Why is Pain Worse at Night?
Pain often intensifies at night due to a combination of factors. Several physiological and environmental changes contribute to this phenomenon.
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Hormonal Fluctuations: Cortisol, an anti-inflammatory hormone, reaches its lowest levels around midnight. This decrease can lead to increased inflammation and, consequently, heightened pain perception for conditions where inflammation plays a significant role. [Source: Common causes of pain at night include: Hormone levels – production of the anti-inflammatory hormone cortisol drops to its lowest point at around midnight, so this could see discomfort rise for certain ailments.]
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Circadian Rhythms: Our internal biological clock (circadian rhythm) influences various bodily processes, including pain sensitivity. Research suggests that changes in these rhythms may affect how we experience pain at different times of day. [Source: https://www.wired.com/story/why-pain-feels-worse-at-night/, https://www.health.harvard.edu/blog/do-we-feel-pain-more-at-night-202301182877]
Environmental and Behavioral Factors:
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Reduced Distractions: During the day, work, activities, and social interactions often distract us from pain. At night, the absence of such distractions allows for a greater focus on discomfort. [Source: https://lluh.org/services/neuropathic-therapy-center/blog/why-nerve-pain-worse-night]
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Sleep Position: Maintaining a single sleep position for extended periods can cause joint stiffness and increased pressure on painful areas, leading to aggravated pain. [Source: Common causes of pain at night include: Sleep position – staying in one position all night can cause your joints to get stiff.]
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Nighttime Movements: Tossing and turning during sleep can exacerbate pain, especially in conditions affecting joints like the sacroiliac joint. [Source: https://comprehensivespine.weillcornell.org/why-is-my-sacroiliac-joint-pain-worse-at-night-2/]
Specific Conditions:
Certain conditions, such as neuropathy, are often reported to be worse at night. This might be due to a combination of the factors mentioned above, along with the unique characteristics of the condition itself. The disruption of sleep caused by the pain can create a vicious cycle, leading to increased pain perception due to lack of rest. [Source: https://www.massgeneralbrigham.org/en/about/newsroom/articles/why-your-neuropathy-is-worse-at-night]
