There are several possible causes of back pain in the morning: 1. Ankylosing spondylitis can appear as low back pain, which usually starts in the lumbosacral region and gradually spreads upward. Low back pain is more pronounced in the morning when you wake up, and you can have a stiffness in your lower back in the morning, which can improve after moving around for a while. This is the time to conduct relevant blood tests, as well as X-rays and CT examinations to confirm the diagnosis. 2, lumbar muscle strain and fasciitis can also appear in the morning when the back pain is very strong, the pain improves after a while of activity, to conduct CT or lumbar spine nuclear magnetic examination to exclude other diseases for diagnosis, common in patients with long-term bending work or sedentary, cold. 3, rheumatoid spondylitis, when rheumatoid involvement of the spine Low back pain can occur, the pain increases in the morning, can also be accompanied by symptoms of morning stiffness, then blood tests and X-rays, CT examinations to further confirm the diagnosis and treatment.