General Question

rojo's avatar

Why does pain seem to intensify during the early hours of the morning?

Asked by rojo (24159points) August 25th, 2015

Not a new phenomena, I have noticed it for as far back as I remember, but recent events have brought the question to mind.

Why does it seem that an injury will hurt/ache more around, for me at least, 2 -3:00 am? It is not that I wake up worrying and focus in on the pain but that the intensity of the pain itself awakens me.
I go to bed with the injury, usually a dull throb at that point, wake up to sharp stabbing pain which gradually slackens off over the course of an hour and allows me to go back to sleep and then awaken with the same dull throbbing pain I had at bedtime.

Does it have something to do with REM cycles or normal sleep patterns? Would that explain why it occurs around the same time period?
I know I am not re-injuring the site while slumbering but am I perhaps stretching/stressing/pushing it past its limits it in my sleep?

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15 Answers

zenvelo's avatar

I would think it is because you have nothing else going on physically or on your mind, so the body’s awareness of pain is heightened.

Also, you are not moving your body much, so the muscles around the injury are not moving and radiate the pain.

SQUEEKY2's avatar

Not a medical expert ,but I would guess circulation is probably at it’s poorest time, and muscles are not limber at that time as well.
When I have night pain it always has helped me to get up and move around a bit.

Pachy's avatar

I wholeheartedly agree with both comments above. I know that when I wake up in the middle of the night with some kind of pain, that’s what my mind laser-focuses on. And, as @SQUEEKY2 says, it’s also the time when I’m least limber. Getting up and walking around, no matter what time of night it is, usually helps the most.

elbanditoroso's avatar

You’re lying down, not sitting up. Blood circulation, I imagine, is at a lower rate because you are relaxed.

ZEPHYRA's avatar

In my view it gets worse at night.

rojo's avatar

so @zenvelo what do you think is focusing on the pain initially? The subconscious? The pain is what wakes me up. And, do you think the pain actually gets worse or just seems worse? In other words is it an actual physical sensation or only an increased mental awareness of pain? In my opinion it is worse but my perspective is somewhat skewed.

Here2_4's avatar

The pain is not more intense. You have slept long enough by then for the pain to wake you. Until then, you are too tired to wake.

rojo's avatar

@Here2_4 And the intensity? Does it just seem worse or is it actually worse? It feels different, at least in this case, more of a sharp, stabbing pain instead of the dull throbbing pain I went to bed with and then subsequently wake up with.

I do like the idea that I have slept long enough. I read somewhere that the natural sleep cycle prior to the invention of electricity was 4 hours sleep, 1 awake then 3 or 4 more asleep depending upon the seasons and amount of daylight hours.

Buttonstc's avatar

Another contributing factor is that at that time, your hormone levels are at their lowest, including Cortisol.

Since Cortisol affects inflammation (among many other things) I would assume that the pain is not solely a matter of perception in the mind, but has a physical component as well. The less inflammation, the less pain.

So since Cortisol affects inflammation, the less of it that’s available to your body, the greater the inflammation.

I’ve noticed this with arthritis in knees as I’ve experienced the same being woken up from sleep by pain. The more inflammation the greater the pain.

Here2_4's avatar

Pain is nothing but a signal. The injury is just getting better, or not. Pain is the signals sent to the brain to make it aware something is wrong, so it can be discovered. It is like the letter that comes to tell someone their best friend has died. The letter did not cause the death, did not happen at the same time, and did not come from the same source. A messenger delivers, and that is when you become aware that something has gone wrong in your life. You can revisit the letter, reading it over and over, letting the reality sink in. The letter will never be anything more than a message though.
Looking at it that way, you can see how during daytime activity can dull the pain. It is distracting you from being fully aware of the letter. Something may happen, a photo, or newspaper could catch your attention, and make your focus return. Maybe a family member calls, whatever. Same with pain. You could stumble, or stop to rest, or any number of things which cause you to focus more directly toward yourself, and your injury then seems more painful.
During the night, you reach a point where you can be well rested, maybe not fully, but enough for a part of your brain to say, “Oh yeah, what about the thing? Is it still needing repair? Oh gosh! I guess so!”
Of course, if something actually gets worse, that too will cause a flare up in the pain, because there is a new message.

JLeslie's avatar

It depends on the injury. If I sleep in the wrong position, with the injuries I have now, it does cause me pain. I sleep very heavy, so I’m likely to stay in an uncomfortable position for a while.

If I sleep in a good position I can wake up in zero pain, and no pain is very rare for me the last 3 years. It’s a gift when it happens and I notice. Being pain free never lasts through the day.

When I had a back injury years ago it was similar. Sometimes the pain at night was just awful, but usually the least pain I had was in my bed, and waking in the morning was my least painful time. As the day progressed the pain got worse.

Hypocrisy_Central's avatar

The BEST ADVICE I can give you is SEE YOUR DOCTOR, second best advice is any advice you get here, get a second opinion from your doctor. I don’t know why people ask question about their health, especially specific things as you describe in Fluther. Unless someone holds a medical degree, how would they know? Even if they did have a medical degree, how would they know without even examining you or running test? Excuse the bad analogy but it is akin to someone asking why when they are driving down the road at 45–51 mph they hear a sound like scraping metal then their instruments go haywire for 15 seconds then all is normal again. How would a roofer, school teacher, UPS driver know? Even if they knew about cars, until they lay eyes on it, take it for a road test, they can still only guess. Go see your doctor how do you know it isn’t a symptom of something worse, even if you feel fine during the day?

msh's avatar

When ill, one always feels worse in the early evening on into the night. When you get hurt physically it always hurts the worst the second day after the incident. But oh, when you have overextended yourself- it zaps you immediately upon lying down or sitting still. Wow! You’re all relaxed and calm then, perhaps even exhausted. Lookout- you’re doomed! I always wonder if the body parts start getting together and begin compiling a list of physical complaints, and spring it on the brain when all is quiet. The brain thinks: ” Ooo good sleeping tonight! Yeeesssss! ” Meanwhile the body thinks: ” Ok, so what time do we all want to gather to wake the brain up out of it’s blissful slumber and ruin the entire night? Uhm, muscles? You went first the last time…Bones? Digestive? Back? Saaay Back- it’s almost two days after the lawn ‘incident’- you have priority….. ”
You can’t win! And all the internal noise and arguing! Wow!

JLeslie's avatar

What exactly is your injury? Where is the pain?

Studies regarding pain show that people can experience pain more depending on many things. When we are distracted the pain often is much less. Distracted meaning busy doing something else. People argue that focusing on being involved or productive can reduce pain. Also, there are studies that show depression can be physically painful. When you wake in the wee hours your mind is possibly more clear to perceive the pain. I personally rejected this theory for pain I suffered with chronically in my late twenties and early thirties, because my pain is what made me able to go to another doctor, do research, and push through bad anxiety regarding the medical community. But, I can see how the theory makes sense.

When I did some reading about pain (I didn’t read much about it) it was regarding my back injury and back pain, which is not the chronic medical problem I mentioned just above.

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