Looking for effective ways to relieve morning back pain? As a Doctor of Physical Therapy specializing in orthopedics, I've developed these evidence-based stretches you can do right in bed to find relief, loosen tight muscles, and improve your morning mobility. Regular stretching and physical activity have been shown to effectively manage chronic low back pain1. In fact, a comprehensive 2021 meta-analysis found that home-based exercise programs, particularly those including trunk, pelvic, and leg stretching, were highly effective at reducing pain intensity and improving function3.
Based on clinical experience treating hundreds of patients with back pain, these stretches consistently prove most beneficial, comfortable, and convenient. My own grandmother, who recently turned 99, is living proof of the power of consistent morning stretching - she has no complaints of back pain and can still climb stairs! When I asked about her secret, she revealed that she does a series of stretches in bed every morning, taking about 20 minutes. She's the perfect example of how consistency with gentle morning movement can impact your quality of life.
Why Is My Back So Stiff in the Morning?
There are two main reasons for morning back stiffness:
- Lack of Movement: During sleep, you typically maintain one or two positions for 7-9 hours. This extended period without movement can lead to muscle stiffness and joint immobility.
- Natural Body Processes: Your spinal discs absorb water during the night to maintain their cushioning function for the day ahead. While this height change is minimal, it can make an already sensitive nervous system more reactive in the morning.
Think of your joints like door hinges - they work better with movement and lubrication. Our bodies are designed so that movement produces joint lubrication, helping to reduce stiffness and discomfort. The stretches outlined in this article are formulated to optimize movement so that you can get moving and attack the day.
5 Lower Back Stretches You Can Do in Bed
Let's explore each stretch in detail, with proper form and modifications for your comfort.
Don’t feel like reading? Check out our video instead.
1. Pelvic Tilting: Foundation for Back Mobility
Clinical Benefits: Pelvic tilts activate core muscles while gently mobilizing the lumbar spine, helping reduce morning stiffness.
Starting Position:
- Lie on your back with knees bent
- Maintain neutral spine position
- Keep feet flat on the bed
Execution:
- Slowly rock your pelvis backward (posterior tilt) as if tucking your tail
- Then rock forward (anterior tilt), creating a small arch in your lower back
- Move smoothly between these positions
- Perform 10-15 repetitions
2. Bent Knee Trunk Rotations: Gentle Spinal Mobility
Clinical Benefits: This movement helps improve spinal rotation while maintaining stability through the core.
Key Points:
- Lie on your back, knees bent
- Find your comfortable foot position - wider or narrower as needed
- Gently rock knees side to side
- Aim for 30 repetitions
- Stay within a pain-free range
3. Hamstring Stretch: Addressing Connected Systems
Clinical Benefits: Research demonstrates that maintaining spinal flexibility through stretches like this can significantly impact chronic low back pain management. This stretch helps maintain proper muscle length and reduces stress on the lower back.
While lying on your back in bed, extend one leg out long while you bring the other leg up towards the ceiling. Use your hands or a stretch out strap to support your leg. You should feel good pull in the back of your thigh. Some people prefer to hold a stretch position while others prefer to toggle in and out of the stretch. You may notice that you’re more stiff in the morning compared to the end of your day. We’re looking to improve your morning stiffness here, so be gentle with your body.
Technique:
- Extend one leg while bringing the other toward the ceiling
- Use hands or a strap for support
- Feel the stretch in your posterior thigh
- Option to hold static or perform gentle oscillations
- Remember: Morning stiffness is normal - start gently
4. Knees to Chest: Classic Pain Relief
Clinical Benefits: This position helps decompress the spine while stretching lower back muscles.
This is an excellent lower back stretch and usually tolerance very well by most people. Simply bring both knees up towards your chest like you’re giving them a big hug. You can alternate between hugging your knees in tighter and then letting them relax a bit. Repeat so that you can feel very a good stretching your low back. Everybody’s hips are built a little bit differently and you may find that your comfortable position has your knees pointing out to the side, almost in a slight butterfly position. Experiment with this angle here to see what feels best for your body.
Execution:
- Bring both knees toward your chest
- Create a gentle "hugging" motion
- Experiment with knee position - slight outward rotation may feel better
- Alternate between gentle pulling and relaxing
5. Thomas Stretch: Hip Flexor Focus
Clinical Benefits: Addresses hip flexor tightness, which research links to lower back pain.
