Midnight four or five o’clock back pain wake up during the day is fine, the main reason to consider and spinal lesions, myofascial lesions, internal organs lesions, cold or mattress is not suitable and so on. 1. Spinal lesions: when there are spinal lesions, such as degenerative lesions such as lumbar disc herniation, lumbar osteophytes, lumbar vertebral body slippage or spinal tumors, may cause spinal pain symptoms when lying down, so that back pain in the middle of the night at 4:00 or 5:00 woke up during the day is fine, normal. 2. Myofascial lesions: usually, if the posture is poor for a long time or excessive exercise and exertion, back muscle strain or myofasciitis, back pain in the middle of the night is likely to occur, but the symptoms will not be particularly obvious during the daytime activities. 3. Diseases of internal organs: when there are diseases of internal organs, such as angina, gallbladder stones, reflux esophagitis, etc., it is easy to produce the symptoms of radiating pain in the back, and the probability of pain attacks in the middle of the night is relatively high. 4. Cold or unsuitable mattress: the middle of the night four or five o’clock temperature is relatively low, if you do not pay attention to the back of the warmth, the local cold easily triggered by the symptoms of pain. Normally, if you choose an inappropriate mattress, the spine is in an abnormal posture for a long time, but also prone to pain. If the pain is frequent, you need to check the cause of the disease, and standardized treatment under the guidance of a professional physician, so as not to aggravate the symptoms.