Chronic Lower Back Pain (CLBP) and Sleep disorder

I wasn’t exactly sure if my sleep disturbance could be regarded as a sleep disorder, but then some research made me understand the issue better. I am grateful that I have no issue with falling asleep or staying asleep but in the past few weeks I have suffered with lower back pain. In the past I have had the same condition that would follow the time when I had small babies. After consulting with my doctor, it was concluded that my lower back pain early morning right after I wake up or during the night is caused by the physical stress my body takes. It’s been a very stressful fall with kids in new school, a toddler and a workaholic husband. I was prepared for it but not sure if my body was J.  So, in my seven days sleep journal I have recorded lower back complain during the night and a desire to sleep in each morning. For my discussion I have chosen ‘Chronic Lower Back Pain” (CLBP) and sleep disorder.

Past research has shown a link between CBLP and sleep impairment with indications that strategies to manage CBLP can also affect control over quality of life (Kelly et al., 2011). Heffner et al., (2011) conducted a study of sleep disturbance on two groups of adults with one who suffered from CLBP and another that did not. The results showed that adults with CBLP had more sleep disturbance and the sleep disturbance also showed a link to higher ‘interleukin-6(IL-6)’ which is an inflammatory cytokine. The study concluded that IL-6 play a role in the sleep disturbance causes in patients with CLBP. The control group of adults showed no sleep disturbance but IL-6 results were similar to the other group.

What’s interesting is to understand if CLBP affects sleep or sleep impairment aggravates CLBP as research has shown to us that both issues are connected. Moldofsky (2001) highlights that there is a reciprocal relationship between pain and sleep, which I agree with. Their study reviews that sleep disturbances, pain e.g. lower back pain and psychological stress is observed in people who have had injury. Patients with irritable bowel syndrome have shown sleep disturbed and it’s understood that recognition of disturbed sleep can lead to management of ‘painful medical disorders’.

A regular exercise routine would be the optimal behavioral intervention to control sleep disorder as well as CLBP. Research has shown that some specific exercises like yoga, Tai chi or other stretching exercises that relieve muscle tension help with CBLP as well as sleep issues (Penedo,Dahn, 2005). Massage therapy is another technique that can be used as a behavioral intervention to relieve CLBP, stress hormone and sleep disturbances. Hernandez-Reif, Field, Krasnegor, Theakston, H. (2001) study design was aimed at comparing two groups of people with lower back pain with one group being treated with massage therapy and the other with relaxation techniques. After a 5 week study, results showed that massage therapy group compared to the relaxation group experienced improved sleep, less pain, depression and anxiety.

References

Kelly, G. A., Blake, C., Power, C. K., O'Keeffe, D., & Fullen, B. M. (2011). The association between chronic low back pain and sleep: a systematic review. The Clinical journal of pain, 27(2), 169-181.

 Heffner, K. L., France, C. R., Trost, Z., Ng, H. M., & Pigeon, W. R. (2011). Chronic low back pain, sleep disturbance, and interleukin-6. The Clinical journal of pain, 27(1), 35.

Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy.International Journal of Neuroscience, 106(3-4), 131-145.

Penedo, F. J., & Dahn, J. R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry, 18(2), 189-193.

Moldofsky, H. (2001). Sleep and pain. Sleep medicine reviews, 5(5), 385-396