Could Night Shift Work Be Causing Your Low Back Pain?

Working the night shift can feel like flipping your world upside down—while others sleep, you're powering through, saving the world one night at a time. But did you know this nocturnal lifestyle might be sabotaging your spine? Disrupting your body's natural circadian rhythm can lead to a whole host of health issues, including low back pain.

In this blog, we'll uncover how burning the midnight oil could be a hidden culprit behind your back discomfort. More importantly, we'll share some practical tips to help you reset your body's clock and keep your back in top shape.

Who Works The Night Shift?

According to the U.S. Census Bureau more than 9 million Americans regularly work nights. This amounts to approximately 6% of the total US workforce. If you include those who regularly rotate in, and out of night shifts, then the American Psychological Association puts this number closer to 15 million.

Night shift workers often fill some of our most essential roles including driving our trucks, manning the emergency room and hospitals, law enforcement, and the fire department. Night shift workers make up a significant portion of our front line workers and we wouldn’t be able to function without them.

How Does Night Shift Work Impact Health?

Unfortunately, we are starting to discover that night shift work has some connections to the state of our health and that it can come with some serious health implications.

Night shift work has been shown to disrupt the body’s circadian rhythms that govern our sleep-wake cycles. This disruption of our body’s “internal clock” can lead to health conditions like an increased risk of developing diabetes, heart disease, obesity, and chronic pain conditions like low back pain.

What Is A Circadian Rhythm?

Circadian rhythms are 24 hour cycles that take place in all of the cells of our bodies that regulate many of the essential functions and processes that our bodies need to stay healthy.

Most living things follow circadian rhythms including animals, plants, and humans. There are many different circadian rhythms that occur in the body and that affect physical, mental, and behavioral changes throughout a 24-hour cycle.

A Clock In Your Spine?

Recent studies have found that the intervertebral discs between our vertebrae in our spines actually have their own internal circadian clocks. These clocks are regulated by age and small proteins called cytokines that control the growth and activity of some of our immune system cells. These clocks have been linked to disc degeneration (we will talk more about that later!).

All of these rhythms are synchronized with a “master clock” that is located in the brain. This master clock is directly influenced by environmental cues like light and darkness. This is why one of the most commonly recognized circadian rhythms is the sleep-wake cycle.

Why Are Circadian Rhythms Important?

When our circadian rhythms are in alignment and working smoothly they can help ensure that we get good, restorative sleep. This quality sleep is important for a whole range of health outcomes like our physical and mental health.

Unfortunately, when our circadian rhythms are not in sync, one of the first problems to occur is insomnia. Insomnia often goes hand in hand with low back pain and it can be a vicious cycle where that insomnia makes us even more sensitive to pain.

How Does Night Shift Work Affect Spine Health?

Did you know your height actually changes throughout the day? As you go about your daily activities, the intervertebral discs—the cushions between your spinal vertebrae—lose fluid due to the pressure of standing and moving. This fluid loss leads to a reduction in disc height, causing you to be slightly shorter by the end of the day. Something else that is interesting? More than half of this height reduction occurs within the first hour after waking, and about 80% happens within the first three hours.

Our spinal discs follow a daily cycle: about 16 hours of daytime activity compresses them, squeezing out the fluid, followed by about 8 hours of sleep during which they rehydrate and regain height.

This nightly restoration is crucial for maintaining our spinal health. During sleep, a process called autophagy occurs within the discs, where cells remove damaged components, promoting cellular health and function.

Disruptions to this natural rhythm, like those caused by irregular sleep patterns or long periods of standing (or spinal loading) without adequate rest, can interfere with autophagy and may contribute to the degeneration of our intervertebral discs.

What Is Autophagy?

Autophagy is a natural process where cells clean out tired and damaged proteins, recycling them for new functions. This clever "cellular housekeeping" follows a circadian rhythm, and it happens mainly during nighttime rest. Lack of sleep can disrupt this process, reducing autophagy's effectiveness. For night shift workers, irregular sleep patterns may impair autophagy and can lead to issues like low back pain.

Keeping consistent sleep schedules and ensuring adequate rest are crucial for supporting the autophagy process. For those working night shifts, adopting strategies to improve sleep quality can help minimize disruptions to this essential process, and reduce the risk of low back pain.

How Does Night Shift Work Affect Circadian Rhythms?

Recent studies have begun to explore the impacts of night shift work on our circadian rhythms and on our overall health. Some studies done on mice have found that there is a higher risk of disc degeneration when the circadian rhythms were disrupted, such as occurs in shift work.

