Sleep is critical to your health and overall sense of wellbeing. But getting enough sleep may be easier said than done if you are experiencing nocturnal back pain. Chronic middle back pain while sleeping can disrupt your sleep enough to affect not just your nights, but your days as well. Keep reading for tips on how to manage or even eliminate middle back pain while sleeping.

What causes middle back pain while sleeping?

Your middle back is also referred to as the thoracic region. It roughly encompasses the area from the base of your neck to just below your ribcage, and includes the space between your shoulder blades.

Middle back pain at night is sometimes caused by something simple, such as bad posture or twisting too quickly. In these cases, the pain is usually temporary and you’ll find relief fairly easily with proper care and patience. In other cases, however, back pain has a more serious cause that will require professional intervention.

Middle back pain while sleeping may not be as widely discussed as other kinds of nocturnal back pain, but it can be just as distressing and must be taken just as seriously. Here are the major causes of middle back pain while sleeping.

Poor posture during the day

Much has been made about the amount of time people spend sitting — whether in the car, at work, or in front of a screen — and the effects this can have on your health and lifespan. But it’s not just sitting itself that can impact your life; it’s also the way you sit.

Spending prolonged periods of time leaning forward or hunching over can strain your back, leading to pain throughout your neck, shoulders, and back.


Arthritis is a very common cause of joint pain. Mostly affecting older individuals, it is characterized by:

  • Joint swelling
  • Stiffness
  • Pain
  • Loss of range of motion

In addition to the pain and discomfort caused by the arthritis itself, arthritis can make you more susceptible to injury as well.


Back injuries run the gamut from minor to life-changing.

In cases of minor injuries, such as those caused by improper lifting technique or turning the wrong way, your pain will likely go away by itself within days or weeks. But if the injury is serious enough, it can lead to long-term problems, including chronic pain.

Herniated or bulging disc

You have discs all along your spine in between each pair of vertebrae. Each disc is filled with a jelly-like substance that keeps your backbones from grinding against each other when you move.

A herniated disc occurs when one of the discs breaks open. A bulging disc is a similar condition, but instead of breaking open, the disc slips out of place and the inner substance “bulges” outwards but doesn’t rupture. Both conditions may be asymptomatic, or they may cause symptoms like pain, numbness, and weakness.

Herniated and bulging discs affect both the surrounding vertebrae and, often, the nearby nerves. These injuries are most common in the lower back, but they can also occur in the middle and upper back and even in the neck.

Vertebral compression fracture

A vertebral compression fracture, when one of your vertebrae cracks or collapses, is usually the result of osteoporosis or a traumatic injury, like a fall or an accident.

Vertebral compression fractures don’t always cause symptoms. When they do, the symptoms tend to vary widely, but there are some commonalities. These include pain and a permanent curve of the spine (kyphosis). The severity of symptoms will depend on the severity of the fracture and may worsen over time.


In rare cases, a tumor may cause middle back pain by pressing against the body parts (e.g. the nerves) near the spine.

Tumors can also trigger a vertebral compression fracture.

When is middle back pain while sleeping serious?

Most cases of middle back pain while sleeping are not serious. It is certainly disruptive, annoying, and even upsetting, but the underlying causes do not pose an immediate health risk. The symptoms can be safely treated with more conservative remedies.

However, as mentioned earlier, some middle back pain causes are more serious than others. If your middle back pain is accompanied by numbness and/or tingling, there may be underlying nerve damage. This can be caused by multiple conditions, some potentially dangerous, so it’s important to visit your doctor as soon as possible.

Further, any middle back pain that occurs with loss of feeling in your limbs or loss of bowel control is an emergency condition. Contact your doctor immediately if this occurs.

In addition, if you’ve tried some basic at-home remedies and your symptoms are still so severe that you can’t sleep well, make an appointment with your doctor as soon as you can. Without proper rest, your body and mind will quickly become exhausted. Any and all medical issues that prevent you from sleeping properly should be taken care of as quickly as possible.

How to sleep with middle back pain: 5 tips

Sleeping with middle back pain can be a challenge, but it isn’t impossible. Some remedies require making a purchase, while you can test out others tonight for no cost.

Below are some tips on how to sleep with middle back pain.

Rearrange your pillows

Most people use pillows to provide support for their head and neck while they sleep. But you can also use pillows to support your back and minimize pain while sleeping.

No matter which sleeping position you favor, there is a way to arrange your pillows to ease your middle back pain and get a better night’s rest. Try pillows between the knees if you’re a side sleeper or a small one under your knees if you sleep on your back. Try a different pillow to manage your neck pain if it’s leading to back issues.

Not working? Talk to your doctor for suggestions that could work for you.


Your nighttime routine can make a difference in how well you sleep at night.

Try performing gentle stretches before going to bed. This can strengthen and stretch your back to relieve pain and discomfort.

Change your sleeping position

When it comes to managing back pain at night, not all sleeping positions are created equal. For example, sleeping on your stomach forces your neck to rest in unnatural positions, straining your back.

The Cleveland Clinic offers this guide to evaluate your sleeping position(s) and to figure out whether it might be necessary for you to try some new ones. Our earlier post also discusses at length how certain sleeping positions can cause back pain and which ones may be better for you.

Buy a new mattress

Back pain can be exacerbated by an old, uncomfortable, or unsupportive mattress. One study suggests that medium-firm mattresses provide the best sleep quality. But don’t think of this as a hard and fast rule. You know your body better than anyone, and you are the only one who can choose the best mattress for you.

While mattress shopping, there are several things you can do to make sure you pick the right one. Before making a purchase, do some research on which mattress brand, style, and firmness might work for you. Some of this work can be done online, but it’s also important to go to the store, ask questions of the sales rep, and test out the mattress you’re con