Why is Chronic Pain so draining?

If you live with chronic back pain, you know it's more than just an ache. It's a constant, unwelcome companion that affects almost every part of your life. One of the most common things people say about it is how utterly draining it can be. You're not just in pain, you're exhausted all the time, but why? Why does the a problem in your back leave you feeling like you've just run a marathon every single day. 

It's not in your head. The link between chronic pain and fatigue is a very real issue, and it unfortunately it can be a very vicious cycle. 

Pain & Sleep

Think of it like this: your body has a limited amount of energy. When you’re healthy, you spend that energy on work, family, hobbies, and just living your life. But when you have chronic back pain, a huge chunk of that energy gets diverted to simply dealing with the pain. It’s like having a computer program running in the background all the time, slowing everything else down.

This creates a nasty feedback loop: 

1. Pain wrecks your sleep: It's very hard to get a good nights sleep when you cannot find a comfortable position. You toss, you turn and the pain might even wake you up. This lack of sleep quality is a huge problem because sleep is when your body does most of it's healing and repairing. 
   
   
2. Poor sleep makes pain worse: When you're sleep-deprived, your body becomes more sensitive to pain. The same ache that was a 5 on the pain scale yesterday might feel like a 7 today, simply because you're exhausted. Poor sleep also increase inflammation, which is a major driver of pain. 
   
   
3. Fatigue leads to inactivity: When you're tired, the last thing you really want to do is exercise. So as a result, you begin to move less and this leads to muscle deconditioning; muscles get weaker and also provide less support for your spine. 

It's a somewhat downward spiral that can feel quite impossible to escape. Essentially your body becomes stuck in survival mode, and it can become quite exhausting. 

Stress and Chronic Pain

Pain is a stress. When you're in pain, your body releases stress hormones like cortisol. In the short term, this can be somewhat helpful, however the issue is that your body is in a constant state of high alert. This chronic stress response can lead to a whole host of possible issues, this includes: 

• Anxiety and Irritability 
• Headaches
• Digestive Problems
• Trouble concentrating
• Overwhelming Fatigue
  

Breaking the Cycle

You can certainly take steps to break the cycle and start feeling more like yourself again. It's not about finding a single 'cure', but about building a toolkit of strategies that work together. 

1. Priortise Gentle Movements 
   This is probably the most important step. Even though it feels counterintuitive, gentle movement is one of the best things you can do. It helps to:
   
   - Strengthen your muscles: Stronger core and back muscles provide better support for your spine. 
   - Improve flexibility: Stretching can help relieve tension and improve your range of motion. 
   - Boost your mind: Exercise releases endorphins, which are your body's natural mood-lifters and painkillers. 
   
   Start small. A 10 minute walk, some gentle stretches or a few simple core exercises can make a huge difference. The key is consistency, don't push yourself too hard, especially during bad pain days. The goal is just to move your body in a way that feels good, not to run a marathon and knacker yourself out more!
   
   
2. Address your Sleep
   Improving your sleep is non-negotiable. Create a relaxing bed time routine. Make sure your bedroom is dark, quiet and cool. Avoid screens for at least an hour before bed, but one other recommendation would be to talk to your doctor if you're still struggling, as there may be an underlying issue like sleep apnea that needs addressing first. 
   
   
3. Fight Inflammation with Food
   What you eat can have a direct impact on your pain levels. Try to incorporate more anti-inflammatory foods into your diet, such as: 
   
   - Fatty Fish: Salmon, mackerel and sardines are rich in omega-3 fatty acids. 
   - Leafy Greens: Spinach, kale and collard greens are packed with antioxidants.  
   - Berries and Cherries: These fruits are full of compounds that fight inflammation. 
   - Nuts and Seeds: Almonds, walnuts with chia seeds are a great sources of healthy fats. 
   
   At he same time, try to limit pro-inflammatory foods like sugar, refined carbs and processed meats. 
   
   
4. The Support
   Don't underestimate the mental side of things. Finding healthy ways to cope with the stress and emotional toll of chronic pain is crucial. This could include: 
   
   - Mindfulness and meditation: These practices can help you to observe your pain without getting caught up in it. 
   - Talking to someone: Whether it's a friend, family member, or a professional therapist, talking about what you're going through can be incredibly helpful.
   - Joining a support group: Connecting with other who understand what you're going through can make you feel less alone.  
   
   
5. Drug Free Pain Relief
   Many people with chronic back pain rely on medication, but it's not the only option. Lets be honest, popping pills everyday isn't the greatest long term solution for most people. The side effects, the worry about dependency, it can be a lot. There are powerful, drug-free therapies that can help you manage your pain and break the cycle. One of the most effective and well-researched is TENS therapy. 
   
   TENS machines for chronic back pain and small, portable devices that use gentle electrical pulses to relieve pain. They work in two ways: 
   
   - By blocking pain signals: The electrical pulses essentially "close the gate" on the pain signals travelling to your brain. 
   - By releasing endorphins: The stimulation encourages your body to release it's own natural painkillers. 
   
   Using a TENS machine is a great way to get on-demand relief without the side effects of medication. You can use it at home, at work, or whenever you feel a flare up is coming on. It can help you reduce your pain enough to get moving, sleep better, and start breaking that pain fatigue cycle. 
   
   The research backs this up too. A major 2022 review of 381 studies found solid evidence that TENS machines provide real pain relief for chronic conditions. For the side effects, very minimal - typically it's a mild skin irritation where the pads sit. Compare that to the long list of side effects that come with most pain medications, and it's easy to see why many people are turning to TENS machines for chronic back pain. 
   
   

Root Causes to Fight Back

Knowing why you're so drained is the first step. But it also helps you understand what's actually causing your chronic back pain in the first place. There are many chronic back pain causes, and getting to the bottom of yours can help you find the most effective treatment. 

Some of the most common culprits include: 

If you're dealing with chronic lower back pain, it's worth talking to a doctor to figure out what's going on. Once you know the cause, you can target your treatment more effectively. 

Simple Routines to Start Feeling Better

If all of this feels like a lot, don't worry. You don't have to do everything at once. Here's a simple route to start with: 

Morning: Before you even get out of bed, do a few gentle stretches. Pull your knees to your chest, one at a time, and hold for 30 seconds. This helps to loosen up your back after a night of sleep. 

During the day: Set a timer to remind yourself to get up and move every hour if you sit a lot. Even a quick walk around the room or a few shoulder rolls can help. Pay attention to your posture - for example, are you slouching? 

Evening: This is a great time to use a TENS machine. Spend 20-30 minutes with the pads on your lower back or where you require the treatment (following the manual), while you relax, watch tv or read. It can help to ease the day's tension and set you up for a better night's sleep. 

Before Bed: Do a few more gentle stretches. Try a child's pose or gentle spinal twist. Then, focus on your sleep routine - dim the lights, put away your phone and try to relax.

When to See a Doctor

While these strategies can make a huge difference, it's also important to know when to seek professional help. 

• Your pain is the result of a recent injury.
• The pain is severe and getting worse.
• You have numbness, weakness, or tingling in your legs.
• You experience problems with your bladder or bowels. 
• You have a fever of unexplained weight loss along with your back pain. 
  

These can be signs of a more serious condition that needs medical attention. A doctor can help you get an accurate diagnosis and create a treatment plan that's right for you.