Night pain can occur in different parts of the body. However, most often arthritis patients or expectant mothers complain mainly of a night pain in the extremities.
What is night pain?
Night pain refers to pain symptoms occurring at rest or during the night. Night pain refers to pain symptoms that occur at rest or at night. This is initially non-specific and must be assessed in terms of cause, localization, frequency and consequences. Pain can be described with indicative adjectives, but this is usually not so easy for the patient. A distinction is made, for example, between pressing, pulling, tearing, stabbing or burning pain. The physician or therapist can identify different patterns by a good description of quality, localization, and whether the pain occurs at rest or in motion. In any case, if a symptom recurs at the same time or with a particular posture, a physician should be consulted for clarification.
Causes
Most often, patients with joint diseases describe the symptomatology. There are various gradations here. A non-specific painfulness of a joint is called arthralgia. Osteoarthritis is the increasing wear and tear of the joint structures. If these are accompanied by recurring inflammatory processes, they are referred to as arthritis or rheumatic diseases. Pain at rest is not uncommon in these diseases. Patients complain of persistent symptoms, especially after overloading. Furthermore, similar symptoms may occur after injury, e.g. to the shoulder or knee, or after surgery with subsequent immobilization. If the capsule-ligament apparatus is involved, the structures are often irritated and react sensitively. Expectant mothers also complain of night pain. It robs them of sleep in particular, as the legs ache. The cause may be an increased storage of lymph fluid in the tissue. One speaks of a physiological storage of up to six liters. However, this can trigger a pressure pain. Neurological diseases such as multiple sclerosis can also cause symptoms such as restless legs syndrome. This is associated with uncontrolled movements and pain at rest and at night.
Diseases with this symptom
- Joint diseases
- Rheumatism
- Carpal tunnel syndrome
- Osteoporosis
- Osteoarthritis
- Arthritis
- Scoliosis
- Herniated disc
- Multiple sclerosis
- Restless Legs Syndrome
- Rotator cuff rupture
- Bechterew’s disease
Diagnosis and course
Joint disease, the most common cause of night pain, can be diagnosed by X-ray, blood work and a comprehensive functional test of the affected joint. Joint degeneration is usually visible on imaging. Visual and palpation findings can be used to make the diagnosis more precise. Often, changes or thickening in the capsule can also be seen in signs of wear. During functional testing, crepitant sounds may be perceived or pain on movement may be reported by the patient. The pain at rest or at night is triggered when the arthrosis is “activated”, i.e. an inflammatory process takes place in the joint fluid. In this process, cartilage is increasingly attacked and degraded. This changes the statics of the joint and, in the course of the disease, leads to relieving postures. Further symptoms of such joint diseases are the typical morning stiffness and pain on exertion of the affected structures. In general, the disease is chronically progressive.
Complications
Night pain often results from joint pain (arthralgia), which has several complications. First, the symptomatology can lead to restless nights, so that there is a lack of sleep the next day, resulting in a decrease in concentration and performance, so that daily work and social life are severely affected. There is also a certain irritability in the affected person. In addition, if the lack of sleep becomes chronic, the risk of suffering a heart attack or stroke increases. The risk of obesity, diabetes or other cardiovascular diseases is also increased. If the night pain originates in the joints, further complications may follow.In the case of joint diseases, this often results in morning stiffness, which can last for a few minutes and impairs movement. In addition, the pain can occur not only at night, but also in the morning, so that everyday life is restricted. In addition, wear and tear of the joint cartilage, osteoarthritis, can occur at the joints. This degenerative process is not reversible. The joint cartilage can become so worn that the two bones that make up the joint rub against each other, causing severe pain. The bones can become comminuted and cavities form in the bones (debris cysts). The joint becomes inflamed and swollen during this process.
When should you see a doctor?
