Treating insomnia improves back pain
When treating a patient for back pain, it’s worth asking “how are you sleeping?”
If the patient is experiencing insomnia, then it’s likely they’ll experience reduced back pain if the insomnia is treated.
This finding comes from a new study by the University of Sydney, showing that treatment for insomnia can help to reduce back pain and further enforcing the complex link between sleep and pain.
Chronic low back pain is the leading cause of disability worldwide, affecting an estimated 540 million people at any one time. More than 59% of sufferers also experience insomnia.
“The latest evidence suggests there is a two-way relationship between sleep and pain, meaning poorer sleep may lead to worse pain and worse pain may lead to poorer sleep,” said senior author Dr Milena Simic, a research physiotherapist in the Faculty of Health Sciences.
The study, published in Osteoarthritis and Cartilage, analysed data from 24 randomised controlled clinical trials treating sleep disorders in more than 1550 people with osteoarthritis and back or neck pain.
Results showed that in people with back pain, sleep interventions like cognitive behavioural therapy and medication improved sleep by 33% and improved pain by 14% compared to control or placebo.
“These findings highlight that we can improve sleep in people with painful conditions, and in some cases lead directly to less pain,” said Dr Simic.
Based on the study results, researchers say health professionals treating back pain patients should be conscious of screening for insomnia and referring for management.
“These findings highlight the importance of not treating painful musculoskeletal conditions in isolation,” said study co-author Associate Professor Paulo Ferreira, who led a 2016 study showing a link between depression and back pain.
“Depression and insomnia are both risk factors for developing low back pain, and people with depression often have poor sleep.
“A person might see their GP or physiotherapist for back pain, but if they are not mentioning other issues, such as sleep problems, anxiety or depression, we miss the potential to treat these co-existing conditions.
“This research suggests we may see even bigger improvement if we were to treat insomnia and back pain simultaneously.”
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