Oh my, you have many things going on that are probably affecting each other and compounding your situation. I’m sure your stress level is surging, making things even worse. First, waking up 4-5 times a night and bad sleep are flags to me. Have you talked to your neuro or urologist about this? Most people with MS at some point develop sleep and bladder issues, but the good news is that there is much that can be done to minimize them. That said, these will contribute to your slow start in the morning plus increase your spasticity. Spasticity is a major symptom of mine, and I take a med (baclofen) that is quite effective in reducing the stiffness, which could also be contributing to your back pain. When I wake up, I’ve learned how to gently stretch my limbs, neck, and shoulders in a matter of 10-15 minutes and it’s extremely effective in reducing the spasticity. I learned how to do my “morning” routine in physical therapy. Again, consult with your neuro about P/T. Finally, a hot shower is a curse for most MSers, and will cause tremendous fatigue, weakness, and low energy—for not minutes, but hours. There are many articles you can search for these problems using this website’s search bar. I hope these ideas help. Check back and let us know how you are doing. 😊 Best- Debbie (Team member)