Back pain in the morning?
August 4, 2013 6:48 AM Subscribe
YANMD. I've started having a new kind of back pain in the morning. Any thoughts/tips? Details inside.
For the past 3-4 weeks I've woken up every morning with acute pain just above the small of my back. Back pain isn't new to me, but this particular flavor is, and since a lot has changed in my life over that same time span I'm not quite sure what to blame/how to get relief.
A few years back I was diagnosed with a herniated disk in my lower back. When I have pain from that, it shows up as pressure/discomfort around my right hip bone. I had some physical therapy, learned some useful stretches, and it's been manageable for a while. It's a very distinct kind of pain that I know pretty well at this point, and it's different from what's been happening lately.
A list of things that come to mind as other possible factors:
1. Two months ago I started a new job. I'd been a full-time grad student up to that point so this is the first time in a while that I've been sitting at a desk job for extended periods of time every weekday. I don't have the best posture while sitting. However, I don't feel this back pain during the day or while sitting.
2. About a month ago I moved into a new place with my girlfriend. We didn't buy a new mattress -- it's my mattress from my old apartment -- but we did get a new IKEA bedframe for it, whereas before I'd used one of those basic metal frames.
3. Around the same time that the pain started (partially in response), I began waking up a half hour early to go to the gym. Mostly I've done a combination of some treadmill running and ab exercises, the latter in an attempt to strengthen my core (which was always the culprit of my earlier pain). I was regularly running and exercising a few months ago, but dropped out of the practice for a while and would be trying to get back into it regardless of the pain.
I've noticed that I mostly stop feeling the pain by the time I'm leaving the gym, and if that's just endorphins masking the pain, well, then that plus the walk to work clears it up because it mostly doesn't come back until the next morning. But it's becoming intolerable -- I'm waking up a few hours too early and the stiffness/pain prevents me from falling asleep again.
Possibly relevant side note: I sleep on my back, I've always slept on my back, and I find it uncomfortable and basically impossible to sleep on my side or stomach. This pain also makes it feel like I can't sleep on my back, though, so it leads to a ton of tossing/turning once it starts.
I'm worried that if I see a specialist about this, all they can really do is treat symptoms (e.g. cortisone shot or pain medication) without locating a cause. (or I can see a chiropractor, but again, the pain's not present all day.) I'm in my mid-20's and otherwise healthy; I don't want to be in a just-manage-the-pain stage with this if I don't have to.
Has anyone experienced this? Is there some exercise/stretch I could be doing at night to ward off the pain? Does some thing I've mentioned here seem like a more likely culprit than another? Should I just see a doctor?
For the past 3-4 weeks I've woken up every morning with acute pain just above the small of my back. Back pain isn't new to me, but this particular flavor is, and since a lot has changed in my life over that same time span I'm not quite sure what to blame/how to get relief.
A few years back I was diagnosed with a herniated disk in my lower back. When I have pain from that, it shows up as pressure/discomfort around my right hip bone. I had some physical therapy, learned some useful stretches, and it's been manageable for a while. It's a very distinct kind of pain that I know pretty well at this point, and it's different from what's been happening lately.
A list of things that come to mind as other possible factors:
1. Two months ago I started a new job. I'd been a full-time grad student up to that point so this is the first time in a while that I've been sitting at a desk job for extended periods of time every weekday. I don't have the best posture while sitting. However, I don't feel this back pain during the day or while sitting.
2. About a month ago I moved into a new place with my girlfriend. We didn't buy a new mattress -- it's my mattress from my old apartment -- but we did get a new IKEA bedframe for it, whereas before I'd used one of those basic metal frames.
3. Around the same time that the pain started (partially in response), I began waking up a half hour early to go to the gym. Mostly I've done a combination of some treadmill running and ab exercises, the latter in an attempt to strengthen my core (which was always the culprit of my earlier pain). I was regularly running and exercising a few months ago, but dropped out of the practice for a while and would be trying to get back into it regardless of the pain.
I've noticed that I mostly stop feeling the pain by the time I'm leaving the gym, and if that's just endorphins masking the pain, well, then that plus the walk to work clears it up because it mostly doesn't come back until the next morning. But it's becoming intolerable -- I'm waking up a few hours too early and the stiffness/pain prevents me from falling asleep again.
Possibly relevant side note: I sleep on my back, I've always slept on my back, and I find it uncomfortable and basically impossible to sleep on my side or stomach. This pain also makes it feel like I can't sleep on my back, though, so it leads to a ton of tossing/turning once it starts.
I'm worried that if I see a specialist about this, all they can really do is treat symptoms (e.g. cortisone shot or pain medication) without locating a cause. (or I can see a chiropractor, but again, the pain's not present all day.) I'm in my mid-20's and otherwise healthy; I don't want to be in a just-manage-the-pain stage with this if I don't have to.
Has anyone experienced this? Is there some exercise/stretch I could be doing at night to ward off the pain? Does some thing I've mentioned here seem like a more likely culprit than another? Should I just see a doctor?
Best answer: Because you're getting stiffness on waking, and you sleep on your back usually but you can't right now because it hurts-- I'm guessing it's something to do with the bed frame and mattress and the way you're sleeping. If I remember correctly, most Ikea frames have wooden slats. It might be too hard. Or even too soft. Given that the pain started a month ago, same with the bed change, then this makes it the most likely culprit.
The best process is elimination.
I'd change bed for a while, and see what happens. Sleep in the guest room, if you have one, or a comfortable couch. Give it a couple of weeks, at least. Maybe even a month. Even if it's a bit of a pain (hah, see what I did there?) to do so, it's better to establish what it is sooner rather than later. Back pain can take forever to heal. If it starts getting better, then you know your culprit is the frame. If this is the case, you can only either change frame or try to retrain your body to sleep differently, if you can.
