A spinal tumor is an abnormal growth of cells within or surrounding the spinal cord. Many individuals with these tumors report that their pain frequently intensifies at night. This article explores the scientific reasons behind this nighttime worsening of spinal tumor pain.
How Spinal Tumors Cause Pain
Spinal tumors cause pain through several mechanisms. They directly compress the spinal cord and nerves, disrupting function and leading to localized or radiating pain. The tumor’s size and location dictate the specific nerves affected and resulting pain patterns. Tumors also invade and destroy bony vertebral structures, weakening the spinal column and causing mechanical pain. Additionally, a tumor often triggers an inflammatory response in surrounding tissues, with chemicals sensitizing nerve endings and contributing to pain.
The Body’s Circadian Clock and Inflammation
The body’s internal clock, the circadian rhythm, modulates pain perception and inflammatory processes over a 24-hour cycle. This rhythm influences hormone and immune component release. Anti-inflammatory cortisol peaks in the morning and declines at night. As cortisol levels drop, the body’s anti-inflammatory defenses diminish, allowing inflammatory processes to become more active, and pro-inflammatory cytokines to increase. This nocturnal shift in inflammatory mediators heightens the inflammatory state around the tumor, increasing pain sensitivity.
Positional and Pressure Changes
Lying down alters spinal canal dynamics, contributing to increased pain from spinal tumors. When horizontal, pressure within the venous system, which drains blood from the spine, increases. This rise in venous pressure engorges blood vessels around the spinal cord and tumor, increasing volume and pressure within the spinal canal. This elevated pressure directly compresses the tumor and compromised nerve roots, exacerbating pain. Lying flat also impacts cerebrospinal fluid (CSF) flow and pressure, and the absence of gravitational forces that typically drain blood from the spinal area when upright, contribute to localized pressure increases around the tumor site.
Other Nighttime Influences
Other factors contribute to the worsening of spinal tumor pain at night. During the day, activities provide distraction, diverting attention from pain signals. At night, with reduced external stimuli and quiet surroundings, there is less distraction, making pain more prominent. Muscle tension can also contribute; some may unconsciously tense muscles around the painful area during sleep. Additionally, altered blood flow and reduced physical movement at night may lead to a buildup of metabolic waste products or a decrease in oxygen supply to the tumor area and surrounding tissues, irritating nerve endings and exacerbating pain.