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Age-related morning and nighttime back pain

, medical expert
Last reviewed: 04.07.2025
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Minor back discomfort caused by active sports, heavy physical labor, or an uncomfortable position during a night's rest is unlikely to be a serious cause for concern, especially if this symptom occurs occasionally and is not accompanied by other health problems. Pain from overwork goes away after a full rest and relaxation of the back muscles, light massage, and wet rubbing. And spinal fatigue due to prolonged stay in an uncomfortable static position is relieved with moderate physical activity and exercise.

A weak irregular pain syndrome, which has quite explainable causes, does not pose a danger, although it prompts one to think about what a person did wrong, and this caused the pain to appear. But different types of severe back pain, even if they appeared once and do not remind about themselves for a long time, should be alarming. This is a clear signal from the body about a specific disorder, which can be deciphered by a visit to the doctor.

It is impossible to ignore such a symptom, as often happens with children and athletes. Very often, acute severe pain in the back signals a fracture, a split, a dislocation of the vertebral joints, as a result of which the spinal cord can be damaged, tumor processes can develop, the innervation of the body and limbs can be disrupted, which, in the absence of appropriate treatment and caution, can lead to disability.

Back pain can also be caused by oncological problems. And although severe pain syndrome usually occurs in the late stages of cancer, there is still hope, and it should not be missed under any circumstances, because there is nothing more precious in the world than human life.

With the help of pain, our body informs us about various disturbances in its work. But even knowing the structure of this complex mechanism, it is not always easy to understand in which section the failure occurred. Nevertheless, this symptom is enough to seek help from someone who will help to solve a difficult medical puzzle. At the same time, it is necessary to take into account both local and reflected pain. For example, pain in the lower back helps to diagnose kidney diseases in time. And discomfort in the right hypochondrium with irradiation to the back helps to suspect liver and gallbladder pathologies in time, until they remind of themselves with complications in the form of failures in the work of other organs and deterioration of the general condition of the patient caused by intoxication of the body (it is provoked by stagnation and necrotic processes in the tissues of the diseased organ).

If intense back pain occurs after an infectious disease, this indicates the development of complications and that the treatment was unsuccessful. This means that in the future there will still be a fight against the consequences of the disease. And the sooner it is started, the greater the chances of success.

In spinal pathologies, severe back pain is typical for acute conditions, and if you react immediately, the progression of the disease can be stopped fairly quickly. If you do nothing to treat the disease, it will most likely take a chronic form, the therapy of which is very difficult and has only a temporary effect. Now the pain will appear with any exacerbation of the pathology, provoked by stress on the back, hypothermia, infections, stress, etc. At the same time, even achieving remission does not completely stop the progression of the disease and the destruction of the spinal structures.

Intense back pain is not a specific disease, but a signal for action. And the prognosis for treating the pathology that caused such a symptom depends on how promptly a person reacts to it. Any type of severe back pain should alert a person, because the greater the intensity of the pain, the more serious the problem causing it, and the more severe the consequences of a careless attitude towards it can be.

Age-Related Back Pain

After a person turns 60, he or she moves into the category of elderly people, and at 75 can already be considered an old man. Life does not end there, but it becomes more difficult in terms of health, especially considering that during life, few people take good care of their health, accumulating a baggage of all sorts of diseases. Moreover, physiological aging is accompanied by age-related changes that do not contribute to excellent well-being.

Try to surprise someone today with the fact that older people often experience all sorts of severe back pain. At the same time, scientists have proven that in older age, sensitivity to pain increases due to the expectation of its appearance, for the same reason, physical activity decreases, which only aggravates muscle and joint pathologies.

Old men and women bent over in three deaths are a common sight regardless of where they live. With age, a person's motor activity decreases, metabolism slows down, which leads to an exacerbation of existing diseases and the appearance of new ones caused by tissue wear.

But if the most common reason for young people to see a therapist and neurologist is considered to be degenerative changes in the spine (osseochondrosis), then older people are more likely to have muscular-ligamentous dysfunction and osteosclerosis, provoked by the chronic course of osteochondrosis and other pathologies of the spine of a dystrophic nature. That is, fibrous changes in soft tissues and joints make themselves known, making them less elastic and mobile, plus adding water to the fire of accumulated diseases.