If it goes on, then try changing work chairs possibly. However I had back pain, (mine was related to nerves though) and it definitely got stiff when I sat in certain chairs or did certain poses.
I personally don't think it's the exercise, but it might be making it worse, working out on something that isn't fully healed. However, given that you feel better for such a long period after working out, leads me to believe it's not that.
Do what you gotta do to get to the bottom of it though-- chronic back pain is terrible and as I said takes forever to heal (took a year for me and I still have issues with it occasionally-- almost three years later) so absolutely try and nip it in the bud.
Hope you feel better soon.
posted by Dimes at 7:49 AM on August 4, 2013
The best process is elimination.
I'd change bed for a while, and see what happens. Sleep in the guest room, if you have one, or a comfortable couch. Give it a couple of weeks, at least. Maybe even a month. Even if it's a bit of a pain (hah, see what I did there?) to do so, it's better to establish what it is sooner rather than later. Back pain can take forever to heal. If it starts getting better, then you know your culprit is the frame. If this is the case, you can only either change frame or try to retrain your body to sleep differently, if you can.
If it goes on, then try changing work chairs possibly. However I had back pain, (mine was related to nerves though) and it definitely got stiff when I sat in certain chairs or did certain poses.
I personally don't think it's the exercise, but it might be making it worse, working out on something that isn't fully healed. However, given that you feel better for such a long period after working out, leads me to believe it's not that.
Do what you gotta do to get to the bottom of it though-- chronic back pain is terrible and as I said takes forever to heal (took a year for me and I still have issues with it occasionally-- almost three years later) so absolutely try and nip it in the bud.
Hope you feel better soon.
posted by Dimes at 7:49 AM on August 4, 2013
Running is awful on my herniated disc in my lower back. Also, I recently learned that morning back soreness / stiffness can also be a symptom of an auto immune disease rearing its ugly head. Go get it checked. Perhaps, for what it's worth, you may also consider sleeping on a different bed/mattress too.
posted by shazzam! at 8:20 AM on August 4, 2013
posted by shazzam! at 8:20 AM on August 4, 2013
If mattress-switching doesn't work then go to an orthopedist or sports medicine doctor and get a scrip for physical therapy; most doctors will choose this option way before they suggest pain meds or injections. Don't let some crank chiro "manipulate" your back into worseness!
Also maybe you need more/less/different arch support in your running shoes?
If you end up doing PT also ask them to evaluate your seated posture and correct it. Stuff lumbar support cushions on your office chair can be comfy but from what I can tell, they make your back/core muscles kind of lazy, which can lead to further injury.
posted by elizardbits at 8:47 AM on August 4, 2013
Also maybe you need more/less/different arch support in your running shoes?
If you end up doing PT also ask them to evaluate your seated posture and correct it. Stuff lumbar support cushions on your office chair can be comfy but from what I can tell, they make your back/core muscles kind of lazy, which can lead to further injury.
posted by elizardbits at 8:47 AM on August 4, 2013
Also for me personally, pain that wakes me up early in the morning, or is present at my normal wake up time, and then goes away by midmorning? It's arthritis from old injuries. The old injuries are themselves long gone.
posted by elizardbits at 8:49 AM on August 4, 2013
posted by elizardbits at 8:49 AM on August 4, 2013
I have similar pain (from too much sitting while nursing) and its my hip flexors that are to blame. Doing hip flexor stretches help. The best is having a massage therapist "releases" it with pressure. A new mattress also helped the situation.
posted by saradarlin at 10:30 AM on August 4, 2013
posted by saradarlin at 10:30 AM on August 4, 2013
Did you get an Ikea foundation too, or just the bed frame? Because I think if you just got the frame, your mattress may not be giving you enough support.
posted by still_wears_a_hat at 2:09 PM on August 4, 2013
posted by still_wears_a_hat at 2:09 PM on August 4, 2013
Best answer: Watch these two MWOD videos and see if any bells ring. It's very easy to fall into sleeping in gross flexion or extension without knowing it, especially if you only sleep on your back.
Is Your Bed Too Firm?
Your bed position
posted by Kandarp Von Bontee at 3:46 PM on August 4, 2013
Is Your Bed Too Firm?
Your bed position
posted by Kandarp Von Bontee at 3:46 PM on August 4, 2013
I'd bet money that it's posture while sitting that's causing the trouble. I never felt back pain while at my 9-5, but the sitting was the culprit, along with driving and not working out. Alternating my office chair with a standing desk helped a lot.
Could you be more specific about what your ab routine looks like? If it's all crunches and other forward bending, that could be a cause. The human back is most resistant to pain and injury when it's strong, and bending forward doesn't strengthen it. (Flexibility is important, too, but not just in that direction.) Do you do any seals, back bends or bridges, or deadlifts? Doing that kind of work (particularly the deadlifts) slowly and carefully with good form but eventually working up to heavy weight helped my back pain more than six months of stretching and yoga. (Note that I'm not sure how to work that around or with your herniated disc.)
posted by daveliepmann at 5:22 PM on August 4, 2013
Could you be more specific about what your ab routine looks like? If it's all crunches and other forward bending, that could be a cause. The human back is most resistant to pain and injury when it's strong, and bending forward doesn't strengthen it. (Flexibility is important, too, but not just in that direction.) Do you do any seals, back bends or bridges, or deadlifts? Doing that kind of work (particularly the deadlifts) slowly and carefully with good form but eventually working up to heavy weight helped my back pain more than six months of stretching and yoga. (Note that I'm not sure how to work that around or with your herniated disc.)
posted by daveliepmann at 5:22 PM on August 4, 2013
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