Sleeping to four or five in the morning back pain may be caused by lumbar disc herniation, ankylosing spondylitis, ureteral stones and other diseases. 1. Lumbar disc herniation: patients with lumbar disc herniation may experience low back pain, which may be persistent or intermittent, and may develop at night, mostly due to the pain caused by the compression of nerves in the lumbar spine. 2. Ankylosing spondylitis: when ankylosing spondylitis develops, it is often accompanied by lumbosacral pain, which is more pronounced at night, and the patient wakes up with pain at night. 3. Ureteral stones: Ureteral stones can cause lumbar pain, accompanied by frequent urination, urinary urgency, urinary pain and other symptoms, lumbar pain in the early morning is more frequent, but may also occur at other times of the day. In addition, other conditions can also lead to waist pain at 4 or 5 a.m., you should go to the hospital in time for examination, after clarifying the cause of the disease, under the guidance of the doctor to deal with it accordingly.