Wellfie Wednesday Tip #137: Sleep & Pain Sensitivity

Happy Wellfie Wednesday! Welcome back! This week is brought to you by Patrick (@TheFuelPhysio) and the topic revolves around how sleep can affect your pain sensitivity.

For starters, pain is a very complex thing, especially chronic pain, and it seldom deals with just a physical sensation. Our brain and neurological system controls a lot of it, and it can be a combination of experiences, exposures, and interpretations of painful situations, whether physical or emotional, that contribute to our sensation of pain. Now sleep, the body’s ability to recover, has been discovered to be something that should be of concern when it comes to pain and pain sensitivity.

A recently published study found that individuals with just a single night of sleep deprivation had a 15-30% increase in pain sensitivity, reducing their pain threshold. Meaning there interpretation of a painful stimuli came sooner than if adequate sleep was had the night before. In agreement with sleep playing a role in pain sensitivity, another recent study found that extended sleep could increase an individual’s pain threshold.

Both of these studies of course have several limitations, but their findings should still be considered. So if you or someone you know is dealing with pain, getting a better night sleep could be a good start. And I know that’s easier said than done for most. Check out this resource by the American Academy of Sleep Medicine for some helpful tips to improving your sleep.

Thanks for all of the support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio, @Eric_in_AmERICa, @FreestylePhysio, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Krause, A. J., Prather, A. A., Wager, T. D., Lindquist, M. A., & Walker, M. P. (2019). The pain of sleep loss: A brain characterization in humans. Journal of Neuroscience, 2408-18.

Simonelli, G., Mantua, J., Gad, M., St Pierre, M., Moore, L., Yarnell, A. M., ... & Capaldi, V. F. (2019). Sleep extension reduces pain sensitivity. Sleep medicine, 54, 172-176.

Wellfie Wednesday Tip #95: Reframing Pain (Part 2)

Happy Wellfie Wednesday! Welcome back! This week's post is brought to you by Aaron (@AaronPerezPT). Enjoy!

     Today's post correlates well with my last #WellfieWednesday post Reframing Low Back Pain. Where I had compared low back pain to the common cold. I really like that analogy; however, it seems most applicable to acute low back pain. Unfortunately, back pain is more likely to persist and can become disabling. Today’s post introduces a helpful way to reframe persistent pain scenarios through a simple yet powerful thought experiment and diagram.

The circle below represents my life and several activities that bring my life meaning and joy.  

At times, pain is also part of my life.

     Fortunately, I’ve never dealt with persistent pain and disability. However, I’ve worked with many people who have. And I’ve learned that sometimes when pain becomes a persistent problem we gradually do less and less of the activities we enjoy. This effectively makes pain a larger part of our life. 

     While pain alleviation is often a primary goal, making this the primary focus of rehab sessions can be unproductive. Rather, focusing on function and strategies that gradually allow us to resume meaningful activities can be really helpful. With more of our life back in the picture, pain will no longer be such a big part of it. It won’t be easy, but it can be done. Pain is often a part of life. Suffering doesn’t have to be. 

     This thought experiment really resonated with me when I first learned it at continuing education course a couple years ago. I’ve used it with many patients since then and found it often helps patients reframe their pain and understand the purpose of rehab. I hope it resonates and helps someone else suffering with persistent pain. 

Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt, @kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #91: Reframing Low Back Pain

Happy #WellfieWednesday! Today’s post is brought to you by Aaron (@AaronPerezPT).

     I hate getting a cold. Don’t you? My nose runs, my head and body ache, I sound even more nasally than I normally do. And what I hate the most, there’s not a damn thing you can do about it! Staying in bed just seems to make it worse as there’s nothing distracting me from the annoying scratch in my throat. Over-the-counter medications sort of help manage symptoms, but time seems to be the best medicine.

     I also hate getting low back pain. It’s just as annoying as a cold. It makes daily tasks a bit more tedious. And what I hate the most, there’s not a damn thing you can do about it! Staying in bed just makes it worse as there’s nothing to distract me from the ache. Over-the-counter medications sort of help, but time seems to be the best medicine.

     I first heard the phrase “Back pain is the common cold of the spine” from Adiraan Louw. I recall him using this metaphor in one of his presentations. When you think about it, the similarity really is striking. In short, damn near everyone gets it, and there’s not much you can do about it, so don’t let it stop you from living your life.

     Now, I know this advice is easier said than done.  Moreover, our reactions to these unfortunate experiences, particularly those of us in the medical field, are often in stark contrast. For a cold, you are likely to receive education, reassurance and encouragement that “this, too, shall pass.” For back pain, your treatment might be similar, but there’s a good chance it may also involve imaging and/or pain medication. How would you respond this recommendation? Would you have any hesitation to scan your back with an x-ray or MRI? Probably not, it seems reasonable enough. Now, how would you respond if the same recommendation were made for a cold? Imagine, “Sir/Ma’am, we’re going to need an x-ray of your face to ensure nothing serious is going on, and possibly an MRI to view the status of your boogers, x-ray won’t show those.” Seems ridiculous, right? It is! And, the kicker, research has shown some of our treatment recommendations for low back pain to be just as ridiculous. Recent guidelines are recommending far more conservative approaches for back pain.

     I realize I run the risk of over-simplifying and discrediting how debilitating low back pain can be. That cannot be dismissed, as low back pain is the leading cause of disability globally. Nonetheless, I firmly believe that reframing low back pain, and pain in general, to improve our response as a society will go a great way towards reducing suffering. Along those lines and coinciding with the title of this post, I highly recommend checking out Pain Reframed Podcast for more on reframing pain. I plan to do a mini-series on low back pain in hopes the blogs may be useful for those of us struggling with it. As much as it sucks, back pain is a part of life. When you catch it, keep calm, and crack on.

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt, @kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew