatigue) and become stiff.
- Back Stiffness after Sleeping Due to Disc Problems: When there is a vertebral disk problem such as disk degeneration, it leads to back stiffness along with pain. A disk is a spongy region present between two vertebrae. Disc degenerates due to hydrostatic pressure and swells. During disk problems such as hernia it bulges in size and shows its symptoms. When a person gets up in the morning there is an uncomfortable feeling due to bulged discs. In other cases, it loses its cushioning ability and causes problems such as muscle tension, muscle spasms and ruptured discs. Patients need to be careful while getting up from the bed; they should not sit straight since it can cause irritation to the disc.
- Back Stiffness after Sleeping Caused Due to Spine Injuries: When spine injuries happen due to accidents or falls, it can result in back stiffness. These injuries are in the form of sprains and fractures. Sprains occur from twisting movements or lifting things inappropriately. While painful fractures result from osteoporosis. Spine injury in sports athlete is very common.
- Other Diseases That Can Cause Stiffness in the Back After Sleeping: The other reasons can be due to medical conditions such as rheumatoid arthritis, fibromyalgia, osteoporosis and osteoarthritis, ankylosing spondylitis, spinal stenosis, sprained muscle and facet joint injury.
- Emotional stress can also be a cause of back stiffness leading to back-pain.
Risk Factors of Back Stiffness after Sleeping
- Age: In most cases, the first back stiffness is experienced during age of 30-40 years. It becomes more common as age increases.
- Fitness Level: People who have poor physical fitness such as overweight people, that extra weight exerts pressure on the spine causing back stiffness after sleeping or any other activity. Daily moderate level of exercise and physical activity is advised to stay away from the stiff back.
- Improper Diet: A diet rich in fats and carbohydrates combined with physical activity leads to obesity which puts additional stress on back and lead to back stiffness after sleeping.
- Hereditary Factors: Back pain due to ankylosing spondylitis, a type of arthritis which affects the spine, has a genetic component.
- Presence of Other Diseases as a Risk Factor for Back Stiffness after Sleeping: Diseases such as various forms of arthritis and cancers might spread to the spine and cause stiff back.
- Occupational Risk Factors for Back Stiffness after Sleeping: Job which involves heavy lifting, pushing and pulling leads to back pain and back stiffness. Similarly, sedentary jobs such as, desk job and sitting in front of a computer leads to back stiffness as well.
- Smoking: People who smoke have unhealthy lifestyles which results in tissue damage of the back leading to back stiffness and pain.
- Pregnancy: The excess weight of carrying a baby can put strain on the back. Back Stiffness during pregnancy can be even more after sleeping particularly after lying down on the back.
- Medicines: A prolonged use of certain medicines (such as corticosteroids) is known to weaken the bones leading to back stiffness after sleeping.
Treatment of Back Stiffness after Sleeping
Treatments vary according to the type of back stiffness. Many a times the back stiffness heals on its own and no treatment is required. It is generally advised that for mild back stiffness one should rest, provide heat and ice application, take medicines, massage and exercise. Medicines such as acetaminophen are used to treat pain and ibuprofen provides relief from inflammation. Both of which should be taken after doctor’s consultation. These are all temporary relief measures for fixing back stiffness, while exercise have long term benefits and prevent stiffness in future too.
Surgery is performed in some rare cases when back stiffness is due to tumor development, spine injuries, or vertebral fractures results in constant pain.
Exercises for Back Stiffness after Sleeping
To improve muscle balance and prevent back stiffness from occurring in future, a combination of exercises is very effective in management of back stiffness after sleeping or any activities of daily living. These include aerobic conditioning, stretching, twisting, strengthening, static and dynamic leg raise, glute stretches, dead lifts, abs and rope crunches, fitness ball wrap, and hyperextension with fitness ball and so forth. Further the exercise of Standing Hip shift has been advised.
Many exercises can be performed to treat the problem of back stiffness. This physical activity relieves tightness and imbalance in lumbar spine, muscles of lower back and hip muscles. Performing these exercises daily helps to keep the back healthy, develop endurance, flexibility and become strong. The American College of Sports Medicine recommends 150 minutes of aerobic conditioning every week, along with stretching and strengthening 2 to 3 days per week. However, before practicing any exercise one should consult a doctor or a physical therapist to know which ones are appropriate to be followed and to what extent they are needed. All the above mentioned exercises need not be performed since they can do more damage than good if overdone.
Prevention of Back Stiffness after Sleeping
Stiff Back after sleeping can be prevented by taking certain precautions such as:
- Maintaining a good posture. The body should be properly aligned while sleeping or while performing desk jobs. Lifting of heavy objects should be avoided. One should constantly change positions while sleeping. Similarly, sitting jobs should be interrupted with intermittent walking movements.
- Finding an ideal firm mattress, with pillow which will ensure good sleep.
- Regular moderate exercises allow keeping all the muscles strong. Exercises such as Tai-chi and yoga should be practiced which increase the balance and strength. Any weight bearing exercises that challenge the balance must be performed. Exercises help to keep the back healthy and strong and they reduce lower back stiffness and pain after sleeping.
- Eating healthy diet and not leading a sedentary lifestyle. Avoid being overweight since it puts a lot of stress on back. Eating plenty of green vegetables and fruits to obtain vitamins and minerals. Consuming foods rich in Vitamin D and Calcium to avoid osteoporosis which also leads to back stiffness and pain in women.
- Stopping unhealthy habits such as smoking.
- Managing stress by using de-stress techniques.
Back stiffness after sleeping is a very common problem and it keeps on recurring. If appropriate cause is known then some of its types can be treated well so that a person can lead a life without misery. For long term benefits, it is highly advised to perform appropriate and only required exercises which will be effective and will provide relief from back stiffness in future.