There are several possible causes for back pain after waking up: first, back fasciitis, back fasciitis is often caused by long-term exertion, cold, then the symptoms of back pain will appear, the pain is worse in the morning, the pain can improve after a while of activity, then we should conduct physical examination and related tests to exclude other diseases for diagnosis. Second, rheumatoid, when rheumatoid involvement of the spine, can also appear back pain symptoms, often aggravated in the morning, then to carry out blood tests and spinal x-ray, nuclear magnetic examination for diagnosis and treatment. Third, ankylosing spondylitis, patients with ankylosing spondylitis can wake up with back pain and morning stiffness, which requires blood tests and spinal examinations for diagnosis and early treatment.