Why Is Pain Worse At Night?

Have you ever wondered why pain seems more intense at three in the morning than three in the afternoon?

Some reasons include skipped doses of pain medicine that you (hopefully) slept through, the absence of distractions, challenges getting comfortable and the normal daily variations in the body’s stress hormones that act as gatekeepers to decide which pain signal gets through to your conscious mind.

Here is what I believe to be the most important reason. Any pain is worse when you’re facing it alone. And at three in the morning it can feel like it’s just you and the pain.

If you like math, here’s the equation

Pain + Isolation = Suffering

Most people can tolerate high levels of pain; what is intolerable is being alone with the pain.

Pain is like the body’s fire alarm that says, “Stop. You’re in danger. Do something!” Two elements of the pain alarm system reside in different parts of the brain.

First, there’s the detector. No one likes a smoke alarm that blares every time you make toast. Your brain’s sophisticated network determines whether and when your conscious mind needs to know about the pain.

If there is danger, the brain activates the alarm in a primitive part of our brains called the cingulate cortex. This loud, annoying alarm is designed to wake you from sleep.

It turns out that the pain of social isolation sets off the alarm just as effectively as physical pain.

Further, the pain medication that treats physical pain also alleviates the pain of isolation.

We all have a thirst for human connection. It’s best managed like the thirst for water. Drink from the love cup during the day, then take a little sip at night as needed.

What do you think?

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6 Responses to Why Is Pain Worse At Night?

  1. Pingback: Tweets that mention Why Is Pain Worse At Night? | The Caregiver Club -- Topsy.com

  2. Mary MacCurdy says:

    I’ve done a good deal of reading on the subject but was unaware of these facts. Thanks for keeping me up to date and better able to handle the daily challenge of chronic pain. Having a computer handy to connect with absent loved one in the middle of the night is a tremendous help to me. One of the places to go is the web-sites of friends such as you who have an archive of such messages to comfort and inform thank you, Vickie!

    • vickirackner says:

      You are welcome, Mary! Leave it to you to find creative ways of managing chronic pain.

      You’re not alone. There are an estimated 53 million people walking in your shoes in the US alone.

      It’s very exciting to see all the new things we are learning about the brain. I’m optimistic that new discoveries about brain health and the body’s innate healing potential will improve the quality of life for people with chronic pain in the very near future.

  3. Sally says:

    Dr. Vicky,
    I had you on my radio show years ago, you were wonderful then and I see still are! I love getting these emails and will share this with many of my own patients!

    Stay well and please keep communicating, it is the best gift we can give to each other!


    • vickirackner says:

      Hi, Sally,
      Yes, communication is a gift, and I appreciate your taking time to write.

      I remember our interview fondly. You are a great host who made the interview fun for all of us–including your listeners.

      I’m honored that you pass these thoughts along to your patients. Please invite them into the conversation! We all benefit from the the shared wisdom, ideas and questions each person contributes.

  4. Trish5058 says:

    Pain is worse at night I think because of the barometer going up or down… I have fibro and disk disease. and neuropathy from diabetes.. and right around 6pm.. pain shoots high…. and goes on all night long..

    some Nights I only get a couple of hours…… and i take my meds on time… It has to do with something in the atmosphere in the dark hours…. this is my theory for what its worth… 🙂 ………. blessings to all who suffer…. I know how you feel…. 🙂

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