How to manage pain for better sleep

Two thirds of people who have back pain also have disrupted sleep. However, disruption in sleep also exacerbates the back pain. Sleeplessness and back pain go hand in hand.

What is Pain

The majority of acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) fit together and move.

Acute back pain is defined as pain that lasts between 4 and 12 weeks.

Chronic back pain is defined as pain that persists for 12 weeks or longer. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year.

Back pain can be caused by:

  • Sprains and strain
  • Sciatica
  • Ruptured discs
  • Disc degeneration
  • Traumatic injury
  • Skeletal irregularities
  • Kidney stones
  • Osteoporosis
  • Endometriosis
  • Fibromyalgia
  • ME and Chronic Fatigue Syndrome

Common Sleep problems that prevent us from sleeping are asthma, cramps, restless legs, sleep apnoea, itching, allergies, colds and pain.

Back pain is a common condition and in the UK & Ireland, it is the largest cause of work-related absence.

In the majority of cases, the cause of back pain can be linked to the way that the bones, muscles and ligaments in the back work together.

People with osteoarthritis and other types of arthritis experience problems sleeping. People with fibromyalgia, a condition that causes joint and muscle stiffness as well as arthritis-like pain, also have difficulty sleeping.

According to the National Sleep Foundation, two out of three people with chronic pain have trouble sleeping. The stimulation of pain is what keeps the brain active.

A study in the April 2009 issue of Sleep Journal showed that normal, healthy individuals are more sensitive to pain when they are low on rest. The reasons why aren’t known for sure. “Some research studies show that sleep deprivation causes increased production of inflammatory chemicals in the body called cytokines, markers for inflammation.

The effects of Stress on Pain

Pain is part of the body’s defence system, which triggers mental and physical responses in order to cease whatever is causing the pain to occur.

When people feel emotional pain, the same areas of the brain get activated as when people feel physical pain. It uses the same neurological pathway. With a physical injury, we can feel the pain in the location of the body. With emotional pain like grief, our muscles react by hunching over to protect the heart. Our body posture can tell a lot about how we are feeling emotionally.

Pain at night that robs you of your much-needed sleep can be absolutely exhausting. A person simply cannot get comfortable enough to get asleep and it can cause a lot of anxiety.

Inflammation, bad gut flora and a weak immune system can contribute hugely to depression.

Chronic stress causes excess cortisol in the body and the brain. This leads to inflammation and a surplus of the neurotransmitter glutamate which in turn leads to free radicals, damaging and even killing brain cells. Excess inflammation can lead to depression and possibly an over active immune system resulting in an autoimmune disease. If there is an over active immune system, the patient is less likely to respond to antidepressants. Therefore, a high percentage of people taking medication, aren’t getting any benefit from them. So keeping a strong immune system and a healthy gut is vital.

Our muscles tighten when we experience stress and tension causing lactic acid which results in pain. Tension headaches along with neck and lower back pain are indicators of stress. Stress increases inflammation in the body and aggravates arthritis. Stress causes a cascade effect in the body when the brain signals the release of adrenaline and cortisol. These steroid hormones boost our blood sugar and oxygen levels, push more blood to the brain, and the result is increased alertness to pain signals. As a result of pain, people are getting shorter sleep durations adding to the already exasperating problem at hand. Those with acute or chronic pain are more likely to have sleep problems impact on their daily lives.

When we are stressed we find it difficult to slow down and turn on the para-sympathetic nervous system, our rest or relaxing state which is vital to prepare for sleep. Making sleep a priority, changing the sleeping environment and getting more sleep will help get a better quality of sleep even those who experience pain.

How do you deal with stressful situations?

People experiencing chronic stress or emotional trauma also experience chronic pain.

  • Acknowledge
  • Be mindful, accept the present
  • Mind yourself and practice self-care
  • Get support
  • De-clutter
  • Exercise/Movement
  • Go for a massage
  • Eat well

If stressful life events are causing you pain, it may be time to talk to a pain specialist. They can help you find holistic methods for managing stress and treating your pain. 

Walking in the park

Managing Pain

Pain is something that hurts you. It is the response of something that hurt you. Suffering is the response to pain. Controlling pain is the first way to help reducing anxiety and depression which will help to improve sleep.

Opioid pain medications like morphine and codeine have side effects that can cause apnea, brief pauses in breathing, during sleep. “Therefore, people who take these kinds of medications for chronic pain are at a higher risk for sleep problems.

If the cause of your sleeplessness is pain, then the most logical step to take is to control or eliminate the pain.

Firstly, you want to reduce inflammation because inflammation is at the root of most, if not all, pain.

  • Always rest for a few days after surgery even if you think you don’t need it.
  • Calm yourself with meditation and other relaxing techniques.
  • The best types of low – moderate exercise for pain is yoga, swimming or gentle walking.
  • Massage or Reiki
  • Take day time naps
  • Don’t use alcohol at night to get to sleep and avoid caffeine
  • Warm bath with salts
  • East anti-inflammatory foods like turmeric, berries and omega 3’s (salmon, nuts and seeds)
  • Talk with your occupational or physical therapist about the right bed/mattress to use.

Stress may be inevitable, but that doesn’t mean we should just let it happen. It can take a serious toll on our everyday functions including our sleep. Learn how to acknowledge and embrace pain, mind the language you use and practice self-care often. This will help significantly to manage pain better and helping you get a more restful and restorative night’s sleep.

If you have mild to moderate pain that keeps coming back and that you can’t manage at home on your own, you may need to see your GP or Health Care Physician. If you have chronic pain that is constant, or if treatment does not control the pain, you may need to see a pain specialist.

If you enjoyed this article, check out my book ‘How to get a good night’s sleep’ for more helpful information.

Resources

https://www.webmd.com/sleep-disorders/features/pain-and-sleep#2

http://www.thejournal.ie/fybromyalgia-3819417-Jan2018/

https://www.webmd.com/pain-management/tc/chronic-pain-when-to-call-a-doctor#1

http://www.norfolkclinic.com/back-pain-uk-statistics/

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