From the Guidelines
Nighttime back pain is defined as back pain that occurs or worsens at night, often indicating underlying medical conditions such as ankylosing spondylitis, infections, tumors, or spinal disorders, which requires prompt medical evaluation for early diagnosis and effective treatment. According to the American College of Physicians and the American Pain Society guideline 1, nighttime back pain can be a symptom of various conditions that may respond to specific treatments. The guideline suggests that clinicians should inquire about the location of pain, frequency of symptoms, and duration of pain, as well as any history of previous symptoms, treatment, and response to treatment. Some key points to consider in evaluating nighttime back pain include:
- Risk factors for cancer, such as a history of cancer, unexplained weight loss, failure to improve after 1 month, and age older than 50 years 1
- Risk factors for vertebral infection, such as fever, intravenous drug use, or recent infection 1
- Risk factors for vertebral compression fracture, such as older age, history of osteoporosis, and steroid use 1
- Symptoms of ankylosing spondylitis, such as younger age, morning stiffness, improvement with exercise, alternating buttock pain, and awakening due to back pain during the second part of the night only 1 It is essential to note that nighttime back pain can be a sign of a serious underlying condition, and prompt medical evaluation is necessary to determine the cause and provide appropriate treatment.
From the Research
Nighttime Back Pain Definition
There are no direct definitions of nighttime back pain in the provided studies. However, the studies discuss various aspects of back pain, including its causes, symptoms, and treatment options.
Causes and Symptoms of Back Pain
- Lumbar spinal stenosis is a prevalent cause of low back and leg pain in older persons, affecting an estimated 103 million persons worldwide 2.
- Back pain can be provoked by lumbar extension, relieved by lumbar flexion, and confirmed with cross-sectional imaging, such as computed tomography or magnetic resonance imaging (MRI) 2.
- Spine-related pain is increasingly common in older adults, and medications play an important role in pain management 3.
Treatment Options for Back Pain
- Nonoperative treatment for lumbar spinal stenosis includes activity modification, oral medications to diminish pain, and physical therapy 2.
- NSAIDs, acetaminophen, corticosteroids, gabapentin, and pregabalin are commonly used medications for spine-related pain in older adults 3.
- Muscle relaxants and NSAIDs may be superior to placebo for reducing pain in acute low back pain, but the effects of opioids, antibiotics, and antidepressants are unknown 4.
- NSAIDs are slightly more effective than placebo for short-term reduction of pain intensity and improvement in disability in acute low back pain 5.