Why Is My Pain Worse at Night?

pain worse at night

Why is my pain worse at night? Tips for a good night’s sleep.

Pain worse at night

Most people who experience chronic pain report worse symptoms at night. There are many reasons behind this, and researchers are still investigating this phenomenon today. In this post, we’re going to look into what makes your pain worse at night, and what you can do for a better night’s sleep.

There are fewer distractions at night

During the day, our attention is drawn to many things besides our pain. Phone calls, business meetings and errands actually serve as powerful distractions, because when our mind is preoccupied with other things, it doesn’t think about the pain. At night, however, the stimulation and diversions around us drop, leaving plenty of time for the brain to focus on our discomfort.

U.S. Armed Forces members at Anzio Beach noticed this phenomenon during World War II. When severely wounded soldiers were evacuated from the front lines, they didn’t react to pain in typical ways. In fact, many of the soldiers reported experiencing little pain despite their serious injuries. Researchers have since concluded that the relief of being removed from danger was so great that it distracted them from their suffering.

Distraction can be a powerful tool when it comes to main management. Researchers today have found that virtual reality can be effective in treating pain management.

  • Pain Resource Tip: Practice visualization therapy, or visualizing something that you love, like decadent chocolate cake or your ideal vacation. Get lost in the day dream. You can also try listening to relaxing music, focusing on the rhythm and words in the music.


Carbon dioxide levels are high

We all know that you breathe in oxygen and breathe out carbon dioxide. However, did you know that your blood vessels expand when your body has higher concentrations of carbon dioxide? The result is that your nerves actually become more sensitive.

Part of your cycle of being awake during the day and sleeping at night, referred to as your circadian rhythm, includes breathing more slowly in the evening, when your body is more relaxed. This causes higher carbon dioxide levels in your bloodstream, which in turn dilates blood vessels, making you feel pain worse at night.

  • Pain Resource Tip: Practice controlled deep breathing. When trying to fall asleep at night, focus on your breathing, and take deep breaths to provide your body with more oxygen. This is not only a great way to quiet your mind, it’s a great distraction from pain that might be keeping you awake. If you’re having trouble focusing, try repeating a mantra to yourself, such as I am strong, I am beautiful, I am enough. Repeating a mantra to yourself as you focus on your breath not only has the potential to distract you from pain, but can also transcend into other areas of your life, boosting your condfidence and reducing stress.

Stress causes pain

Any time you exert yourself physically, your body can build up lactic acid in muscle tissue, causing soreness. Physical activity also causes increased blood flow around the joints, and if you suffer from conditions such as arthritis, cartilage problems, bursitis or tendonitis, you will likely experience more inflammation and tenderness in those areas. While physical activity is an important part of pain management, it can also place stress on your body. Aching may just be your body’s way of telling you that it really needs some rest.

Emotional stress can cause pain, too. Prolonged stress can cause symptoms such as back pain or stomach aches.

“Emotional stress alerts the body to produce stress chemicals such as cortisol, which—if produced on an ongoing basis—begin to break down the immune, gastrointestinal, neurological, and musculoskeletal systems,” said Nancy Molitor, Ph.D., a psychiatry professor at Northwestern University Feinberg School of Medicine.

  • Pain Resource Tip: Regular exercise is a great way to fight stress and work through physical pain as well. If it’s been a while since you exercised, set the goal of walking for 10 minutes a day to start. You can always increase in time. Also, be sure to listen to your body when it’s telling you that you need to rest. The more physically active you are, the easier it will be to listen to and understand what your body is trying to tell you.

Temperature changes can affect pain levels

The same peripheral nerves that tell your brain whether you’re hot or cold also transmit pain signals. Nights are cooler than days, and the temperature drop can affect your perception of pain and make pain worse at night.

For example, if your nerves are damaged, your brain might “translate” any change in temperature into feelings of tenderness, tingling, sharp pain or achiness. Low temperatures also make your heart beat more slowly, causing your blood to flow more slowly as well. This results in a slight buildup of carbon dioxide, which can interfere with your nerve endings.

  • Pain Resource Tip: To combat cool temperatures at night, consider investing in a heated blanket or pad. Heated pads can also be great treatment for pain, such as back pain, for example. If you have air conditioning, you might also consider turning the temperature up a few degrees before heading to bed.

If you’re experiencing severe pain at night, be sure to talk with your doctor. He or she may be able to recommend relaxation techniques or massage therapy, and, in some cases, might prescribe a medication such as a lower-dose nighttime painkiller or a non-addictive sleep aid to help you get a better night’s sleep.



  1. Very interesting. Why don’t most or all doctors know this?? When asked why pain is worse at night, most of them just have a blank look, as if they are thinking about cleaning out the trunk of their car and realizing they never check the spare tire.

    • Lee,

      Thanks for taking the time to leave a comment. Managing chronic pain often takes a comprehensive approach, as things like diet, exercise, mindset and so many other factors can contribute to your pain. Doctors are trained to follow a procedure – diagnose an illness and prescribe a solution. Doctors are human, and one doctor might not necessarily have the same knowledge as a doctor that practices down the street.

      We are glad that you found this information to be helpful, and our goal is to provide you with information and tools that you can use in addition to what you are working on with your primary care doctor. That being said, it is important that you’re getting the best care and all of your questions answered by your primary care doctor. If you don’t feel that your needs are being met, don’t be afraid to go in with a list of questions and make sure they get answered. If you’re not getting the help you need, don’t be afraid to seek out a new doctor. This is your life, and it’s important that you get the care that you need.


      Your Friends at Pain Resource

    • Aaron,

      Many people report a change in symptoms with the changes in position of the moon. If you’d like to collaborate with others who are also working to manage their pain, we welcome you to join our community by visiting forum.painresource.com.

      Wishing you the Best,

      Your Friends at Pain Resource

  2. My pain is definitely worse with extreme changes in weather, like a storm front moving in or when the temperature one day is drastically different than the next. I live in Alabama where this time of year we may be in the 30’s one day, and a day or two later be in the 60’s. When this happens I always hurt more. I also noticed that I got a migraine anytime it rained, I thought I was a little crazy but one day mentioned it to my neurologist. He said it is actually common to get headaches when the barimetric pressure changes and that there is medication for it. I now always take “weather pill” anytime there is rain in the forecast.

  3. I jammed my shoulder mid December , recovery plateaued around end of Feb & I still have pain part way through the night. I can relieve it by pressing on various spots which are sore to touch but get best relieve with a cold pack. Anti inflammatories do nothing. Best treatment ?- Massage ? light exercise ?

    • Hi Dave,

      Thanks for your comment. I’m sorry to hear that you’re still experiencing pain. First and foremost, I would recommend consulting with your doctor. Additionally, many people with this type of pain have experienced relief from deep tissue massage therapy and yoga. I would be very careful doing upper body exercises, which might cause injury if the area is already tender. One massage therapist recommended to me to put a tennis ball in a long sock, and throw it over your shoulder and roll it over the tender area while sitting in a comfy chair. I hope these tips help and that you start to find some relief soon.



  4. I was so glad to find this site. I am on Oxycodone and only 2 per day(5 mg). I split 1 pill in half to help through out the day and save the whole pill for night. Sadly they only last a few hours (3 to 4) so that leaves a lot of in between time with pain. I have a curved spine at the neck with dead blocks and a pinched nerve that has settled mostly in hands and arms. I also have DVT in my left leg. Anyway, I have tried deep breathing and practice different sayings to help me relax. The pain cause anxiety and so on. Trying a new way through lite exercise and music. Thanks Again


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