A new perspective

The sleep-pain cycle

It is known that chronic pain can impact a person’s mood, social life and work, as well as their mental and physical wellbeing.

These are all things that happen during waking hours, but chronic pain also affects the hours that are supposed to be for sleeping. 

“Chronic pain and poor sleep are closely connected, and for many people, one fuels the other,” says Lisa Artis, deputy CEO of The Sleep Charity.

“Disrupted sleep doesn’t just leave us feeling tired – it can intensify how we experience pain. “Sleep is essential for the body’s repair and recovery,” Lisa explains.

“When sleep is poor or fragmented, our pain threshold drops and the nervous system becomes more sensitive. This means pain can feel stronger and more persistent the next day.”

While we sleep, our bodies are working to process emotions, heal our muscles, and rest. If we can’t get to sleep – or stay asleep – due to pain, our bodies are not able to perform these crucial tasks and we end up in more pain, discomfort, and feel mentally drained the next day.

The Sleep Charity notes how a lack of quality sleep increases inflammation and reduces the body’s natural ability to regulate pain, and sufferers end up with short patches of light, less restorative sleep.

“Over time, this creates a self-perpetuating cycle,” the charity says. “Pain disrupts sleep, and poor sleep worsens pain.”

Quality and quantity

Taking steps to improve the quality and quantity of sleep should significantly improve a customer’s life. This may be because they wake up with better mental clarity to make decisions about their pain management, or because their muscles have actually had a chance to rest.

“Keeping regular bed and wake times helps stabilise the body’s internal clock, which can improve sleep depth and make it easier to fall asleep, even when pain is present,” says Lisa.

Customers also need to give themselves the best opportunity for good quality sleep by ensuring they have a supportive mattress and pillows that reduce pressure on joints and muscles.

Other sleep hygiene practices like keeping the bedroom as a place for sleeping only (not watching TV or scrolling through social media in bed) and making sure it is dark and cool are all factors that will promote a better night’s sleep.

“Practising relaxation techniques such as deep breathing or progressive muscle relaxation can quieten the nervous system and reduce pain-related tension,” says Lisa.

“Improving sleep won’t cure chronic pain, but it can reduce how intense pain feels and improve quality of life. Better sleep supports resilience, mood and the body’s ability to cope – which is vital for anyone living with long-term pain.”

With the right support and practical strategies, good sleep can become a powerful tool in managing chronic pain, making people feel better rested, more in control, and better able to get through the day.

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Can food fix it? 

Amongst the self-care practices that pharmacy teams can suggest to customers with chronic pain is for them to consider the foods they are eating more carefully.

Nutrition is a cornerstone of wellbeing in general, and even more so for those struggling to manage their pain levels.

Registered nutritionist, author and The Wellness Scoop podcast co-host Rhiannon Lambert notes that while every individual is different, there is a link between dietary patterns and pain markers that is worth exploring.

“Chronic pain is complex and multifactorial, and it’s important to be clear that food alone is not a treatment for pain conditions,” she says.

“However, from a nutrition perspective, what we eat can influence underlying processes such as inflammation, gut health, blood glucose regulation and overall metabolic health, all of which may play a role in how pain is experienced or managed over time.

“Certain dietary patterns may support the body’s ability to regulate inflammation, while others may do the opposite and exacerbate it, particularly if they are low in fibre and micronutrients and high in ultra-processed foods,” Rhiannon explains.

All part of the plan

“Diets characterised by a higher intake of vegetables, fruits, wholegrains, legumes and healthy fats, and a lower reliance on ultra-processed foods, such as the Mediterranean diet, have been associated with reduced inflammatory markers,” says Rhiannon.

The Mediterranean diet focuses on plants – but does not wholly exclude meat –  and is recognised by the World Health Organization as a healthy eating plan. Studies have linked the diet with a lower risk of long-term diseases like heart disease.

While there is no single definition – and it is eaten all over the world in different variations, despite being known as the Mediterranean diet – it most often consists of daily consumption of vegetables, fruits, whole grains, nuts and seeds, olive oil, and seasoning with herbs and spices.

It encourages weekly portions of fish, poultry, beans, legumes and eggs, with moderate portions of dairy, limited red meat and limited added sugar foods. Hand in hand with this, the eating pattern also includes sharing meals with family and friends, regular exercise, and wine in moderation for those who drink alcohol.

“Gut health is another emerging area of interest,” says Rhiannon. “Research increasingly highlights a potential connection between the gut microbiome, immune regulation and inflammatory signalling.

Blood glucose regulation may also be important here, too. Diets that lead to frequent sugar spikes and crashes can increase oxidative stress and inflammatory responses in the body.

In contrast, balanced meals that include fibre, protein and fats tend to promote more stable glucose levels, which may indirectly support overall inflammatory control and energy levels, and both could be important considerations for people living with persistent pain.”

Rhiannon emphasises the point that there is no one-size-fits-all approach here, however, and that anyone with chronic pain should discuss management options with a suitably qualified healthcare professional.

Stay consistent

Dietary changes can play a part in a person’s overall pain management plan, but they should be tailored to the person’s own particular needs and circumstances. So, what might this look like in reality?

Customers need to look at their diet as a whole, to see where they can improve things like fibre intake or the number of gut-friendly foods they are eating.

“For individuals with chronic pain, adopting a more nutrient-dense, fibre-rich dietary pattern may support overall health, energy levels and metabolic resilience, all of which can influence day-to-day symptom management,” Rhiannon says.

“Overall, the strongest evidence supports focusing on consistent, long-term dietary patterns rather than short-term interventions or specific, ‘anti-inflammatory’ foods.

“Nutrition shouldn’t be viewed as a cure for chronic pain, but dietary factors may play a role in the mechanisms associated with pain. For this reason, dietary changes are best viewed as one piece of a much larger puzzle, alongside medical care, physical therapy, psychological support and lifestyle factors such as sleep and stress management.”

Any customers who want to more carefully consider their diet and the role it can play in their pain management should ultimately focus on minimally processed whole foods that are nutrient dense.

“Importantly, this way of eating is not about restriction or perfection,” says Rhiannon. “For people living with chronic pain, flexibility and sustainability are key, and dietary choices should be adapted to individual needs, preferences and tolerances.”