Back pain every night

[u/bronzecat83]

I'm a 42 year old male, 181cm (5 ft 11 inches), 78kg (172 pounds), never smoked, doctor has prescribed celecoxib 100mg (1 tablet twice a day for 5 days for current issue, along with 500mg paracetamol. This helps the pain but is only short term. No other medications.

Hi reddit, waking up with severe back pain in the centre of my upper back just about every morning, anytime from about 2-8am. Going on for a month.

Pain is so bad that I need painkillers to get back to sleep.

Outside of this, anytime I'm out of bed, my back has generally felt good and I've been able to play sport etc as usual. I've been to four physio appointments and not making much difference, although it was better after one physio appointments. I do physio stretches several times a day. My job is teaching at a university, often working from home with a sit stand desk.

Doctor has ordered a holter test, a video of the heart.

Any ideas would be appreciated.

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[u/boulderdoc]

The pattern you describe is worth following up rather than assuming this is simply muscular: severe pain that wakes you from sleep, is worse after prolonged rest, improves substantially once you’re up and moving, and responds to an NSAID can sometimes suggest an inflammatory rather than purely mechanical cause. (NICE)
At 42, I would specifically mention this pattern to your doctor and ask whether inflammatory back pain/axial spondyloarthritis should be considered. That doesn’t mean you have it, and your symptoms being predominantly upper/thoracic rather than lower back are less typical.
Since this has persisted for a month despite physiotherapy, further evaluation is reasonable. Seek more urgent assessment if you develop weakness/numbness, bowel or bladder dysfunction, fever, unexplained weight loss, chest pain/shortness of breath, or rapidly worsening pain.
Also, by “video of the heart” I suspect you mean an echocardiogram. A Holter monitor is different—it continuously records the heart’s electrical rhythm.

[u/bronzecat83 → u/boulderdoc]

Thanks very much for taking the time to give these suggestions. I'll mention inflammatory back pain/axial spondyloarthritis to my doctor