Facet syndrome is the name of a common cause of back pain in older people. Facet joints are processes on the vertebrae that provide the spine with sufficient mobility (movement between the vertebrae) and flexibility, and at the same time act as a kind of fixator that prevents excessive movement (provides stability).

Facet joints, especially in the lumbar and cervical regions, are in constant motion, so they wear out faster with age. Joint wear is characterized by thinning of the cartilage, to which compensatory mechanisms respond with excessive bone growth and the formation of osteophytes on the vertebrae, which increase the size of the joint but limit its mobility. We are talking about the development of osteoarthritis, which is called facet joint syndrome. Inflammation of the facet joints provokes a protective reaction in the form of painful muscle spasm, which is experienced by more than 85% of elderly patients.

Since the pathology does not imply an impact on the nerves, the pain is usually aching in nature, increasing when bending backwards, straightening the body, while sitting and driving in a car. It is impossible to predict the onset of pain. The frequency of pain, its duration and intensity can also vary.

Symptoms of facet syndrome in the cervical spine include localized pain that may radiate to the shoulder and upper back. If the patient is also diagnosed with a herniated disc in the neck, he or she may also experience pain in the arm and hand.

Pain syndrome in the lumbar region is characterized by irradiation to the buttocks and the back of the thigh. If the pain spreads lower, the cause may again be a herniated disc, but in the lumbosacral region, which affects not only the muscles, but also the nerve fibers.

Age-related decrease in the elasticity of the muscular-ligamentous joint in combination with the pathologies of the spine accumulated over the years of life (what is osteochondrosis, diagnosed in 80% of the population, worth) and wear of the facet joints leads to a redistribution of the load on the tissues of the spine and excessive muscle tension, which results in chronic pain. The situation is also aggravated by a decrease in bone density (osteopenia and osteoporosis).

The hardest part is for women, for whom osteoporosis is common and is diagnosed twice as often as for men. During menopause, it is caused by a decrease in the production of female hormones. Compression fractures of the spine (usually in the thoracic region) are considered to be a consequence of osteoporosis in the post-menopausal period, which causes severe acute back pain that intensifies with any movement. In more than half of patients, the pain becomes chronic, can torment a person almost throughout the day and prevent a normal night's rest.

Dysplastic processes and age-related instability of the spine are the reason why doctors diagnose degenerative spondylolisthesis (shift of individual vertebrae relative to the axis of the spine) and spinal stenosis in elderly people. Reduced physical activity, partly caused by pain syndrome, and leg pain, which is also often reflected from the spine, forcing elderly people to walk less and sit more, only complicate the situation. After all, in a sitting position, the load on the spine is especially great, and the lumbar region suffers the most. And it is not surprising that when getting up on their feet, elderly people can experience quite severe pain in the lower back, radiating to the legs.

As we can see, elderly people and old people have more reasons to complain about different types of severe back pain. And we have only talked about dorsalgia – a pain syndrome caused by diseases of the spine. But with age, not only skin, bones and cartilage wear out, a decrease in functionality is also noted in internal organs.

Few people over 60 can boast of a strong, healthy heart. This muscular organ is also subject to significant wear and tear over time, and in old age we have different degrees of heart failure. The risk of a heart attack also increases in old age, and this pathology, like angina, is characterized by irradiation of pain to the back.

Those who were fond of alcoholic drinks in their youth may have kidney and liver problems in old age, the pain from which is often reflected in the back and can be quite intense. And it is difficult to protect yourself from infectious diseases at any age, plus the presence of a baggage of chronic diseases significantly undermines the immune system.

Among infectious diseases in old age, osteomyelitis and tuberculous and ankylosing spondylitis are most often diagnosed, which most often develops against the background of pulmonary tuberculosis, even if the latter has been treated. Both diseases are accompanied by intense back pain.

Another problem is oncological diseases, the risk of which increases when a person crosses the 40-year mark. Chordoma, hemangioma, osteosarcoma are the most common cancerous tumors in the spine. But in addition to local tumors, metastatic tumors are often recorded in old age, which in 70% of cases metastasize to the thoracic region (less often to the lumbar and cervical).

