• Research in Frontiers in Neuroscience, analyzing data from more than 400,000 people, found a link between back pain and insomnia.
  • While poor sleep can increase risk of back pain and vice versa, experts suggest focusing on addressing sleep first, as it plays a role in many health factors, as well as athletic performance.

In the same way that back pain can sabotage sleep, insomnia can also worsen pain levels, creating an ugly cycle, according to new research in Frontiers in Neuroscience.

Researchers looked at self-reported and health data of more than 400,000 people, collected as part of a large-scale study by the UK Biobank. Participants provided information on sleep patterns and general health status, and also underwent genetic tests.

Focusing on factors related to poor sleep quality—including insomnia, long and short sleep duration, and frequent bouts of daytime sleepiness—researchers chose participants with genetic variants associated with sleep difficulties. Variants in 10 genes have been previously identified as contributing to short sleep duration and to sleep timing (yes, being a “morning person” may be in your genetic makeup).

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Study participants with these variants had higher incidence of lower back pain compared to the general population, leading researchers to conclude there’s a causal relationship, meaning insomnia can prompt lower back pain, and vice versa. That means treating one of these could ease symptoms of the other, they added.

Although these participants were genetically predisposed to sleep issues and lower back pain, previous research has found a similar connection without that genetic component. For example, a study in PLoS One found that increased insomnia symptoms were predictive of back pain, and research published in Nature noted that people with long-term poor sleep had nearly twice the risk of back-related disability compared to those who get good sleep. (The latter study also said focusing on good sleep and a physically active lifestyle through adulthood could help to reduce the incidence of back pain.)

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For someone struggling with both lower back pain and insomnia, breaking the cycle can be challenging, but it may help to spend more effort on sleep quality than pain management—especially because good sleep can also confer performance benefits for athletes, according to W. Chris Winter, M.D., of Charlottesville Neurology and Sleep Medicine, and author of The Sleep Solution.

“Sleep is essential for protein synthesis, muscle recovery, modulation of your inflammatory response, and immune system function,” he told Runner’s World. All of that can not only play a significant role in pain management, but also in health overall.

That includes injury prevention. For example, a study in the Journal of Science and Medicine in Sport looking at endurance athletes like runners and cyclists found the most injuries among those who got fewer than seven hours of sleep every night.

Winter added that if better sleep habits aren’t helping with insomnia or sleep disruption—and especially if your lower back pain is worsening or interfering with everyday activity—it’s time to see your health provider.

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Elizabeth Millard

Elizabeth Millard is a freelance writer focusing on health, wellness, fitness, and food.