Chronic Pain

Sleep, Exercise and Pain

Taking healthy college students and restricting sleep and exercise will result in chronic pain. [Clauw DJ, et al. Best Pract Res Clin Rheumatol. 2003 Aug;17(4):685-701.]

In this article, it was found that symptoms of central sensitization, similar to Fibromyalgia, could be induced simply by restricting sleep and limiting activity in students who had previously never experienced symptoms before.

In a similar experiment, a physician named Jose Ochoa found that he could reproduce signs and symptoms of RSD simply by immobilizing a limb in a cast for a few days.  Both fibromyalgia and RSD are felt to be central sensitization syndromes.

Anyone who has had for prolonged periods of sleep has probably had a similar experience of developing aching, stiff muscles and joints, having difficulty concentrating and thinking, and a general feeling of malaise.  I lived my life for years feeling like that when I was a medical student and resident physician suffering from chronic sleep deprivation and lack of exercise due to long work hours.  I remember it being hard to tell if I was coming down with flu, or if I just needed sleep.

In a study of patients who were septic, it was found that they suffered from cognitive impairment and functional limitation after they recovered from their infection.  [Iwashyna TJ, et al. JAMA. 2010 Oct 27;304(16):1787-94]. Their ability to live independently was limited as well.

What each of these examples has in common is the effects of central sensitization and inflammation. Studies are ongoing to try to find a way to reverse these effects.  In the mild cases such as the sleep deprived students or those who had a limb casted for a period of time, exercise and proper rest seem to be all that is required to completely heal.  The same can be said for many patients who have other central sensitization syndromes. The trick is being able to overcome the functional limitations brought on by the condition and being able to perform meaningful exercise and get good restorative sleep.