The purpose of this exercise is to stretch out your thigh muscle and your hip flexors at the same time. Start by lying close to the edge of your bed with your shoulders supported on the table and one leg hanging off the table. Bring your opposite knee to your chest. You should feel a stretch in the front of your hip or in the top of your thigh in the leg that is resting off the table. To take this stretch up a notch, you can use a stretch out strap around your ankle to bend your knee further towards your bottom.
Technique:
- Position yourself near edge of bed
- Let one leg hang while bringing opposite knee to chest
- Feel stretch in front hip/thigh of hanging leg
- Optional: Use strap around ankle for deeper stretch
Bonus Morning Mobility Exercises
These additional exercises are particularly effective for morning stiffness and can be incorporated into your routine as needed.
Cat-Camel Stretch
This exercise starts while on the hands and knees. It is important to keep your arms and hands in line with the shoulders and the knees directly under the hips. Most of the time the bed will be soft enough, but if your knees need more cushion, then you can add a pillow under your knees. Start by tilting the pelvis backwards and arching the back up like a cat would do when stretching.
Remember to keep the ranges small in the beginning as you get acclimated to the movement. Follow this arching motion by tilting the pelvis forward and allowing your back to arch in the opposite direction and sticking your butt out. Work your way between both of these positions to improve the mobility of the back. Symptoms that go away from the back and into the hip or leg are a sign that you are going too far or aren’t ready for this exercise just yet and may do best with adding in extension based stretches. There may be some discomfort associated with this at first, but nothing that goes down the leg or back.
Prayer Stretch
The prayer stretch allows the spine to flex priming the vertebrae for the day. Start in the bed with your hands and knees set up similarly to the cat camel. This allows you to remain stable throughout the movement. Start with your hands under the shoulders and knees in line with the hips. From there, tilt your pelvis so that it is underneath you. Think about contracting your abs. Arch your back up like a cat then rock backwards bringing your hips down to the back of your legs. Make sure you keep your hands where they started as you go back. Hold this pose for about one full breath, then return to the starting position.
Common Questions About Bed-Related Lower Back Pain
How do you stretch your lower back and hips in bed?
Start with gentle movements like pelvic tilts, trunk rotations, and knee-to-chest stretches. These foundational movements help activate core muscles while gently mobilizing stiff joints.
Focusing on these exercises is an excellent way to get your body moving and potentially avoid morning stiffness.
If you've been diagnosed with a pinched nerve in your back, or think that you have that, you might be a bit more sore in the morning! Nothing to fear here, but you may benefit from a slightly different version of stretches for a pinched nerve in your lower back.
How do I relieve lower back pain when sleeping on my back?
The quick fix would be a night time stretching routine to relieve lower back pain, initially lying on a heating pad when you lay down, or rolling up a kitchen towel to place in the arch of your back when you first lie down. The long term fix would be to see a movement specialist to figure out WHY your back is hurting in the first place.
Everyone's back pain is unique. It is usually a matter of your activity or lack of activity during the day that is contributing to your symptoms. According to clinical practice guidelines from the American Physical Therapy Association, pain patterns often reflect daily activity levels rather than sleep position alone2.Inflammatory pain is worse at night and we also have less things to distract us at night so we are more receptive of the pain.
It is more common for people to have pain right when they lay down that goes away once they can fall asleep. However, if you are only having pain during the night that is waking you from sleeping, that is an important conversation to have with your physician.
Usually the mattress gets late for issues that are caused from activity or lack of activity during the day. Meeting with a specialist I can send the activities you’re doing during the day can help to alleviate that rebound pain and you may be feeling at night.
Why does my lower back hurt only in bed?
Is it very unlikely to be your beds fault and much more likely to be due to a movement pattern throughout the day or injury your body is healing from. Before you throw out your mattress and go buy something adjustable that promises you all of the relief you've been dreaming of, consult with a movement specialist to tease this out.
The Impact of Consistent Morning Stretching
Starting your day with gentle stretches can significantly reduce the time it takes for your body to overcome morning stiffness. Just like my grandmother's example shows us, consistency is key. A regular morning routine can:
- Reduce pain and improve function before starting your day
- Prime your body for movement
- Improve mood and reduce stress
- Create a positive start to your day
Getting a win by completing 10-15 minutes of self-improvement can have a lasting effect on the rest of your day.
Revision Health Services offers telehealth for Florida residents and in-person physical therapy in Jacksonville, Nocatee, and St. Johns, Florida. To discuss whether our approach could help you, reach out to schedule a consultation.
Until next time, stay healthy, keep moving, and take care of yourself.
