Ever wondered why chronic pain often worsens at night? Chronic pain fluctuates during the day and can sometimes be better in the morning or worse in the evening and vice versa. Havard-affiliated Benson-Henry Institute of Mind Body Medicine director Ellen Slawsby said that at the end of the day, it doesn’t mean one will get a break from the flare-ups. Still, in some instances, this is when pain is elevated and can interfere with sleep. 

How is chronic pain characterized? 

Chronic pain persists for at least 2-3 months, frequently long after the initial injury or sickness has healed. The discomfort might persist indefinitely. It could affect a single joint or muscle or exclusively impact certain parts of the body, such as the neck and back. Diffuse chronic pain may result from diseases like fibromyalgia or arthritis.

Signs and intensity of chronic pain can range from a dull ache to shooting, burning, piercing, and electrifying shock-like sensations, along with numbness and tingling.

What does chronic pain increase at night?

There are various explanations for why pain worsens at night. Slawsby explains that hormones could be the reason. According to her, cortisol, an anti-inflammatory hormone, is at its lowest at night, which explains the elevated pain. Additionally, research suggests that pain might follow a circadian rhythm similar to the internal 24-clock responsible for regulating the sleep-wake cycle. Slawsby says this could explain why pain worsens at certain times, like at night.

There is never a better moment for chronic pain, but the night is particularly bad since it interferes with sleep. Lack of sleep impairs your capacity to control discomfort. And those who have chronic pain frequently experience sleep issues. Most patients diagnosed with insomnia, the most prevalent sleep disorder, experience chronic pain. 

Slawsby explains that sleep insomnia can result in sleep deprivation which increases cytokines involved in inflammation response making someone more sensitive to pain. To manage pain at night, consider a pre-bedtime relaxation routine, have a healthy sleep environment and reframe thoughts to avoid anxiety and stress.