What Causes Upper Back Pain in the Morning?

Starting the morning with pain and strain in the upper back is an unwelcome way to start the day. With the added stress and muscle strain across the upper hack that comes with morning back pain, it may be difficult to see what exactly is causing this rude awakening.

So what are the reasons for upper back pain in the morning? The most likely cause is an incorrect sleeping position that causes unnecessary pressure in the upper back or the thoracic spine. Aging, inflammation, and medical conditions may also influence the persistence and severity of upper back pain in the morning.

Why Do I Have Upper Back Pain in the Morning?

Upper back pain can happen in the area between the neck and the bottom of the ribs. It can also come in the form of neck pain and shoulder pain. Though it is usually caused by overusing  the muscles or physical trauma, another common factor of upper back pain is poor posture, especially during sleep.

The body spends nearly a third of the day asleep, so its sleep posture matters as much as how it moves on a daily basis. Any stiffness or added pressure in the upper back due to poor posture will translate to morning upper back pain or lower back pain when you wake up. This may also be exacerbated by a hard mattress that makes it uncomfortable to rest on.

However, there may be other reasons why upper back pain may still occur after waking such as inflammation, lingering muscle tension and muscle stiffness, and medical conditions that are diagnosed by damage or mispositioning in the spinal cord and other bones in the upper back. As the body moves in its sleep, it may be accidentally grinding degraded bones or compressing nerves in the upper back. Taking precautions will help alleviate some of the morning back pain. 

Conditions Related to Severe Upper Back Pain in the Morning

Any conditions that affect the integrity of the spinal cord, muscle rigidity, and bone structure will influence the pain levels and duration of upper back pain in the morning. If severe levels of morning back pain persist with proper sleep posture and direct treatment, consult a doctor or pain specialist for a diagnosis. 

1) Inflammatory Back Pain

Inflammatory back pain or spondyloarthritis is chronic back pain that lasts throughout the morning without naturally subsiding. The immune system mistakenly attacks spinal tissue, causing pain and inflammation. The upper back pain or lower back pain can be so severe, it may wake the body from sleep. It can be caused by injury in the spine, mild inflammation from aging, and other forms of arthritis like ankylosing spondylitis and rheumatoid arthritis. 

The main differences between inflammatory back pain and mechanical back pain, like those caused by poor posture and injury, is that inflammatory back pain occurs in the morning and night, last longer than 3 months, increases incrementally after the course of weeks, lessens after physical therapy and medication, and originates from lower back pain.

2) Spinal Stenosis

When bone spurs are unnaturally grown in the spine, it lessens the space around it. This will cause the bones in the spine to compress the nearby nerves, leading to pain and consequential inflammation. This may cause numbness and pain to spread across the upper back and limbs like in the neck, shoulder, and arms. If added muscle tension is applied in the upper back, this will cause upper back pain to increasing in the morning.

Spinal stenosis can occur in the neck or in the lumbar spine, otherwise known as the lower back. Just like spondyloarthritis and other forms of arthritis, it does not go away as it accelerates with aging. However, treatment plans like medications and minimally invasive procedures are available to manage the condition. 

3) Fibromyalgia

Fibromyalgia, or myofascial pain syndrome, is a disorder that causes pain throughout the body, whether in the upper back, lower back, neck, shoulder, arm, and hand. It is caused by trigger points—tender areas in worn-out or expended muscles—generating aching pain in various areas around the body. Other symptoms include fatigue, insomnia, itching, dry eyes, and headaches. 

Why Is Upper Back Pain Worse in the Morning? 

Upper back pain may usually spike in the morning, despite resting in a stationary position for several hours. If it slowly subsides as the day passes, you may need to change your sleeping routine to suit the current condition of your upper back or lower back. Finding the best spine alignment for your body while it sleeps will help alleviate upper back pain, middle back pain, and lower back pain as you sleep.

For example, some women may not anticipate the back pain that comes with pregnancy. The added weight on the stomach will add extra tension in the upper back and lower back, causing muscle stiffness or chronic back pain without any proper adjustments. A specialized pillow, mattress, and change in sleep posture will be able to relieve the pressure brought on by pregnancy.

