By Jenny Lim
Physiotherapist at Life Ready Physio CBD

With some injuries, your pain can feel worse at night, which can be a frustrating, or even a worrying experience. If you do have night pain, it is important you discuss this with your physiotherapist or doctor and have this properly assessed. Night pain may simply be due to being unable to position comfortably or accidentally rolling onto a painful site whilst sleeping. However, if the pain is waking you even when you’ve been lying still, this may suggest more serious pathologies.

These are some causes of night pain:

• Arthritis
• Cancer or tumours
• Fractures
• Infections
• Nerve irritation or compression
• Pain after surgery
• Strains or sprains

Fewer distractions at night can make pain seem more prominent. Our minds become pre-occupied with work and daily chores during the day that we don’t pay as much attention to what we’re feeling. Try not to focus on your pain, and go to sleep as usual if possible. If not, being more active during the day (adding in some walking or appropriate exercise) will make your body more tired and ready for sleep at night.

Bony stress injuries can feel worse at night due to increased inflammatory processes happening at night. This process is important to bring necessary cells to the affected site for growth and remodelling or healing to occur.

Nerve pain also tends to be worse at night time as our bodies have a lower blood pressure during sleep. With a reduced blood supply to nerves, they can be more sensitive than normal. If you wake up from a known sensitive nerve issue, performing some simple exercises that your physiotherapist prescribed can help settle this down. Essentially, with movement, the nerves will be nourished with blood again and you should be able to return to sleep.

Appropriate and supportive positioning can also help reduce night pain if it is due to a known sprain, strain or post-surgery discomfort. Utilising one or two pillows to support an affected limb and reduce the possible over-stretching, compression or movement during sleep may help.

These are just a few examples of why pain may be worse at night, so if you are suffering from any of the above, it is important you get this investigated with your doctor or physiotherapist.