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Night and morning pains

The fact that your back hurts a lot at night does not necessarily indicate a tumor. The cause of such pain may be an uncomfortable position or bed during a night's rest, severe overwork the night before, poor posture, which increases the load on the back muscles and provokes the development of such pathologies as osteochondrosis, spondylolisthesis, scoliosis, herniated discs, myositis, etc. With all such diseases, a person may be tormented by night pain of varying intensity, while a change in position sometimes helps to reduce their severity.

But the intensity of back pain at night due to diseases of internal organs (heart, kidneys and genitourinary system, liver, lungs) and pathologies of the nervous system usually does not depend on the position in which a person sleeps and the comfort of the bed. Their intensity and other characteristics depend on the type of disease and the degree of development of the pathology.

Sometimes patients complain that their back hurts badly in the morning after sleep. If such a symptom appears in a pregnant woman, there is nothing to be surprised about, because it is not so easy for the expectant mother with a belly growing day by day to find a position that is comfortable for sleeping and relaxing the back muscles.

Back pain in the morning can also be a consequence of using synthetic bed linen (friction can cause electrical charges, causing muscle contraction and fatigue). In this case, the person does not notice other symptoms of discomfort, and the discomfort goes away when the bed linen is changed.

Morning back pain is a problem that can be an echo of back injuries, various diseases of the spine and internal organs. Pain after waking up and when getting out of bed most often torments patients with osteochondrosis. Due to the decreased mobility of various parts of the spine, any change in body position can be accompanied by a painfully strong pain syndrome.

An identical situation is observed with damage to the joints of the spine ( spondyloarthrosis ). With damage to the cervical spine, pain can be noted along the spine between the shoulder blades and in the shoulders. Spondyloarthrosis of the lower spine is characterized by pain in the lumbar region.

Pain in the morning and at night is also characteristic of pathologies of the kidneys, liver, gall bladder, with the above-mentioned diseases, severe pain is localized mainly in the lumbar region, i.e. in the back under the ribs. But pain between the shoulder blades after sleep can indicate diseases of the respiratory system and heart.

Morning pains often occur with neurological problems. During sleep, a person can be in a position for a long time, which causes additional compression of the affected nerve. It is not surprising that the patient can wake up with severe back pain, because an uncomfortable position the day before waking up can provoke such a symptom even in a healthy person.

The types of morning and night spinal pain depend on the pathology that causes them. In diseases of the spine and neurological problems, the pain is usually sharp and strong. But in inflammatory pathologies of internal organs, the pain will be rather aching and vary in intensity. Although in kidney stones and renal colic, we are again talking about an acute pain syndrome that makes a person freeze and not move.

Manual therapy and exercise therapy: do they heal or cripple?

Spinal diseases are a serious problem that requires a comprehensive approach to treatment. This includes drug therapy, surgical treatment, and auxiliary methods: manual therapy and massage, therapeutic exercise, osteopathy, acupuncture, various methods of physiotherapy, etc. But given that any disease greatly weakens the tissues of the spine, any manipulations should be carried out with special care.

Unfortunately, both patients and doctors often simply forget about caution. Manual therapy is the leader in the number of complaints related to the fact that after a treatment procedure, various types of severe back pain appeared. Quite often, patients say that before the treatment, the intensity of the pain was lower. And some even claim that the pain changed its location and nature (for example, they treated the back, and the shoulder began to hurt, and the pain turned from aching to sharp, tearing).

The reason for an undesirable treatment result is the insufficient qualification of the manual therapist. Sometimes people who do not have a medical education and act practically at random due to ignorance of how their impact will affect the condition of diseased organs and nearby structures consider themselves manual therapists and osteopaths.

An experienced manual therapist must accurately calculate his strength, because excessive zeal will more likely stretch the muscles than relax them. Such a massage will only bring temporary relief, after which the pain will appear with renewed vigor. Insufficient muscle relaxation due to the doctor's haste can cause painful muscle spasms. And if the doctor also uses extraordinary strength, then it is not far to ligament sprains. Not to mention that only a highly qualified professional can adjust vertebrae, whose actions will never lead to a spinal fracture or its blockade.

