Waking up with back pain may be caused by physiological factors such as fatigue and incorrect sleeping posture, or it may be caused by pathologic factors such as ankylosing spondylitis and lumbar disc herniation. 1. Physiological factors: Due to overwork during the day or incorrect sleeping posture at night, soft beds, etc., the lumbar muscles can be fatigued and strained without enough rest, and the next day you will feel back pain, which can be relieved after rest. 2. Ankylosing spondylitis: it is a rheumatic immune disease, the main lesions are in the sacroiliac joints, spine and its surroundings, which can cause pain in the lower back and obvious morning stiffness, and it is difficult to turn over in the morning. 3. Lumbar disc herniation: patients with lumbar disc herniation can suffer from pain in the lumbar region and hip due to nerve root compression, accompanied by pain and numbness in the lower limbs. Sleeping wake up feeling back pain may also have other reasons, such as rest symptoms have not been relieved, it is recommended that timely hospital consultation, improve the relevant examination, clear cause for standardized treatment.