When there are primary tumors or metastases in the vertebrae and accessories of the lumbar spine, there can be symptoms of back pain when sleeping but no pain after getting up, then CT, MRI and blood tests of the lumbar spine should be examined for diagnosis. Second, osteoporosis, patients with severe lumbar osteoporosis can have symptoms of back pain when sleeping but not after getting up, so it is necessary to check the X-ray, CT and blood tests of the lumbar spine for early diagnosis, and if necessary, go to the endocrinology department to find out the cause. Third, severe lumbar strain and lumbar dorsal myofasciitis can also have symptoms of back pain when sleeping or worsening back pain when waking up in the morning, but can improve after moving around for a while during the day, so it is necessary to check and examine early to exclude other diseases for diagnosis.