October 17, 2017
Back and Neck Pain. How they Disrupt Sleep
by Dr Raymond Hall, DC
The brain is an incredible system of our body of detecting stimuli, processing information and
producing thoughts, emotions and movement. However, with all the information received, the
brain can get confused, overload and even cross the messages, all which can affect our sleep patterns
including our deep sleep as well as our dream state, aka "REM" sleep.
Taking a Closer Look:
When we have back or neck pain which commonly have a pinched nerve component, we have
energy in the form of nerve transmissions that fire and send pain and temperature information
(through A-Delta fibers) from your spine to a specific part of your brain (thalamus) in less than a second. The
second pathway, the slower C-fibers, also transmit stimulating messages about pain, but also send about chemical, pressure and more temperature information. This C pathway sends the data to other parts of the brain including the Limbic system. It is called the Limbic “system” because it is actually is a collection of different parts of the brain (such as the amygdala and hypothalamus) that control other aspects of our emotions and thus explains why we are often moody, irratated, depressed and emotional disturnbances such as anxiety when we have pain during the night.
Although the science and neurophysiology of neurological pathways such as the body’s
perception of pain, pressure, temperature and chemicals that are all associated with injuries and
painful conditions is well researched, there is little written about the exact connection between disturbed sleep and
all the various stimuli, yet, we certainly know it is real. Pain and the other various stimuli
certainly affect and change our sleep patterns to create fragmented sleep, or otherwise
understood as disturbed and interrupted sleep. This sleep fragmentation ultimately effects the
quality of our sleep and thus, how we heal, feel the next day and whether we feel well rested.
Again, what we do understand is that the same areas in the brain that I have described above,
particularly the thalamus and the limbic system that includes the hypothalamus- are all involved
with the perception of pain, emotion as well as the sleep wake cycles. So my postulation of the
understanding of WHY we awaken when we have pain is that it is truly a very natural
phenomenon of our bodies in order to change position to reduce pain, change our surrounding
temperature to make our bodies more comfortable, or change the actual state of our sleep to
adapt or compensate for a psychological stress such as awaking from a nightmare or simply not
being able to fall asleep due to stress.
The HOW we awaken or have disturbed sleep after painful or irritating stimuli is directly related
to neurotransmitter activation. What appears to happen is that the painful stimuli communicate
this high alert status to the brainstem and hypothalamus which then transmit these neuro-signals
via the key transmitters, histamine, norepinephrine and serotonin to the arousal system. This system is in the outer portion of the brain itself called the cerebral cortex. This portion of the brain is what actually creates an “arousal” or sometimes even complete wakefulness.
Therefore, the two options are: we either are simply aroused (which could only last between 3-15 seconds
and not create full wakefulness (by an alpha or theta frequency greater than 16 Hz) or we can go
completely into a full wakeful status (of beta or gamma frequency of 25 to 100 Hz) if the
stimulus is strong enough. Both of these case scenarios create “disturbed sleep” as it pulls us out
of slow wave deep sleep or from REM sleep and can result ultimately in many factors such as
depression, poor healing, tiredness, weight gain, confusion and lack of concentration.
In my next article, I will describe several very important factors that can help promote better
sleep through nutrition, pain management and proper support while you are sleeping.