Women may wake up with back pain in the morning for the following reasons: 1. There may be misalignment of the small joints of the thoracic spine. This condition is common in women who sit and work with their heads down for a long time, or in women who are relatively thin. Once this occurs, there is often a sore back after waking up and there is a significant restriction of movement. 2, there may be a case of overexertion. This is often seen when the patient has done excessive exercise involving the back on the first day, which leads to a large amount of lactic acid deposition in the muscles here, thus feeling soreness in the back the next morning. 3, there may be an injury here. For example, if the patient has done activities such as dance or yoga before and strained the muscles here, he or she may feel soreness here the next day. 4. It may be caused by cold. This is often seen when the patient’s back is underclothed during the day or not covered at night, causing muscle spasm or sterile inflammation, which causes women to wake up with back pain in the morning.