Getting up in the morning with back pain may be physiological factors, lumbar muscle strain, lumbar vertebral osteophytes, lumbar intervertebral disc herniation, ankylosing spondylitis and other factors. 1. Physiological factors: some strenuous exercise or heavy physical labor during the day may lead to the accumulation of lactic acid metabolites in the lumbar muscles, which may cause lumbar pain when getting up in the morning, mainly manifested as soreness without other clinical symptoms, and can be improved by itself after reasonable rest. 2. Lumbar muscle strain: the existence of lumbar muscle strain disease or at night when the waist is cold, caused by lumbar musculoskeletal fasciitis, can lead to get up in the morning lumbar pain, with the hand pressure, the pain can be aggravated. 3. Lumbar spondylolisthesis: If you have lumbar spondylolisthesis disease, when you get up in the morning, the proliferated bone will cause irritation to the surrounding tissues, which will lead to lumbar pain, and the pain will be relieved after light activities. 4. Lumbar intervertebral disc herniation: Lumbar degenerative disease, lumbar acute injury and other factors may induce lumbar intervertebral disc herniation. When sleeping at night, improper sleeping posture may aggravate lumbar intervertebral disc herniation, and lumbar pain may appear when getting up in the morning, which may be accompanied by numbness of the lower limbs, radiating pain in the lower limbs and other symptoms. 5. Ankylosing spondylitis: it may be related to environmental and genetic factors, patients may have lumbar pain when they get up, which may be accompanied by lumbar stiffness in the morning, which can be alleviated after activities. Getting up in the morning with back pain, lasting longer, and exclude physiological factors, it is recommended to go to the orthopedic department of the hospital for appropriate examination and treatment to avoid aggravation of the lesion.