Having Middle Back Pain when Lying Down at Night? Here’s How to Fix it

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Suffering from acute middle back pain when lying down at night can rob your precious night-time! The problem gets worse when the pain isn’t better even when you sleep.

People with a Herniated disc usually doing bed rest and lying their back flat as the therapy to loosen out the spinal stress. But, continuously doing bed rest is also has two side effects and can aggravate your middle back pain when lying down even more.

What is the main cause of the middle back pain when lying down?

The actual causes of nocturnal back pain when lying down might be undetermined. Since it different according to each person’s condition. I try to separate the causes into internal and external causes. The internal causes, mainly focus on your body, while external cause it is from your surroundings.


Internal Causes

  • Muscular tension

If this is your first case, and you don’t have a medical history of back disease such as Herniated disc, then there is not necessarily to seek for a special treatment.

Some little or occasional pains, which we feel especially at night or in the morning when lying down or getting up, are very often caused by muscle tension and soreness of the back muscles due to work.

A regular motion and everyday life as well as maintain prolonged posture will strain the tendons, ligaments, muscles, and joints. These also affect the lumbar region, spine, shoulders blades, and neck.


  • Injury

Injuries such as muscles sprains or spinal fractured and related severe damage tissue that caused by a fall or an accident.


  • Disease

Several back diseases such as scoliosis, which is an abnormal curvature on your spine, or spinal stenosis, which is a condition of narrowing of the spinal column, are the most common problem that caused nocturnal back pain.

Kidney stones, and other variation of arthritis that not only attack the knee joint but also can affect the spine as well.

If the pain comes with accompanying symptoms such as radiated pain in the legs and arms, fever, and sharp-warm spots on the specific pain when touched, it is a sign of other complication serious disease and you should see a medical doctor.


External causes

  • Bed and pillow

Rare but could be the cause is when the bed is too short. The length of the bed should be at least 20 centimeters longer than the height of the body in order to provide the right surface when sleeping.

If it becomes too cramped in bed, we unconsciously ended up in a fetal position when sleeping.

Avoid your pillow position getting too high. Most people need a comfortable shoulder position while sleeping to allow themselves to sink into their deep sleep.

We sometimes pull the shoulders up unconsciously and this would increase the tense on the neck and the entire upper body. This can lead to upper or middle back pain.


  • Room temperature and humidity

The ideal relaxing sleeping room temperature for most people is between 16 and 18 degrees Celsius. And sometimes people like to have one or two degrees warmer.

If you prefer the cooler temperature it is fine. But you should take note that when the air is colder, moisture evaporates from our skin in the sleep.

Apart from the risk of mold formation, an uncomfortable, moist-cold bedroom also leads to muscle tensions that can be shown in a stiff neck, shoulder and back pain.

A favorite for creating a warm, dry room climate are the beds made from solid wood. In contrast to metal or plastic bed, a wooden bed can improve good temperature and humidity.


So, how can I avoid middle back pain when lying down or sleeping?

The first thing to do is determine why you have the pain from the causes above.

If you have a disease history, seeking a medical advice is recommended. For a muscular tension problem, doing an appropriate sleeping position is the best way to relieve the pain.

  • The back position

Middle back pain when lying down 265article - image source Google


This is the most back-friendly sleeping position. In order to relieve the lumbar spine, it is advisable to put a thicker pillow under your knees. However, the pillow should not be too thick, otherwise, the area of the upper spine will be bent too much. Special neck pillows are particularly well suited to relieve neck and shoulders.


  • The lateral sleep position

Middle back pain when lying down 265article - image source Google

In the lateral position, especially on hard mattresses, the spine is bent to one side and the pelvis is skewed. This position can be compensated by a pillow between the knees. A thin pillow under the waist supports the middle area of the spine.



Middle back pain when lying down at night caused by a muscular back problem is not the same as disease-caused back pain. Also, depending on whether there is an injury, a herniated disc or a nerve damage, the appropriate sleeping and reclining positions may also be different.

What is good for one may harm the other. Common cases, the back pain is based on muscular tension.

These tensions can not only be amplified during sleep but also result from an unfavorable reclining position and an inappropriate bed. With the correct sleeping position, these complaints can be significantly alleviated.

In addition to the correct sleeping position to avoid middle back pain when lying down, the bed also plays a decisive role. The right choice helps to avoid back pain when sleeping and to relieve the back.

A bed should be stable and at least 20 centimeters longer than your body, so that you could stretch and sleep comfortably. The mattress should not be too hard or too soft and therefore also depends on the weight of the body.

Maintaining a good healthy habit such as back stretches and exercise might help to minimize the risk of getting a middle back pain when lying down especially at night.


Web MD: Nighttime back pain

NCBI: Spine alignment in men during lateral sleep position