Why does my back hurt more in the morning?

You wake up with your back hurting, every morning. It’s hard to get out of bed when you know the pain is waiting for you. And it seems like no matter what you do, pain just keeps coming back. Trust me, you’re not alone. I’ve done ~30,000 dry needling & acupuncture treatments and most people with achey backs say the same thing. In this blog we’re going to dive into why this happens.

So why does your back hurt more in the morning?

Well to really understand that, we need to understand the multifidus – the main deep stabilizing muscle in our low backs.

Multifidus 101

These little muscles are the most important low back muscles – and I can almost promise you your orthopedic doctor completely ignores them and has nothing they can offer to help them, even though they are the biggest contributor to back pain!

[picture of multifidus]

The multifidus muscle is an important stabilizer of the lumbar spine. It works together with the transversus abdominis and pelvic floor muscles for spine stability. Multifidus muscle weakness and atrophy is associated with chronic low back pain.

Multifidus strength has been the subject of some interesting research in recent years. Investigators have looked at the types of fibers that comprise this little muscle — and the way in which these fiber types contribute to spinal stability.

One researcher found that the multifidus provides about 2/3 of the stiffness at the L4/L5 intervertebral joint. Other studies have demonstrated that a multifidus contraction controls the motion of uninjured low back joints, and increases the stiffness and stability at injured low back joints.

These short little muscles span 2 vertebrae and contract along with your core muscles in the front to provide spinal stability. If they’re turned off, then you’re going to have back pain.

Why Your Back Hurts in The Morning (or when you get up from sitting)

The multifidus muscle turns off when you’re in prolonged flexion (1). This happens when you sleep, sit for periods of time, or even when riding a bike.

This means that a move or jerk or load in the wrong direction can irritate a disc, nerve, or low back facet joint. This will feel like you threw your back out.

What can you do to make sure your back doesn’t go out?

If only it was about doing core strengthen exercises. Unfortunately this approach has been around since the 80’s – and low back pain is still the largest contributor to disability in the United States. So obviously it isn’t working.

The problem is it’s a sequencing issue. You can’t strengthen a muscle if it’s functionally turned off.

So how do you turn on your multifidus?

The fastest way to get your low back muscles turned back on is with dry needling and electro-acupuncture.

The Next Step

If you’re dealing with nagging backspin that is worse in the morning or after sitting for long periods of time then your multifidus is likely one of the main culprits. Your regular doctor, physical therapist and orthopedic doctor don’t even know this muscle is the cause of your pain and certainly don’t have the tools to treat it.

Dr. Josh Hanson, DACM has been treating the multifidus muscle for years. And is the most experienced dry needling practitioner and electro-acupuncture clinic in the Tampa Region (and all of Florida). After performing 30,000+ procedures I have developed a time tested approach to help patients with back pain feel better faster. Click the button below to schedule your session today!

Summary:

  • Your multifidus are the main stabilizing muscle in your low back.
  • They “turn off” or become inhibited during sleep and in flexion (so sitting / biking).
  • It can take 1 hour for them to turn back on.
  • The fastest way to get your multifidus back online is with dry needling & electro-acupuncture.

References:

1) Granata KP, Rogers E, Moorhouse K. Effects of static flexion-relaxation on paraspinal reflex behavior. Clin Biomech (Bristol, Avon). 2005 Jan;20(1):16-24. doi: 10.1016/j.clinbiomech.2004.09.001. PMID: 15567532; PMCID: PMC1630677.

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