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Ask A PT! Low Back Pain at Night

My name is Dr. Brad Conder. Today is my first blog post that I am starting to put on my website. Hopefully, it’s going to be a weekly type of an event or habit for me. It’s to kind of start answering questions to some of the common issues that I’m getting as far as my current clients and patients to help give more information and education out there. So one of my first topics I’d like to talk about is low back pain and having Night Time Low Back Pain. One of the more common questions I get from some of my clients is, “Why do I have pain at night?” Well, it’s a complicated answer but one of the more important things to know is that it’s pretty common.


Even myself I’ve had back pain over the years from bad body mechanics and I actually got injured working on patients at the hospital. So, I’ve had some of my own back issues and I know a little about Night Time Low Back Pain. In particular, that has been one of the main irritating factors as far as having that type of condition.

Now, why do people have pain at nighttime or why that’s such a severe part of having low back pain? Well, a lot of it goes back to what’s going on in the spine when you have an actual injury. So, not everybody has to have a specific injury when it comes to low back pain. You don’t have to have lifting injury. You don’t have to have a car accident or anything like that. It’s more common that more people will have back pain just from routine everyday activities such as sitting for eight hours a day or standing for long periods of time, those type of things give your back a lot of stress to actually cause some of the issues like pain at night.

So when it comes to Night Time low back pain, let’s say you’re sitting all day, you’ve had back pain for six months, you really didn’t do anything which is a common complaint. “I have back pain, I didn’t do anything.” “I sit for eight hours, I’m in an office job.” So that right there is a lot more irritating activity than you would give it credit for. Your back is not meant to sit for long periods of time. So, without going into much detail as far as our anatomy, you can get several structures in your back that might start giving you stress or pain whether it be your discs or your joints.

So what happens when you have back pain, you have an inflammation process that starts going on. The inflammation is where a lot of that nighttime back pain is going to come from. So what happens, you have your injury in your back, whether you sit for too long or if you do have a lifting injury and your back itself is trying to heal, and the healing process actually is inflammation. Inflammation can be good if it’s controlled by the body or in the right way. When it’s out of control, as far as over inflammation or too much on a daily basis is when we start getting a lot of these issues.

So what happens with Night Time Low Back Pain? You’ve had inflammation all day, you’ve been sitting for eight hours, and then you go and rest. So you think that will actually make you feel better but in some cases, you’re going to wake up, your back’s going to be super stiff or maybe have pain and maybe even have pain down your legs. Something I’ve experienced myself when I don’t do my homework and keep care of my back.

The inflammation in the tissues, from the muscles, the joints, the discs. You have had inflammation all day, it starts to really tighten up all your tissue at nighttime and it’s really the prolonged period, that eight hours of not being moving, is where a lot of that pain and inflammation and swelling are causing that problem.

Well, how do you take care of that. A lot of times people want to always go to heat because it does feel good but ice is the actual anti-inflammatory, It’s natural, they can actually get specific to the area. So, one of my first recommendations for all my patients and clients is that you need to actually put an ice pack on your back and two or three times a day and sometimes if you do it maybe about 30 minutes before you go to bed that might actually, help with some of that night pain and maybe sometime in the next morning.

Some other ways that you can maybe help some of the back pain is if you found some exercise or stretches that work for you, maybe if you’ve been prescribed exercise from your physical therapist. Do your exercises right before you go to bed or right when you wake up can really help to kind of just ease some of that tension and tightness.

If you have any more questions about low back pain and you’re not very sure if what you’re doing is correct you can always email me at

drconder@physicaltherapylouisville.com or call me or text me at 502-509-3136 and you can hopefully look at my website for more resources. I have a free ebook on low back pain that might be able to answer some questions, too, if you sign up for that and I can send it to you for free. Thanks