Lower back pain when lying down can be caused by a number of things. Sometimes, getting relief is as simple as switching sleeping positions or getting a mattress that’s better suited to your needs.

However, if you can’t get relief from changes to your sleep environment, or if the pain occurs only at night, it may be a sign of something more serious, like arthritis or degenerative disk disease.

Talk to your doctor if your back pain is accompanied by:

  • fever
  • weakness
  • pain that spreads to the legs
  • weight loss
  • bladder control issues

Your spine and the muscles surrounding your spinal cord can be sensitive. They form the central structure of your body and work hard to keep you standing straight and balanced. If you have pain when you lie down, here are some possible causes.

Pulled muscle or strain

A pulled muscle or strain can happen while lifting or twisting incorrectly. Muscles, ligaments, and tendons can be overstretched to a point of being painful when in certain positions or during specific movements.

Ankylosing spondylitis

Ankylosing spondylitis (AS) is a type of arthritis. The pain from AS typically is located in the lower back and pelvis area. Often, the pain gets worse at night when you’re less active.

Spinal tumor

If you’re experiencing back pain that has gotten worse over time, you may have a tumor or growth in your spine. Your pain will likely be worse when you’re lying down due to the direct pressure on your spine.

Disc degeneration

Often called degenerative disc disease (DDD), the exact causes of this disease are unknown. Despite the name, DDD isn’t technically a disease. It’s a progressive condition that happens over time from wear and tear, or injury.

Treatment for your lower back pain varies depending on the diagnosis. Short-term treatment can be done at home to try to alleviate minor aches and pains. At-home treatment includes:

  • changing sleeping positions
  • elevating legs or knees when sleeping
  • applying heat pads
  • taking over-the-counter medication
  • getting a massage

Try not to remain idle or inactive for long periods of time. Consider refraining from physical activities for a few days, and slowly ease yourself back into your normal activities to prevent stiffness.

Minor lower back pain will usually go away on its own after a while. If it doesn’t, review your situation with your doctor.

Treatment for AS

Treatment for ankylosing spondylitis depends on the severity of your case. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).

If the NSAIDS aren’t effective, your doctor might talk to you about biologic medications, such as a tumor necrosis factor (TNF) blocker or an interleukin 17 (IL-17) inhibitor. You may require surgery if your joint pain is severe.

Treatment for spinal tumor

Treatment for a spinal tumor depends on the severity of your tumor. Your doctor may recommend surgery or radiation therapy to help prevent nerve damage in your spinal cord. If you catch symptoms early, you have a better chance of recovery.

Treatment for degenerative discs

Degenerative discs are usually treated with nonsurgical approaches, such as:

  • pain medication
  • physical therapy
  • massage
  • exercise
  • weight loss

Surgery is typically complicated and thus postponed until other efforts prove ineffective.

If your back pain when you lie down is only slightly uncomfortable, chances are you’re suffering from a tweak or a pull in your back muscles. With rest and time, the pain should subside.

If you’re suffering from back pain when you lie down that increases in severity with time, you should consult with your doctor as you may have a more serious condition.