My back hurts when I lie down but not when I stand. Why?

If your back hurts when you lie down, you should be alert to whether it is ankylosing spondylitis, because the pain of this disease is usually more obvious, especially it cannot be relieved after rest. In addition, this disease may also cause patients to experience symptoms such as fatigue, fever, anorexia, and medium in physical examination. It may also be symptoms of diseases such as cholecystitis or appendicitis.

(1) Ankylosing spondylitis

Ankylosing spondylitis is a chronic, progressive disease that causes pain in the sacroiliac region that radiates along the spine. The pain is aggravated by compression of the pelvis. The pain is often worse in the morning or after a period of activity and is not relieved by rest. The inability of the lumbar spine to flex forward is also a characteristic. The disorder causes local tenderness, fatigue, fever, anorexia, weight loss, and occasionally iritis.

(2) Appendicitis

Appendicitis is a life-threatening disease that causes pain that is vague in the upper abdomen or dull pain that moves to McBurney's point in the right lower abdomen. Inflammation of the retrocecal coccyx, pain can radiate to the back. The pain metastasis is preceded by anorexia, nausea and associated fever, occasional vomiting, abdominal tenderness especially at McBurney's points, and rebound tenderness. Some patients experience urinary urgency.

(3) Cholecystitis

Cholecystitis causes severe upper abdominal pain that may radiate to the right shoulder, chest, or back. The pain may occur suddenly or gradually worsen over several hours. Many patients have a history of pain after eating a high-fat meal, and symptoms and signs associated with the pain include anorexia, fever, nausea, vomiting, upper abdominal tenderness, abdominal muscle tension, pallor, and sweating.

(4) Chordoma

Chordomas are slowly progressive tumors that can cause persistent lower back pain and sacrococcygeal pain. As the tumor continues to spread, constipation and incontinence may occur along with the pain.

(5) Endometritis

Endometritis can cause sacral pain and severe cramping in the lower abdomen. The pain worsens before and after menstruation and during bowel movements. The pain is often accompanied by constipation, abdominal tenderness, menstrual disorders and dyspareunia.