Manual therapy is a mechanical effect on human tissues, the purpose of which is to relieve muscle tension, stretch the spine and restore its original shape. These goals can only be achieved by professional actions of a doctor. The patient only depends on the choice of a manual therapist and the implementation of his recommendations after the procedure.

A little less often, complaints about the resumption and increase of pain are received in relation to therapeutic physical training. Every tenth patient complains about this. But here it is much more difficult to look for someone to blame. The fact is that here we are talking about the joint efforts of the therapeutic physical training trainer and the patient.

Yes, people with various problems with the spine often say that they are prescribed group classes with the same set of exercises for both osteochondrosis and spinal fractures. And if they bring relief to patients with degenerative changes in the tissues of the spinal column, then with injuries some exercises can only provoke increased pain.

Here we see the negligence of the exercise therapy doctors, because the set of exercises should correspond to the patient's diagnosis and, ideally, should be compiled individually. In addition, those exercises that are acceptable during remission of the disease can be harmful during its exacerbation.

But often the patients themselves are the ones to blame for their problems. Before complaining that after exercise therapy your back hurts more than before, you should ask yourself whether you did everything correctly. For example, exercise therapy is generally undesirable in the acute stage of the disease. There are not many exercises that are allowed during an exacerbation. These are mainly static exercises with minimal load on the diseased organ, which, if performed correctly, help reduce pain.

Any exercise therapy for spinal diseases and back pain does not involve pain. This is not a sport where there is intensive muscle training. In the case of exercise therapy, the same goals are achieved by more gentle methods, gradually, gently. There is no need to increase the number of exercises or take on those that will be too difficult in a given situation. If pain appears or intensifies, stop exercising.

Physical therapy exercises can be performed both in a medical facility under the supervision of a trainer and at home. But in any case, moderation and caution will have to be observed, especially if the patient has already crossed the 60-year mark. Age is not a contraindication to physical therapy, but it should be taken into account that bones and joints do not get stronger with age, which means that heavy loads cannot be given to them.

By the way, regarding contraindications. Almost any medical manipulations have them, especially those that involve physical or mechanical impact on the body structures. Therapeutic exercise therapy in the acute stage of the disease, especially after spinal injuries, is possible only with the permission of a doctor, when he considers such activities to be completely safe. Manual therapy is carried out only during the period of remission.

Such manipulations are also undesirable during any acute inflammation in the body, especially those that occur with an increase in temperature and are associated with infections. Both manual massage and exercise therapy stimulate blood circulation and lymph flow in the tissues affected by the disease. And this is fraught with the fact that the temperature will rise even more, and the infection will actively spread throughout the body by hematogenous and lymphogenous routes. It is not surprising that in this case, pain can intensify, and sometimes appear where it was not there before.

Physical therapy will not help with oncological causes of pain. Physical exercises can only be used during the recovery period after an illness and then only in strict doses.

It is also worth giving up exercise therapy in case of some systemic diseases, acute tumor processes, after head injuries. Some chronic diseases (for example, hypertension) and vascular diseases may also be contraindications to standard complexes. In any case, you cannot start exercising without consulting a doctor, and even more so, hide from him the presence of various concomitant diseases. Such short-sighted behavior most often leads to the fact that after exercise therapy and manual therapy under the guidance of professional doctors, the back begins to hurt more.

When it comes to treating diseases accompanied by pain syndrome, it is difficult to determine whether the increase in pain is associated with moderate stress on the diseased organ (and this is normal), or whether it is a matter of complications that increase inflammatory-degenerative processes due to tissue damage due to excessive stress on them. It is very important to pay attention to the nature and localization of pain.

The presence of sharp pain during exercise is a signal to stop. Most often, this symptom is associated with muscle or ligament strain, which happens if you move on to basic exercises without preliminary preparation and warming up of the muscles. In this case, the patient can accurately indicate where his back hurts.

But aching or nagging pain without a clear localization, often appearing after several sessions, is not considered a symptom of complications. The patient may think that the treatment has the opposite results, which is actually wrong. The path to recovery often lies through pain, but its intensity will be much lower than that which indicates an existing disease.

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