When Lying Flat Leads to Back Pain

If you have upper or lower back pain when lying down flat, you're not alone. Back pain is a common reason people visit their doctor. It has a variety of potential triggers, and treatments often depend on the cause of pain. Here's what to know about back pain when lying flat and how to fight back.

Every eight in 10 people deal with back pain at some point in their lives, according to the U.S. National Library of Medicine (NLM). The types of back pain people can experience vary between dull aches and sharp pains, and it can either come and go or become chronic, lasting longer than three months.

Several conditions are linked to back pain, including ligament or muscle strains, bulging or ruptured discs, osteoporosis and arthritis, according to the Mayo Clinic. Factors that put you at risk of developing back pain include:

• Being older.
• Not exercising often.
• Obesity.
• Smoking.
• Lifting heavy objects incorrectly.

And sleep posture is another factor, according to the Cleveland Clinic.

Arthritis often affects the bones and joints in the lower back and can cause the lining of the joints to become irregular, leading to changes in the lubricated surfaces that allow those joints to move, says Griffin R. Baum, MD, a spine surgeon and assistant professor of neurology at Lenox Hill Hospital in New York City.

When lying flat, arthritis can often be a key cause of back pain, especially due to the facet joints in the back, says David F. Drake, MD, the medical director of the Interventional Pain Clinic at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia.

"In these cases, if the back is straighter or even hyperextended, the pain is often worse. If you're laying completely flat on your stomach or back, that would cause pain in those facet joints," Dr. Drake says.

Musculoskeletal strains, inflammation or sprains of the muscles or ligaments are also among the most common causes of upper and lower back pain, Dr. Baum says. And the fascia, or the overlying tissue on muscle, often plays a role in back pain when sleeping or lying flat, Dr. Drake says.

​Read more:​ 10 Popular Exercises That Can Hurt Your Back

The majority of patients with back pain are able to be successfully treated with conservative, non-surgical therapies and, in many cases, time and patience are often the answer, Dr. Baum says. Of course, this does not necessarily work for every case, especially with severe pain.

When it comes to treating upper or lower back pain when lying down flat, options often vary depending on the cause. NLM notes these standard treatments:

• Medication.
• Injections.
• Complementary therapies.
• Exercises.
• Hot or cold packs.
• Surgical interventions.

Changing your sleep position may also be helpful, especially if arthritis and your facet joints are causing your back pain when lying flat. "If sleeping with your spine straight bothers you, you might take comfort curling up in a ball or fetal position," Dr. Drake says.

Back sleepers may benefit from placing a pillow under their knees, says Cleveland Clinic. And for stomach sleepers experiencing pain, sleeping on your side with a body pillow may help, it says.

Exercises such as aerobic activities or yoga can also play a key role in pain relief, Dr. Baum says. These types of activities can help stabilize muscles and relieve tension.

​Read more:​ 6 Exercises That Can Help With Back Pain for People Over 50

NLM recommends calling your doctor if your back pain lasts longer than three days or if it resulted from an injury.

Specific symptoms that should alert you to a potentially serious back issue include feelings of constant numbness, tingling, or weakness in your toes, feet or your legs, Dr. Baum says. In addition, any incapacitating back pain that does not respond to over-the-counter pain relievers or rest warrants a visit to your doctor.