Why Is My Pain Worse at Night?

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Most people experiencing pain report worse symptoms at night.

If you’ve ever experienced any sort of prolonged pain, from a bad toothache, to bursitis, to fibromyalgia or any of the other myriad causes, you may have noticed that you experience more discomfort after the sun goes down. There are many reasons behind this, and the phenomenon is still being researched.

There are fewer distractions at night.

During the day, we need to concentrate on many things besides our pain. Phone calls, business meetings, and errands actually serve as powerful non-drug painkillers, because when our mind is preoccupied with other things, it feels less pain.

At night, the stimulation and diversions around us drop, leaving plenty of time for the brain to focus on our discomfort. This phenomenon was noticed in American armed forces at Anzio Beach during World War II. When severely wounded soldiers were evacuated from the front lines, they didn’t react to pain in typical ways. Why not? The relief of being removed from danger was so great that it distracted them from their suffering. You probably don’t experience bombs and gunfire going off around you on your average day (we hope!), but even the stress and distraction that accompanies a busy weekend, or a day at the office, can keep your focus off of what hurts.

Carbon dioxide levels may be to blame.

You breathe oxygen, and breathe out carbon dioxide. That’s common knowledge. But most people don’t know that your blood vessels expand when your body has a higher carbon dioxide concentration. Part of the circadian rhythm (your cycle of waking in the day, and sleeping at night) includes breathing more slowly in the evenings, when you are relaxing. That results in higher carbon dioxide levels in your bloodstream, which will dilate your blood vessels, and cause your nerves to become more sensitive.

Your body may just be tired.

Lactic acid builds up in muscle tissue when you exert yourself physically, which will cause soreness. Physical activity also causes increased blood flow around the joints, and if you suffer arthritis, cartilage problems, bursitis, or tendonitis, you will experience more inflammation and tenderness in those areas. Heavy workload and stress can also cause your brain to work hard enough to make your nerve endings more sensitive to stimuli. Aching may just be your body’s way of telling you that it really needs some rest (even if the pain isn’t very helpful towards your getting a good night’s sleep!).

Nights are colder, and temperature drops affect pain levels.

The same peripheral nerves that tell your brain that you’re hot or cold also transmit pain. Nights are cooler than days, and the drop in temperature can affect your perception of pain. Sometimes, the nerves are damaged, and your brain “translates” any temperature changes into feelings of tenderness, tingling, sharp “stabbing” pain, or aches. Low temperatures also cause your heart to beat more slowly, which causes your blood to flow more slowly, causing a slight buildup of carbon dioxide, dilating your blood vessels, and interfering with your nerve endings.


The above are but a few of the reasons you may be suffering more during the evenings. Talk to your doctor about relaxation techniques, massage therapy, the possibility of a lower-dose nighttime painkiller, or a non-addictive sleep aid, to help you keep you feeling your best in the morning.


Article Originally Published in: Pain Solutions Magazine, Fall 2009
Modified & Updated: September 2012
Photo Credit: Jon Sullivan, courtesy of PDPhotos

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