[Maru]

Daily Magnesium malate+malic acid for energy production/metabolism, which is very important for the health of muscle, and it has the benefit of working as a natural muscle relaxant and helping it repair. It can help with any diet/toxicity problems and increases movement/mobility. Magnesium helps a lot with sleep also and poor sleep quality can make it harder to heal. It helps balance calcium in the diet, especially if your diet is mainly processed foods.

General advice on pain medication/pain management: Start pain medication right away when you start to feel you might be heading for a flareup. Don't wait until the pain is so bad you can barely tolerate it. The pain medication won't be not nearly as effective, or worse, not work at all. Imagine pouring a cup of water into molten lava, it just creates steam. Maybe consider to take the medication 30 minutes earlier than the normal time during bad flares so that it isn't coming out of your system, so that can help to get through a flare. Obviously only if you really need it. If you're overly dependent on the medication and still miserable, then you might need to change it. It's normal to need to cycle through medications because we build a dependency. Imo, pain medication is really best done temporarily and it's a band aid. It's not at all addressing the issue and the pain cycles will only get worse, especially if already immobile.

Being sedentary will definitely make the pain worse. Physical activity is really important here, even if it's just walking or moving around. 1-2 mile walks a day is often all you need. Sitting for long periods isn't advisable, especially for the back? Muscle imbalances tend to occur in the back from example, if you have one or two spots in your back that likes to tighten up, there's another muscle that connects in the front of the ribcage that supports that muscle. It could be compensating for weaker/shortened muscles in the front of your torso because of poor/long periods of sitting. It took me a year to heal from neck spasms because of my height, I wasn't able to sit correctly to work and this caused issues. Narcotic pain medication actually wasn't needed and would've been a band aid. Instead I was put on Meloxicam/NSAID and a muscle relaxer while I went through physical therapy. I took these on and off, especially taking breaks from NSAIDS like Meloxicam, as constant use of it has a tendency to cause stomach ulcers. That's possible also with pain meds, so just be mindful. Pain medicine won't address the cause, it'll just mask the pain, but a good combination anti-inflammatory and a muscle relaxer will allow the muscles to heal and the knotted areas to release. They're still injured and that tender area will still have a lot of trigger points, so you have to do some kind of daily exercise/daily maintenance to make sure they don't knot up again. This can include diet.

Stay away from a high sugar diet, it is a mood depressant (which causes more pain) and can also cause inflammation to get out of control. Do a food elimination diet, if possible, to discover which foods may be a trigger. We all get inflammation from foods we eat, but it just depends. You can find list of common foods that cause inflammation online.

Cherie is 100% right, that strengthening the core is a possible cause. If you have no underlying issue, it's likely muscular and that may mean you have weaker muscles and then the pain could be the muscle that is overcompensating. You need strong enough muscles to sit up and hold up the neck for example (or sit straight) and if they're weakened, then eventually it will develop pain as other muscles overcompensate. So even if you get pain in one spot, it's more like referral pain, because the cause is elsewhere (weakened core/muscles in general).

If you struggle with chronic anxiety/stress also, look also into pelvic floor therapy. It's something that can be researched and done at home, but strengthening that can help with moods and also your back as a lot of the exercises (yoga-ish/yoga-based) are really very similar. Pelvic floor health is connected to nerve health and so supporting that can help release tight muscles in other areas as it impacts everything, including breathing. This is all stuff yoga addresses.

If you find sleeping on a bed makes your pain much worse, you might try sleeping in a recliner. Some people swear by it, especially if they also have problems with breathing.