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3 Tips for MS Pain When it Threatens a Good Night’s Sleep

It may seem that, everywhere you look, messages emphasize the importance of getting enough sleep. (As a sleep health educator, some may have come from me!)

Of course, good sleep is one of the three pillars of good health (joining regular exercise and healthy diet).1

What happens when you go to bed, hoping to cash in on some of that good sleep—the kind that heals the body and rests the mind, the kind that those of us with MS need after an exhausting day living with symptoms and setbacks—and your body fights back with pain?

In my field, the saying goes that “pain is the enemy of sleep.” No doubt all human beings have lost sleep due to pain and inflammation. It can creep in and haunt you, night after night.

So how do you strive for good sleep when pain seems to be in charge of your body after the lights go out?

Tip One: Don’t be a hero

Powering through pain—day or night—isn’t effective for someone with MS.

I get it, you want to avoid meds (I do, too) and that means trying to ignore the throbbing, burning, spasming, zapping realities that MS dishes out daily.

There’s no shame in taking medications to curb discomfort and inflammation. A body that’s allowed a break from pain can relax, your mood will improve, and—guess what?—you’re more likely to catch quality Zzz with managed pain.2,3

Pain relief

If medications are not an option, other drug-free pain-relief solutions can be helpful for pain management. I seek monthly massage, use of a TENS device, practice, apply cold or heat to affected areas, take warm (not hot) Epsom salt baths, and even sneak in some meditation.4,5

Tip Two: Pain is not your friend, but your coworker

Someone once suggested to me that “pain is a state of mind.”

Really? I don’t think so. Pain is pain.

I’ve since come to discover a nugget of truth to this idea.

Pain is a reality of life. We feel pain doing things that bring us pleasure, and we endure pain to get through tough situations. In both cases, this pain is partly “managed” by simply reframing it.

Framing one’s MS pain as a bad actor that needs management—rather than a villain one must eliminate entirely—may seem only intellectually useful.

But the fact is, pain and discomfort are signals that we may be overdoing things, or experiencing a relapse, or developing habituation to medications that may no longer be serving us.

Pain may not be our friend (it will never be mine!), but it can still be a useful coworker reminding us to practice good self-care.

Reframing pain

Reframing pain like this changes things. Pain is no longer an aggressor creating anxiety. Instead, it’s a messenger. Listening and acting on the messages can make it go away. And if it goes away, that means you can enjoy more or better sleep.

Tip Three: Stop catastrophizing

Who hasn’t tossed and turned all night trying, in vain, to find a comfortable pain-free position, thanks to persistent leg cramps, zapping sensations in the toes, or throbbing facial pains? I know I can’t sleep through it.

But what about all that lost sleep?

Well, it’s lost. But it’s not the end of the world.

Yes, we should get as much sleep as possible. Less sleep tends to intensify our perception of pain, after all.4 We also need sleep to give our bodies and brains time for cellular repair.

But catastrophizing about sleep lost to pain —allowing yourself to entertain anxious, obsessive worries about losing sleep—will not help matters.5

Orthosomnia: losing sleep over losing sleep

There’s a clinical term for this: orthosomnia.6 It comes from losing sleep over losing sleep. A fair amount of insomnia is actually orthosomnia.

Pain can certainly take up residence and be the noisy neighbor that keeps you up all night. But you don’t have to poke at it with racing, intrusive thoughts.

Instead, acknowledge the pain is there. Hello pain, I see you.

Then take several breaths and ask, what can be done about this?

Then do the things you can do. Problem solve for the win!7

Sometimes this works, and you sleep (even if only for a few hours). Or you might not sleep. But your pain might go away. Or it might not.

If it doesn’t work, that’s when you reach out to others—like your MS specialist, your primary doctor, your specialty nurse, your caregiver, your alternative medicine practitioner—in search of support and solutions.

You know, eventually, you will find a solution for the pain, and with that, a solution for lost sleep.

So try not to lose sleep over losing sleep. One day—or night—at a time is the best way forward.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Allf, B. The Three Pillars of Human Health. Diering Lab, University of North Carolina Chapel Hill. Accessed July 25, 2019.
  2. Ingraham, P. Anxiety and Chronic Pain. July 6, 2019.
  3. Why Chronic Pain Brings You Down — and How to Feel Better. Cleveland Clinic. Accessed July 25, 2019.
  4. Carey, B. Why It Hurts to Lose Sleep. New York Times. January 28, 2018.
  5. Pain Catastrophizing Scale. Physiopedia. Accessed July 25, 2019.
  6. Baron KG, Abbott S, Jao N, Manalo N, Mullen R. Orthosomnia: are some patients taking the quantified self too far? J Clin Sleep Med. 2017;13(2):351–354.
  7. Greenberg, M. Why Worrying Is Unhelpful, and One Thing You Can Do Instead. Psychology Today. March 30, 2019.


    5 months ago

    I only sleep 3 or 4 hours at a time. sometimes I can function all day. (I do nap though). I run out of steam.

  • TK Sellman moderator author
    5 months ago

    Have you ever mentioned this to your MS neuro? You might feel better and more energized if you got at least 7 hours of sleep at a time. I recommend you bring it up at your next meeting; they can guide you toward your next steps to achieving better sleep. Sleep is critical for healing. Best wishes,

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