Upper Back and Chest Pain After Sleep: Causes and Solutions

Waking up with upper back pain and chest pain?

In the past two weeks, I have started to feel discomfort in my chest when lying down, and it becomes more painful upon waking.
Initially, I thought it was pleurisy, but after paying closer attention, I realized it is upper back pain that radiates to the front of my chest.
Breathing and changing positions are painful.
During the day, it’s manageable (I only feel slight pain when pressing on certain areas or in specific positions), but at night, I wake up or feel intense pain in the morning, along with discomfort in my chest.
What should I do? Will it heal on its own, or which specialist should I consult? Additionally, I have been playing badminton four days a week for two hours each session for over ten years.
Last year, I had severe sciatica that made it difficult to walk, diagnosed as compression at the fifth lumbar and first sacral vertebrae, and I underwent a nerve root block.
Although it didn’t completely resolve the issue, it hasn’t affected my activity.
Is there a connection between this and my recent symptoms? I kindly ask for your guidance, thank you.

Fen, 50~59 year old female. Ask Date: 2022/03/17

Dr. Wang Shouji reply Orthopedics

Hello, the upper back pain is not related to the lumbar spine.
This pain may be associated with your physical activities.
It is recommended to reduce intense activities, apply heat, and perform stretching exercises.
You may take some pain relievers, anti-inflammatory medications, and muscle relaxants.
If the pain alleviates quickly, there should be no major issues.
However, if there is no improvement, you may visit an orthopedic or rehabilitation specialist for further evaluation.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2022/03/17

More Info

Understanding upper back and chest pain after sleep can be quite complex, especially considering your history of sciatica and previous spinal issues. Based on your description, it seems that your pain is localized in the upper back and extends to the chest, which can be indicative of several potential causes.

Possible Causes
1. Muscle Strain: Given your active lifestyle, particularly playing badminton four times a week, it's possible that you may have strained the muscles in your upper back. This can lead to discomfort that is exacerbated when lying down or changing positions during sleep.

2. Postural Issues: Poor sleeping posture can contribute significantly to upper back pain. If you sleep in a position that puts strain on your back or neck, it can lead to muscle tightness and pain upon waking.
3. Intercostal Muscle Strain: The muscles between your ribs (intercostal muscles) can become strained, especially if you engage in activities that involve sudden movements or heavy lifting. This can cause pain that feels like it's coming from the chest area.

4. Nerve Compression: Given your history of lumbar issues, it's possible that there could be some nerve involvement, particularly if there is any residual compression affecting the thoracic spine. This could lead to referred pain in the upper back and chest.

5. Referred Pain from the Spine: Conditions such as thoracic disc herniation or degenerative disc disease can also cause pain that radiates to the chest area.
6. Anxiety and Stress: Psychological factors can also manifest as physical pain. If you are experiencing anxiety or stress, this could lead to muscle tension in the upper back and chest, resulting in discomfort.

Solutions and Recommendations
1. Consult a Specialist: Given your symptoms and history, it would be prudent to consult a healthcare professional. A visit to a physiatrist (rehabilitation physician) or an orthopedic specialist would be beneficial. They can conduct a thorough evaluation, including physical examinations and possibly imaging studies, to determine the underlying cause of your pain.

2. Physical Therapy: Engaging in physical therapy can help address muscle imbalances, improve posture, and strengthen the muscles in your back. A physical therapist can provide you with exercises tailored to your specific needs.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain and inflammation. However, it’s important to use these medications as directed and consult with a healthcare provider if pain persists.

4. Ergonomic Adjustments: Evaluate your sleeping environment. Ensure that your mattress and pillows provide adequate support. You may benefit from a firmer mattress or a pillow that maintains proper neck alignment.

5. Stretching and Strengthening Exercises: Incorporate stretching and strengthening exercises into your routine. Focus on exercises that target the upper back, shoulders, and chest to alleviate tension and improve flexibility.

6. Mindfulness and Relaxation Techniques: If anxiety is a contributing factor, consider incorporating mindfulness practices such as meditation, yoga, or deep breathing exercises into your daily routine to help manage stress levels.

7. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur and any activities that may exacerbate them. This information can be valuable for your healthcare provider in diagnosing the issue.

Conclusion
While it is possible that your symptoms may resolve on their own, given your history of spinal issues and the nature of your pain, it is advisable to seek medical attention. Early intervention can prevent further complications and help you return to your normal activities more quickly. Remember, it’s essential to listen to your body and address any pain or discomfort proactively.

Similar Q&A

Understanding Morning Chest Pain: Causes and Solutions for Better Sleep

For the past two months, I have been waking up in pain almost every day after about 5 to 6 hours of sleep. The pain usually subsides within an hour. Initially, for over a month, I experienced pain in my entire upper back, specifically on both sides of the spine at the level of th...

Dr. He Dongjin reply Cardiology
Hello, it seems that the issue is related to muscle and nerve problems or possibly internal organ issues, which are generally unrelated to posture. If you experience pain when turning over, try eating some bananas, take B vitamins, and use muscle relaxants or pain relievers. Let&...

Understanding Back Pain After Sleep: Causes and Treatment Options

For about two months, I have been experiencing pain in my upper back after going to bed, which starts in the middle of the night. The pain can be severe enough to prevent me from falling back asleep, especially after drinking alcohol, which seems to exacerbate the condition. The ...

Dr. Ye Boshou reply Neurology
Back pain may be related to spinal or muscular issues. It is recommended to visit Taipei Hospital and consult a neurologist.

Chest Pain When Lying Down: Understanding Causes and Solutions

Hello, doctor. I have had trouble sleeping easily since my student days. In the past three to four years, I have noticed that sleeping in a position where my body is flat, my arms are raised, and my head is resting on the pillow helps me fall asleep better; so I have mostly maint...

Dr. Xiao Yongxun reply Family Medicine
Dear Ms. H: 1. When a clinician addresses the issue of chest pain, the first four critical conditions to rule out are myocardial infarction, pulmonary embolism, pneumothorax, and aortic dissection. If none of these conditions are present, differential diagnoses should be conside...

Understanding Chest Pain During Sleep: Causes and Concerns

Hello Doctor, I would like to ask: Yesterday while sleeping, when I turned to my left side, I suddenly felt a sharp pain in my left chest (although I usually sleep on my left side). When I turned back to my back or to my right side, the pain went away. I also happened to be exper...

Dr. Wu Yingxun reply Pulmonology
Hello: First, assess whether you have hypertension, hyperlipidemia, or diabetes, and a history of smoking. If so, you are at risk for cardiovascular disease. Please consult a cardiologist for evaluation or undergo a chest X-ray to rule out pulmonary issues. Gastroesophageal reflu...