The question of when medical treatment is necessary and thus when a visit to the doctor is indicated can only be answered according to the specific individual case. A patient should identify all relevant concerns. An objective risk assessment must be carried out. In this context, it is certainly advisable to decide in favor of a visit to the doctor in cases of doubt. However, exceeding a certain risk threshold should be a prerequisite for a visit to the doctor. This is because, from a medical point of view, many conditions do not require treatment. In the case of night pain, it should be taken into account that a restful night’s sleep is indispensable for the organism. In case of long-lasting sleep deprivation or sleep complaints, not only insignificant physical and psychological impairments are threatening. The occurring pain symptoms should therefore be extensively observed and, if necessary, noted. Before visiting a doctor, the affected person should be able to localize the pain and describe the frequency and intensity of the pain. This is an indispensable prerequisite for a successful visit to the doctor. Sufferers should always consult a doctor if they feel that their sleep is significantly impaired by the pain they are experiencing. If, on the other hand, the pain occurs merely occasionally and without serious restrictions, a visit to the doctor is not necessarily mandatory. Those who decide to consult a doctor should first contact their family doctor. He or she can clarify the initial causes and, if necessary, refer the patient to specialists such as orthopedists. It is also possible to consult a physiotherapist.
Treatment and therapy
Treatment of these progressive conditions is very lengthy and must be tailored precisely to the patient. The goal is always pain reduction and prophylaxis and a containment of joint wear. On the one hand, the inflammatory process must be treated with medication. Here it can be suppressed or a controlled inflammatory reaction is induced, which is accompanied under supervision of the individual inflammatory phases until the scar heals. The resulting connective tissue can be treated accordingly. Furthermore, the function of the joint, range of motion and strength as well as the surrounding structures must be considered, strengthened or at least preserved. The patient is given strengthening and stretching exercises tailored to his needs, which he should perform several times a day for the therapy and prevention of general symptoms and also night pain. Supportively, he can use thermal media to mitigate the symptoms of the acute and chronic phases. Within the acute phase, light cooling alleviates the symptoms. This can be realized by the application of a wet-cold cloth with adapted water temperature for the patient in a pleasant range. If the application is perceived as unpleasant, the patient is already in the chronic phase. Here it is better to act with heat. Whether this should be moist or dry again depends on the patient’s well-being. The vessels dilate, the musculature relaxes. Cherry pit cushions, heating pads, red light or even warming ointments are used. If the joint wear is far advanced, there is the possibility of joint replacement. These total endoprostheses are often used for knee or hip arthroses. The intervention should be discussed intensively with the attending physician. Because here, too, discomfort can occur afterwards due to the changed posture and positioning of the joint at night.
Outlook and prognosis
Night pain is unpleasant in any case and occurs especially in expectant mothers. In most cases, it is pain in joints, so that ordinary sleep is no longer possible.This often leads to a lack of sleep the next day, which can express itself in stress and a depressed mood. Concentration and performance drop, so that social life and everyday work are severely affected. In most cases, night pain disappears after only a few days. However, if they persist longer, a doctor must be consulted. Night pain can also be caused by chronic diseases. These diseases negatively affect the cardiovascular system and should be examined in any case. If, after the night pain, morning stiffness also occurs in the morning, a doctor must be consulted immediately. Often the night pain occurs not only at night, but also in the middle of the day. Tension can develop in the joints, which leads to severe pain. There is no general therapy, as a rule, the treatment prevents the pain and inflammation. It takes place mainly through stretching exercises, so that the chronic pain can be relieved. Whether the treatment is successful depends greatly on the physical condition of the patient.
Prevention
To prevent arthritic night pain, it is important to take early diagnostic measures and seek appropriate drug and therapeutic treatment. Regular therapy, exercise, and a healthy diet are the mainstays of pain prevention.
Here’s what you can do yourself
A healthy lifestyle generally helps against night pain. This definitely includes healthy diet and some sports activities. The night pain can not be completely limited or avoided with this, however, a healthy lifestyle always has a positive effect on the human body. In most cases, night pain is not reversible, so there is no treatment that can completely prevent night pain. Before going to bed and after getting up, the body should be relaxed. This can be done with the help of stretching exercises and yoga. The night pain can be prevented as much as possible with this. If the night pain is relatively severe, painkillers can also be taken. Here, sufferers should make sure that the painkillers are not taken for too long a period of time. It is advisable to consult a doctor at the slightest sign of night pain and to find out the cause of this pain. In this way, consequential damage and pain in old age can usually be avoided. A good mattress and the correct position of the pillow also help against night pain. During the day, the body should also be protected and not exposed to unnecessary strain or stress.
