Dr. Mark Kestner (crop)


Last week a patient told me, “Since I have been coming here, not only am I having much less pain, but my husband says I don’t snore as much. Is that possible?”

One of the more frequent things patients tell us is how much better their sleep is, often after the very first treatment. We are often primarily focused on a complaint of chronic joint pain, perhaps neck or back pain or it could be rotator cuff, carpal tunnel, knee joint pain or any other joint pain. But we constantly hear patients tell us of a side benefit of better sleep.

Obviously, there is a relationship between poor sleep and joint pain. But, is the pain causing the poor sleep or is it the other way around; poor sleep resulting in joint pain.

According to research, it can be both. Joint pain can cause sleep interruptions. Poor sleep can cause joint pain and many other maladies.

According to the Arthritis Foundation over 80% of patients with joint pain report sleep troubles. The foundation also reports there is a reverse association as well. 

“Patients often attribute sleep problems to pain. While pain can certainly contribute to sleep problems, the more we learn about sleep, pain and inflammation, the more we find the relationships are likely to be multidirectional,” says Yvonne Lee, MD, Assistant Professor of Medicine at Brigham and Women's Hospital in Boston.

“Which problem starts first is different for different people — but once one of these issues occurs, they lead to the others and can come full circle.” –Arthritis.org

What we have seen in our own office is that when patients tell us they are sleeping better very early in a treatment plan they are very likely to report significant improvement in their pain shortly thereafter.

It is impossible to be truly healthy if a person is not sleeping well. Without the adequate amount of restful sleep during the night various health issues will begin to develop.

For patients with arthritis or other chronic painful conditions, poor sleep will often result in increased pain the following day. It can turn into a vicious cycle. The sleep problem persists and so the chronic pain issue becomes worse.

When we work with patients with chronic pain, we may be providing medical acupuncture, gentle chiropractic type care, neurological rehab to reduce persistent neurological pain such as neuropathy, physical rehab to help restore normal movement, non-surgical spinal disc decompression to relieve pinched nerves such as sciatica or other treatments. 

Regardless of the exact treatment regimen, we have heard multiple patients report improved sleep soon after beginning their regimen.

This sleep improvement applies to a wide age range as well, from patients in their 30s to over 80.

Sleep problems can result in numerous health issues that can cause increased pain. Arthritis Foundation’s Dr. Lee explains why the sleep affects the pain experience:

The big question is why does disrupted sleep affect pain? The culprit, Lee says, may be found in the central nervous system (CNS). Lee explains that studies show CNS pathways (the spinal cord and brain) that regulate pain may be abnormal in people who are not sleeping well.

Another theory is that sleep problems may lead to increased inflammation throughout the body. 

“Studies in healthy individuals have found that sleep deprivation is associated with an increase in inflammatory markers measured in the blood,” Lee explains. “It is possible that an acute inflammatory response to sleep deprivation could lead to more long-term problems.”

The study of pain is perhaps one of the more important areas of research to improve the lives of patients. I have found that the research of pain leads to developing a greater understanding of how the body’s inflammatory response works, how the central and peripheral nervous system modulates the pain response and how our bodies work in such complex ways that involve the painful experience.

Amazingly the impact of pain-relieving drugs, the emotional state of the patient, lifestyle factors such as nutrition, drugs, posture, activity levels, sleep habits and even choice of entertainment and news sources can play a role in pain. By participating with groups such as America Academy of Pain Physicians I have learned more about the need for multiple types of professionals to work together to address solving the mysteries of pain.

Although many people that experience sleep issues will resort to taking a pill that makes them sleep, these chemical solutions may not actually produce healthy restful sleep. Even though the person sleeps more during the night, many health issues such as increased chronic pain may persists.

That is why it is rewarding to hear patients report better, healthier sleep simply as a result of treatment to improve their body’s natural function and reduce pain. For better function and less pain, look for healthy ways to improve your sleep.

Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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