A consistent daily routine, such as going to bed and waking up at the same time, may reduce chronic pain without medication, according to a new study from the University of Missouri.
The Centers for Disease Control and Prevention estimates nearly one in four Americans, about 60 million people, live with some form of chronic pain, most commonly back pain, headaches and arthritis.
Researchers analyzed survey data from older adults, many of whom had insomnia, which has been shown to increase sensitivity and lead to inflammation that raises the risk of chronic pain. They found that people who maintained consistent daily routines saw significant reductions in average pain levels and reported fewer symptoms of depression.
The researchers said the improvements may occur because a regular routine helps regulate the body's internal clock, or circadian rhythm, which boosts hormones such as cortisol, melatonin and serotonin that affect mood and pain.
Study Details
The study, published in the Journal of Behavioral Medicine, surveyed 67 older adults with an average age of 68, 37 of whom had insomnia. For seven consecutive days, participants recorded when they got out of bed, had their first social interaction, began work or housework, ate dinner and went to bed.
A routine counted as "regular" if it occurred within 45 minutes of a person's average time, with scores ranging from 0, for very irregular routines, to 7, for extremely regular routines. Participants also completed surveys measuring pain intensity and depressive symptoms.
For each one-point increase in routine regularity scores, researchers found an average six percent improvement in pain scores over the study period. For each one-point increase in routine social interactions, there was a 0.7-point decrease in depressive symptom scores, which reflected behaviors such as little interest in activities, feeling down or hopeless, fatigue and difficulty concentrating.
Researcher's Comments
Eunjin Tracy, the study's author and an assistant professor in the College of Education and Human Development at the University of Missouri, said that regardless of sleep quality, those who reported having a regular daily routine had lower levels of physical pain and less depression compared with those without one.
Tracy said that being consistent with when people wake up, eat, work or study, interact with others and go to bed helps synchronize the body's internal clock, and that over the long term this appears linked with improved health outcomes.
Tracy also said that when circadian rhythm is well regulated, the body functions well, but that function declines when the rhythm is too disrupted.
The researchers noted several limitations to the study, including its small sample size and reliance on self-reported data, which can be subject to bias.
