Sleep and Musculoskeletal Health: Why Might Your Osteopath Ask About Your Sleep?

by Carien Boshoff

You come in to see your osteopath about your back, neck, jaw or shoulder… so why are they asking how you sleep?

Sleep can provide useful information about a musculoskeletal presentation. Pain at night, sleeping positions, teeth clenching and difficulty getting comfortable can all help your osteopath understand the bigger picture.

Sleep and recovery

Sleep is important for overall health and is involved in processes such as muscle recovery, learning, memory, immune function, and physical and mental performance. Most healthy adults require approximately 7-9 hours of sleep per night, although individual needs vary. Pain can also make it difficult to get comfortable or stay asleep, which is why sleep may come up during your osteopathic consultation.

Jaw pain, headaches and neck pain

If you present with jaw discomfort, headaches or neck symptoms, your osteopath may ask whether you clench or grind your teeth at night.

They may also ask whether you:

• Wake with jaw or facial muscle discomfort

• Experience headaches on waking

• Wear a night guard or splint

• Have been assessed by a dentist

Where appropriate, your osteopath can assess the musculoskeletal structures around your jaw and neck. Suspected teeth grinding or dental concerns may also require assessment by your dentist.

Back, hip and pregnancy related discomfort

Lower back, hip or pelvic discomfort can sometimes make finding a comfortable sleeping position difficult.

Depending on your individual presentation, simple strategies may include:

• A pillow between your knees when side sleeping

• A pillow underneath your knees when lying on your back

• Modifying positions that aggravate your symptoms

• Changing how you get in and out of bed

During pregnancy, your osteopath may also ask about turning in bed, getting in and out of bed and which positions are comfortable. Pregnancy specific sleeping advice should be discussed with your maternity healthcare provider.

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Shoulder and arm symptoms

Your osteopath may ask whether shoulder or arm symptoms change depending on how you sleep. For example, some people notice symptoms when lying on one shoulder, keeping an arm overhead or remaining in one position for a prolonged period. Persistent numbness, pins and needles or weakness should be appropriately assessed rather than assumed to be caused by your sleeping position.

What about your pillow?

There isn't one "perfect" pillow for everyone. Your sleeping position, body shape, mattress, symptoms and personal preference can all influence what feels comfortable. Rather than recommending one particular pillow, your osteopath may discuss your current set up and whether simple changes are worth trialling.

Where does osteopathy fit in?

Osteopathy isn't a treatment for insomnia or other sleep disorders.

However, if musculoskeletal pain or discomfort is affecting your comfort at night, your osteopath can assess your individual presentation.

Management may include:

• Hands on treatment where appropriate

• Individualised exercise and movement advice

• Strategies for managing aggravating movements or positions

• Education and self management advice

• Referral to another healthcare professional where appropriate

  
  

Sometimes asking "How are you sleeping?" simply gives us another piece of the puzzle. If ongoing sleep difficulties are affecting your daily life, speak with your GP or another appropriately qualified healthcare professional.

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Take home message

Sleep and musculoskeletal symptoms can interact in several ways. Your sleeping position may affect how comfortable you feel. Pain may make it harder to sleep. Jaw clenching may be relevant when assessing jaw or facial symptoms. Pregnancy may change which positions are comfortable. Lower back pain may make getting in and out of bed more challenging. That's why your osteopath might ask about sleep even when sleep isn't the reason you booked your appointment. Understanding these details can help build a more complete picture of your musculoskeletal presentation and guide an individualised management plan.

References

Sleep Health Foundation. Pain and Sleep.

Sleep Health Foundation. Teeth Grinding/Bruxism.

Sleep Health Foundation. Pregnancy and Sleep.

Watson, N. F., Badr, M. S., Belenky, G., et al. (2015). Recommended amount of sleep for a healthy adult: A joint consensus statement. Sleep, 38(6), 843–844.