Though night pain is often experienced with those who have musculoskeletal problems, especially when they attempt to change position in bed, there are other problems we should consider.
One of the red flags when listening to the history of a new/old patient is pain that is worse at night even when not moving.
We need to consider cancer as well as neuropathic pain as causes for this pain.
Neuropathic pain can be the result of:
- Injury or repetitive trauma
- Metabolic and endocrine disorders: Diabetes
- Small vessel disease
- Autoimmune diseases: Sjogren’s syndrome, lupus, and rheumatoid arthritis and Guillain- Barré syndrome,
- Kidney disorders
- Cancers can infiltrate nerve fibers or exert damaging compression forces on nerve fibers.
- Infections :herpes varicellazoster (shingles), Epstein-Barr virus, West Nile virus, cytomegalovirus, herpes simplex and Lyme disease.
- Heavy alcohol consumption: Excessive alcohol consumption causes a reduction in B12, folate and thiamin