Another condition that may signal a shift in sleeping routine is disc degeneration disease where the bone discs in the spine slowly degrade due to age. Depending on where the degeneration occurs in the spine, you may need to incorporate stretching or use another pillow to support the weakened part of your back.

What Causes My Upper Back Pain Every Evening?

Conversely, upper back pain or lower back pain may manifest at the end of the day, then continue after you sleep. This is mostly due to mechanical issues in the spine like poor posture, hunching, constant sitting, muscle overuse, and injuries. Targeting these issues will eliminate the possibility of upper back pain before you sleep and after you wake up.

A bedtime routine to prepare your body for sleep like lying down at a specific time or not using your phone before going to bed will help relax any lingering muscle tension from the day’s activities. Stretching before going to sleep will also prevent morning stiffness by keeping the spine, neck, and upper back limber before resting for an extended period of time. Consult a physical therapist to learn the best stretches to do at home for the upper back. 

The most effective treatment for providing relief from evening upper back pain is using sports medicine like medication and physical therapy to strengthen your body from muscle overuse and underuse. With proper knowledge of stretching and how to move the muscles for sports and other activities, the chances of a muscle strain are considerably lowered. 

Best Sleeping Positions to Relieve Upper Back Pain

An efficient method to completely or partially alleviate upper back pain in the morning is utilizing the correct sleeping posture for your upper back. While there are sleeping positions for optimal spine alignment, there are sleep postures that are perfect for those with specific conditions. Adjust accordingly by adding a pillow to sensitive muscles or bones to keep the body and spine straight 

1) Sleeping on the Back

Sleeping straight on the back is the most effective sleeping position for keeping the spine aligned with its natural curvature. An equal amount of gravity is applied throughout the upper back, so the spine does not need to support any more extra weight. Placing a pillow under the knees, neck, and head can help prevent any form of muscle tension in the upper back and lower back.

This sleeping position should not be used by pregnant women because it decreases the blood flow of the mother and the fetus. Because of the lowered blood circulation, it will only increase the likelihood of upper back pain in the morning.

2) Sleeping on the Side

The next best sleeping position is lying on one side of the body with the legs stretched out. It is a comfortable position for many because it opens up the airways in the nose and mouth. Putting a small pillow under the knees will straighten the legs and pelvis to prevent lower back pain in the morning.

3) Sleeping in an Upright Position 

Going to sleep while sitting down is great for chronic neck pain and muscle tension in the morning as well as upper back pain. It can even be done by pregnant women to ease the weight on their abdomen. However, without lumbar support with a pillow, it may promote lower back pain in the morning because this position adds extra there. 

Sleeping Positions That Cause Upper Back Pain

Poor posture is a prime factor in upper back pain and accounts for the likelihood of morning back pain. Though the postures below are not good at all for the upper back, any sleep posture can be detrimental for your upper back if it is not done correctly or is not supported by pillows or a suitable mattress. 

1) Sleeping in a Fetal Position

Also known as sleeping on the side with the legs bent or folded toward the chest, this sleep posture can be extremely uncomfortable if the body curls too much. This may be to the benefit of those with spinal stenosis, herniated discs, and pregnant women because the additional bending of the back provides more space in the spine. 

2) Sleeping on the Stomach

The worst sleep posture for the upper back and lower back is sleeping on your stomach. This will increase the chances of stiff neck, tense shoulders, and upper back pain in the morning because resting in this posture adds stress to the neck and puts more weight on the upper back. However, patients with degenerative disc disease can use this position to alleviate pressure on the spinal discs. Use pillows to relieve added stress in the neck and the upper back.

Prevent Morning Upper Back Pain at Gramercy Pain Center

Morning upper back pain can be an unpleasant surprise. It may be a mishap during sleeping or it could signal the coming of an aging spine and the difficulties that come with it. Upper back pain is best dealt with with a tailor-made treatment plan that is considerate of your lifestyle and medical conditions. 

At Gramercy Pain Center, our first-rate pain specialists can fully assess your upper back to find any hidden causes for morning back pain. We offer a wide array of non-surgical and minimally invasive procedures to provide effective upper back pain relief. Call us at 732-788-0349 or schedule a consultation online to start your morning without any upper back pain.