Several things can cause your lower back to hurt when you lie down. Relief may require a new mattress, resting and icing an injury, or medical care. Many people injure their backs when lifting or moving heavy objects. Sometimes the pain feels better when you lie down, but in some cases, it does not. Kidney problems and arthritis in the back can also cause lower back pain when lying down. 

This article explores several reasons your lower back may hurt when lying down. It discusses when to seek medical care and available treatments. Lastly, there are tips for living with lower back pain and prevention.

There are several reasons you may experience lower back pain when lying down.

Medical professionals refer to back strains, sprains, or other damages as mechanical back injuries. These injuries typically affect the spine or surrounding muscles, tendons, or ligaments. 

Often, the person experiencing the pain can recall lifting something heavy or incorrectly that caused the pain. However, mechanical injuries sometimes happen for unknown reasons. 

Health experts recommend resting from movements that cause pain, applying topical heat, and taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Sometimes lying down may bring relief from the pain, but this is not always the case.

Arthritis describes swelling and inflammation of the joints or tissues surrounding them. 

Osteoarthritis affects several joints, including the lower back. Osteoarthritis can change the spine and pressure nearby nerves. This causes weakness, numbness, or tingling in the legs. 

Learn more about osteoarthritis. 

Ankylosing spondylitis is another type of arthritis that affects the ligaments and joints of the spine. People with ankylosing spondylitis experience pain and stiffening of the lower back and hips. 

Learn more about ankylosing spondylitis.

Sciatica is inflammation of the large nerve that exits the spinal column in the lower back and travels down each leg. People with sciatica describe lower back pain or a deep burning sensation in the buttocks. One of the legs may also feel pain or weakness. 

Sciatica occurs when the surrounding tissues constrict or push the nerve. Most cases of sciatica resolve on their own within 4–6 weeks. 

Disc degeneration is wearing down of the cartilage pads between the vertebrae. Each disc provides support and flexibility, but they can herniate, tear, and become thinner over time. This condition is most common in older adults.

Classic symptoms include lower back pain that may radiate down both buttocks and into both legs. Physical therapy focusing on core strength typically helps relieve pain from disc degeneration. Taking NSAIDs can also help with pain relief. Severe cases may need surgery. 

Learn more about degenerative disc disease.

The kidneys sit in the lower back on either side of the spine. Kidney infections, known as pyelonephritis, often begin in the bladder and travel up to the kidneys. 

Symptoms of a kidney infection include: 

Kidney infections require antibiotics for treatment. Prompt treatment can avoid serious complications. 

Learn more about kidney infections.

Pebbles can form in one or both kidneys when there are high levels of minerals in the kidneys. These hard formations can be as small as a grain of sand or as large as a pea.

Small kidney stones can pass through the urinary system without causing discomfort. However, larger stones can cause significant pain and become lodged.

Seek medical care if you have signs of a kidney stone, such as:

Learn more about kidney stones.

Seek medical care if you have lower back pain that persists after resting the back for several days, or if the pain prevents you from performing your daily activities.

Also seek medical care if back pain is accompanied by these symptoms:

Learn more about when to seek medical care for lower back pain.

Limiting activities that cause pain to your lower back can help the healing process. Other at-home treatments include:

Depending on the underlying cause, medical treatment may include:

Here are some tips you can follow if you experience persistent lower back pain.

To help you sleep better, use a medium-firm mattress. Try to sleep on your side with your knees slightly bent and a pillow between them. If you prefer sleeping on your back, try putting pillows under your knees and a small pillow under your lower back. Avoid sleeping on your stomach.

Lower back pain can be especially frustrating when there is no relief, even when lying down. The back has many muscles, bones, and ligaments that can experience injury or disease. Another common cause of back pain is kidney infections or kidney stones.

Try taking NSAIDs, such as ibuprofen, for pain and using ice or hot packs. Gentle stretching of the back and hamstrings can also help. When you lie down, support your lower back by lying on your side with a pillow between your knees. When lying on your back, add pillows under your knees. 

Seek medical care if lower back pain persists, keeps you from your daily activities, or is accompanied by symptoms suggesting a kidney problem. 

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