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Lower Back Pain When Lying Down

Lower Back Pain When Lying Down

Lower back pain, especially when lying down, is a prevalent condition that affects people’s personal and professional lives to various degrees. You may experience this pain due to several causes requiring urgent medical attention. That is why you need to visit your physical therapist.

This article explores the common causes of lower back pain when lying down when you should see your physical therapist, and how treatment can help. Please read along.

Understanding Lower Back Pain

Lower back pain is pain that affects the lower portion of your back. Your lower back, also known as the lumbar region, starts below your ribcage and ends above the buttocks. This region supports the weight of your body, protects your spinal cord, and allows you to move in different directions. 

Unfortunately, pain in the lower back, especially when lying down, can restrict movement and make it difficult to carry out daily activities.

In some instances, lower back pain usually resolves itself. However, at other times, you may need to seek the help of a physical therapist for back pain therapy in Austin, TX.

Common Causes of Lower Back Pain When Lying Down

You may experience lower back pain when lying down due to one or more of the following reasons;

Strains And Sprains

Strains and sprains are the primary causes of lower back pain when lying down. Because your lower back supports the weight of your upper body, it is necessary for twisting and moving, so it is prone to strains and sprains.

A strain occurs when you overstretch your muscles, while a sprain occurs when you overstretch your ligaments. Regardless of the injury, lying down can cause discomfort.

You are likely to develop a sprain or strain as you age or if you do not exercise. Also, excess weight, improper lifting techniques, and smoking increase your risk. 


Sciatica is nerve pain radiating from your back to your leg through your hip. This nerve runs from your spine to your foot on either side of your body. Therefore, certain sleep positions can irritate the nerve, leading to lower back pain when lying down. 

You are also more likely to experience sciatica if you are overweight, sit for long periods, or have diabetes. Also, if your job requires you to twist your back o carry heavy loads, you can experience this pain.

Spinal Osteoarthritis

Spinal osteoarthritis is the degeneration of the joints in your spine. This condition results from the wear and tear on the cartilage between your joints. If your lower back pain is caused by this condition, you may experience significant pain when you bend, twist your back, or lie down. 

Obesity, past injuries, and chronic joint stress can increase your risk of developing spinal osteoarthritis.

Ankylosing Spondylitis

Ankylosing spondylitis is a rare form of arthritis. It is the chronic inflammation of the spine and pelvis, occurring in the joints where the lower back and hips meet. This condition can also cause stiffness and pain in the lower back, especially if the person has been inactive.

Ankylosing spondylitis also causes lower back pain when you lie down. If your back pain results from this condition, you may find it difficult to fall asleep at night.  

Risk factors for ankylosing spondylitis include family history, age, and childhood infections. In addition, men are more likely to develop this condition compared to women.

Spinal Tumor

A spinal tumor is a growth in your spine that can cause pain when you lie down. It is important to note that not all spinal tumors are cancerous. However, you must visit your doctor if you have difficulty walking or experience numbness and lower back pain.

When Should You Seek Medical Help For Lower Back Pain?

Sometimes, your lower back pain when lying down may resolve on its own. However, if this is not the case, you should seek immediate medical attention. Contact your doctor if you;

  • Experience lower back pain after an accident
  • Have difficulty sleeping
  • Experience radiating pain to other parts of your body, especially your legs
  • Have pain lasting more than a week
  • Experience numbness and tingling in your lower body

How Is Lower Back Pain When Lying Down Diagnosed?

You will undergo an assessment when you visit your physical therapist for lower back pain. This assessment usually involves reviewing your medical history and symptoms, which will help your physical therapist identify the cause of your lower back pain.

You may also undergo a physical examination to help your therapist understand the intensity of your pain, what makes it worse or better, and if you experience accompanying symptoms. You may also undergo imaging and lab tests, depending on the severity of your symptoms.

Your diagnosis will help your physical therapist develop an appropriate treatment plan for you.

Lower Back Pain Treatment 

There are several treatments for lower back pain. Some can be done at home, and others require assistance from your physical therapist. The best treatment for you will depend on the cause and severity of your pain.

Treatment for lower back pain includes;

Heat Therapy

Heat therapy is suitable for lower back pain as it helps relax muscles and dilate blood vessels, improving blood circulation. You can use a hot pack or shower when applying heat to your lower back. You can also use an electric heating pad on low or medium heat. 

Applying heat for 15 to 20 minutes at a time is best. Avoid using the heat source for longer, as it can damage your tissues or dehydrate the area. 

ICE Therapy

Ice therapy is similar to heat therapy. It can help relieve pain and swelling in your lower back. For this treatment, it is advisable to use a cold pack. You can also wet a towel with cold water, squeeze it until damp, and freeze it in a plastic bag for 15 minutes. 

Like heat therapy, you should ice the sore area for 15 to 20 minutes. Leaving ice on your skin for too long may cause tissue damage and frostbite. 

Manual Therapy

Manual therapy is a hands-on treatment for lower back pain. After your physical therapist identifies sore areas in your lower back, they will apply appropriate techniques to relieve your pain. 

Manual therapy treatments include massages, soft tissue mobilization, and manipulation. These treatments involve using varying levels of pressure to relieve muscle tension and pain.

Dry Needling

Dry needling is another treatment used in back pain physical therapy in Austin, TX. This treatment is carried out by a licensed physical therapist, and it involves the use of needles. Dry needling does not use medication. Instead, your physical therapist will insert the needles into tense or trigger points in your lower back to ease tension and improve circulation. 

Before getting dry needling for lower back pain, inform your physical therapist of any underlying medical conditions. Your physical therapist will let you know if the treatment is safe for you. 

Therapeutic Exercises

Therapeutic exercises for lower back pain include stretching and strengthening exercises. These exercises may help release muscle tension, improve range of motion, and restore function.

Your physical therapist will let you know the best therapeutic exercises for you to do. Also, depending on the severity of your lower back pain, your physical therapist may recommend starting with passive exercises and moving gradually to active exercises. Passive exercises require assistance from your physical therapist, but you should be able to do active exercises independently.

What Sleeping Positions Can Help With Back Pain?

Your sleeping position can also strain your back and cause lower back pain. You can make simple changes to your sleeping position to prevent lower back pain when lying down. Some of these changes include;

Sleeping On Your Side

If you sleep on your side, draw your legs slightly towards your chest and place a pillow between your legs. Doing this can improve the alignment between your spine, pelvis, and hips. This also takes the pressure off your spine, reducing lower back pain.

Sleeping On Your Back

When sleeping on your back, place a pillow under your knees to relax your back muscles and maintain the curvature of your lower back. For additional support, you can also place a small rolled towel under your waist.

It is also ideal to support your neck with a pillow in this sleeping position; ensure that it aligns your neck with your chest and back to prevent strains.


If you experience lower back pain when lying down, getting medical help is your best bet. Your physical therapist can help identify the root cause of your condition and recommend an appropriate treatment plan. As you progress in your treatment, your physical therapist will monitor your progress and make necessary adjustments to your treatment plan.

At Carter Physiotherapy, your health and well-being are our primary focus. Contact us to schedule an appointment if you have difficulty sleeping or experience numbness alongside your lower back pain.