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Sleeping with musculoskeletal pain​

If you’re experiencing chronic pain from a musculoskeletal disorder (MSD), it has likely interfered with your sleep. You may find it hard to fall asleep and then feel fatigued the next day because you didn’t get quality sleep. Your lack of sleep can worsen your physical abilities and intensify any pain you’re feeling.

The alphabet soup of chronic pain disorders

An MSD is an injury or disease of the muscles, nerves, tendons, joints, cartilage and spinal discs that can lead to chronic pain. It’s common to have pain in the knee or hip joints or lower back.

If your work involves any type of physical activity, you may be at risk for a work-related musculoskeletal disorder (WMSD). Activities such as excessive vibrations, repetitive reaching, heavy lifting and other forceful tasks are primary culprits for WMSD injuries. About one third of work injuries in a recent study were characterized as a WMSD1. Another finding: If it takes 30 minutes or longer for you to fall asleep, you have a greater risk of developing a WMSD2.

Having a desk job does not make you immune to a work-related injury. Carpal tunnel syndrome, a numbness and tingling in the hand and arm caused by a pinched nerve in the wrist, is an MSD. Those who spend a large part of the day using a keyboard are not the only ones who can develop carpal tunnel — anyone whose job demands long hours of hand and wrist use is at risk. Other risk factors are high job strain and an elevated Body Mass Index (BMI). Women are more likely than men to develop carpal tunnel syndrome3.

What your sleep can tell you

Adults with sleep problems are at higher risk for developing musculoskeletal pain4. Symptoms of insomnia increase the risk of developing a chronic pain disorder, according to The Journal of Pain5. Other research points to a higher risk for fibromyalgia, a condition that causes musculoskeletal pain throughout the body6.
Musculoskeletal pain is also associated with restless legs syndrome (RLS), especially in young adults. RLS is a sleep disorder characterized by uncomfortable sensations or urges to move the legs, arms or any body part while at rest. While not completely understood, there appears to be a cyclical relationship between RLS, depression and poor sleep. When you experience disrupted sleep due to RLS, you may start to show signs of depression that, in turn, can further erode your sleep. Poor sleep exacerbates RLS, followed by a deepening depression7.

How to help your sleep

Consult your doctor about any pain issues. Pain control can make it easier to get the sleep you need, and improving your sleep can lead to better pain treatment outcomes.

Here are some additional tips:

  • Go to bed and wake up at about the same time each day.
  • Establish a relaxing routine to prepare yourself for sleep, like taking a bath, reading a book or light stretching.
  • Get some moderate exercise, if you’re able to, but not within one to two hours of bedtime.
  • Avoid light and stimulation from your electronic device within one to two hours of bedtime.
  • Keep your bedroom quiet, dark and cool.
  • Limit your alcohol and caffeine intake before bedtime (three hours and seven hours, respectively).

If you have RLS, and are experiencing symptoms:

  • Take a quick walk around your home or neighborhood.
  • Rub or lightly massage your legs.
  • Engage in a mentally stimulating activity, like a crossword puzzle.
  • Use heat, cold or compression for relief.
  • Avoid or decrease alcohol, nicotine and caffeine consumption.
  1. Work-Related Musculoskeletal Disorders & Ergonomics. https://www.cdc.gov/workplacehealthpromotion/ health-strategies/musculoskeletal-disorders/index.html
  2. Zhang, Y., Duffy, J. F., de Castillero, E. R., & Wang, K. (2018). Workplace health & safety.
  3. Harris-Adamson, C., Eisen, E. A., et. al. (2013). Occupational and environmental medicine.
  4. NCBI’s PubMed 2017 Jul 1;40(7)., https://pubmed.ncbi.nlm.nih.gov/28531332/
  5. Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The Journal of Pain.
  6. Bigatti, S. M., Hernandez, A. M., Cronan, T. A., & Rand, K. L. (2008). Arthritis Care & Research: Official Journal of the American College of Rheumatology.
  7. Hoogwout, S. J., Paananen, M. V., et. al. (2015). BMC musculoskeletal disorders.

57% of Americans experience chronic or acute pain on a weekly basis.

Those with chronic pain lose on average 42 minutes of sleep per night.

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