Much has been made the last few years about non-biological factors affecting pain. Psychological and sociological ones. What’s referred to as the BioPsychoSocial approach to pain management. For instance, if you’re someone who is prone to depression, or in poverty, that can influence your chronic pain susceptibility.
This has had times of being incredibly overblown,
–This whole pain science “revolution”
Since the dawn of man, we’ve known pain can be quite individual. One person sprains their ankle and they keep playing basketball. Another does it and is on the couch for a month.
One recurring theme from the Psycho element is the importance of sleep. You get a solid eight hours a night? You’re less likely to suffer chronic pain. Again, I don’t think this is surprising anybody.
However, optimal sleep is always tied to a better mental state. Something I’ve reiterated on this site is almost any psychological factor we look at with pain cannot be removed from biological factors.
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Sleep influences your joints too
We saw this in,
–Morning low back pain- cause and solution
The longer a person is horizontal per day, the longer their spine gets. This is why we are taller in the morning than in the evening. The spine fills with fluid during the night while laying down, then empties out as gravity compresses our spines during the day.
Get too much fluid in the spine? The low back can get painful. Astronauts are notorious for painful low backs due to a lack of gravity.
Wellllll, get too little fluid in your spine (like from not laying down / sleeping much), and that’s not good either. After all, what do we call discs which have lost their normal height? Degenerated ones.
A degenerated disc won’t have as much cushion in it,
Thus, we have a clear biological factor when we sleep too little: how our discs are hydrated.
Same deal with the knees. We’ve seen this in,
–How sitting kills you(r knees)
When we compress our knee, 
We squeeze the fluid between the top of the knee and the bottom of the knee. This happens when we say, take a step and our foot is contacting the ground.
Then we continue that step, our foot comes off the ground, and we decompress the knee: fluid comes back in:
Cartilage can only handle so much compression in a given day. Given enough, cells start to die.
-> Cells die quicker if they’re statically loaded than if dynamically. That is, walking is healthier than sitting.
Where again, if you’re someone not sleeping as much as you should be, you may very well be compressing your knees more than you otherwise would.
This same line of reasoning can be extended to the hips and the ankles. Essentially all the daily weight bearing joints.
More can happen at the spine. Let’s say you’re someone who is prone to having extension issues at your lower back. That is, extending back is more likely to flare you up.
Extension on left; Flexion on right.
Another way to view this is having more of an arch in your lower back makes you more likely to have pain (anterior pelvic tilt):
The more we sleep, the less of a curve we end up having in our lower back:
Before (left) and after (right) bed rest.
Thus, if you’re someone who isn’t sleeping much, you’re not lessening that low back arch each night. You’re more likely to be in that extension you’re susceptible to having pain in.
Or, if you’re someone who is prone to having pain from having your upper back hunched over,
Then by not sleeping as much you’re not giving your body as much of a break from that kyphosis. After all, when we lay down, the spine is either straight, or it at least isn’t having to resist gravity. This is why many with upper back issues will find relief in sitting in a recliner, or laying down.
Nobody disputes a poor night of sleep can make everything feel like crap. That someone regularly not sleeping well can be signs of a host of issues. It’s one reason I ask every new client how they judge their sleep habits…but it’s not the only reason. Because you can’t immediately say the only effect of poor sleep is purely a mental change.
If your only lens is whether a muscle is strong or flexible, then yeah, it makes sense to think a lack of sleep didn’t change whether a muscle is strong or flexible (though it might!), so “we have to look at the brain.” However, if your lens is how a person moves through the day, then changing how much a person lays down, changing the amount of hours they’re standing or sitting, obviously you’ve also changed how they move!
And let’s not forget, the position you sleep in can cause pain too!
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Posted on October 2, 2020