Q. I wake up with severe low back pain every morning. Please suggest a cure.

Answered by
Dr. Lokesh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 17, 2017

Hello doctor,

My problem is, I wake up in the morning and feel a severe pain in the lower back. Please tell me the solution.



Welcome to

  • It is known that during sleep our back muscles relax. So, back pain is particularly felt early in the morning due to a degenerative or inflammatory disease of the spinal elements. Also, an awkward sleeping position may aggravate this symptom.
  • Follow these simple steps:
  1. Avoid lifting heavy weights.
  2. Avoid arching your back. Instead, bend your knees to pick something from the floor.
  3. Avoid sitting for long hours.
  4. Avoid two-wheeler rides.
  5. Improve your posture while sitting.
  6. Try to get up from your chair every 20 minutes and take a quick walk around and then continue working.
  7. Always sit on a chair with back support.
  8. Do not get up suddenly from a sleeping position. Rather, turn to the side and then get up.
  9. Take bed rest if there is severe pain.
  10. Do hot fomentations locally over the affected area at least twice daily.
  • I suggest the following medicines:
  1. Use Oxalgin gel (Diclofenac topical) for local application, twice daily.
  2. Tablet Pregabalin 75 mg one tablet at night for 15 days before food at 7 PM every day.
  3. Tablet Etoricoxib 60 mg one tablet each at morning and night for 10 days after food.
  4. Tablet Rabeprazole 20 mg one tablet each at morning and night for 10 days before food.
  5. Tablet Shelcal (Calcium) 500 mg at morning and night for 30 days before food.
  6. Tablet Vitamin D (60K units) once daily for 10 days, then once a month for 11 months.
  • Consult your specialist doctor, discuss with him or her and start taking these medicines with their content. Take these tablets only if you are not allergic to them. Do not take these tablets if you have bronchial asthma. Follow up immediately in case of any untoward reactions.
  • I suggest the following physical activities:
  1. Do physiotherapy.
  2. McKenzie back extension exercises.
  3. Back core strengthening exercises.
  4. Glute strengthening exercises.
  5. Passive straight leg raising exercises.
  • These exercises can be done initially under the supervision of a physiotherapist or learn to do it at home. Start physiotherapy once the pain reduces. Only regular exercises can give results.
  • After the pain reduces, the following activities are good for you:
  1. Swimming.
  2. Yoga.
  3. Walking.
  • Jogging, running and weight-lifting may aggravate back problems.
  • Investigations to be done:
  1. CBC (complete blood count).
  2. Anti CCP (cyclic citrullinated peptide).
  3. HLA B27 (human leukocyte antigen).
  4. Serum uric acid.
  5. ESR (erythrocyte sedimentation rate).
  6. X-ray of lumbosacral spine in AP and lateral views.
  • Follow up with the reports.

This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings.

For more information consult a spine health specialist online -->

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