These studies support the idea that shift work may be a contributing factor for an increased risk of developing degenerative intervertebral disc diseases (IDD) and increase the risk for low back pain.

Are Night Shift Workers Being Left In The Dark?

Recently data have emerged showing that "prolonged intensive" physical work (for 12 months) impacted circadian rhythm genes and induced IDD even in normal environments. When the researchers added a light-dark cycle disruption to the working environment this effect was made even worse.

How Can You Fix It?

Essential workers are, well, essential. We rely so much on the incredible people who staff various night shift jobs around the nation and to leave them with no answers would be terrible.

While there is no doubt that working the night shift is not ideal for your health and that it can definitely be a risk factor for many health problems, like low back pain, there are some things that night shift workers can do to try and combat these challenges.

4 Ways To Help With Circadian Rhythm Disruption And Prevent Back Pain

1. Focus On Regulating Sleep Schedules

While it might be challenging to do (especially if you have to help out with family responsibilities), maintaining a regular sleep schedule is key. Night shift workers should try to stay on the same sleep schedule every day of the week - even on your days off.

The more you can stick to a regular schedule, the better your body will learn to deal with this sleep pattern. The faster your body can learn what your schedule is, the better your quality of sleep will be.

How To Do It:

Switching from night sleeping to day sleeping just throws your body clock off and it never has time to get into a regular pattern. Your body literally never knows when you are going to sleep so it can’t prepare to do the important biological processes that it needs to do.

If you simply can’t do this - maybe you are a pilot or you work rotating shifts - try adjusting your sleep time before your schedule change. On the last few days of your current shift, try pushing out your bed time and waking time by 1-2 hours each day. This will help signal to your body that there is a change coming which might not be so abrupt when you switch over to evenings or days.

2. Melatonin

If you simply can’t regulate your schedule or prepare for a new one, melatonin might be an option for you. Melatonin is a hormone that the brain releases at night (in response to darkness). Melatonin has been found to help with circadian rhythms.

If you are flying, changing time zones, or switching schedules, taking melatonin might help since studies have found that it is very effective at helping people with jet lag.

While melatonin has been found to be safe in healthy adults, you should definitely read the dosage and directions and only take the recommended amount. Recently hospital systems have reported an alarming increase in melatonin poisoning amongst children, so if you have children in the home you should be particularly careful.

3. Light Therapy

Something that has been tested and that is completely safe and often effective is light therapy. Studies have shown that using intentional exposure to bright light is an effective way to adjust your sleep cycle.

Light therapy takes special artificial bright lights and exposes your eyes to intense (but safe) amounts of light. If you are trying to reset your circadian rhythm, ideally you would use light therapy in the evening, either before your shift, during your shift, or both. Then, when you need to start winding down your “day” you would turn the light therapy off, and make sure that you also avoid daylight on your way home. Wearing dark sunglasses can help with this.

How Light Therapy Works

There are lots of different makes, models and sizes of light boxes that you can purchase and they are not very expensive. It is important to note that light therapy is different from the stark overhead lighting often found in office buildings.

Therapy lamps are designed to produce a certain level of something called LUX. LUX is a measurement of light-level intensity or illumination. While typical office lights can help our sleep-wake cycles, they don’t have enough LUX to impact medical conditions like circadian rhythms or depression.

Light therapy boxes have been proven to help with medical conditions like seasonal depression, seasonal affective disorder, and circadian rhythm disruption. Sessions don’t need to be very long and can be as short at 15 to 30 minutes. Depending on your body and your specific needs you might need more than one session per day. Finding the right time and the right duration will be key to managing your sleep.

4. Sleep Hygiene

Developing good sleep habits is essential to combating the negative effects of night shift work. Plan your sleep schedule and don’t let other tasks and chores get in the way of your schedule. Plan errands and home repairs for after your sleep. Make your sleep a priority - not a luxury.

Avoid eating big meals right before bed, as well as avoiding caffeine or alcohol as those will definitely cause you to have a more restless sleep. Save your morning coffee for when you wake up and before you head to work. Then make sure you don’t have caffeine too close to the end of your shift.

Sleep Hygiene Tips and Tricks

Having a nice dark room with black out curtains can also help you to stay asleep. You might want to invest in some sound proofing for your room or a white noise machine to help block out those unwanted daytime disruptions. It is also important to put away your cell phone or turn off blue-light emitting devices a couple of hours before bed.

Don’t start your shift sleep deprived. Injuries and mistakes are common when we are tired, and depending on your job these could be life-threatening. If necessary, take a nap before work or during your shift to help you stay alert.

Conclusions

Our bodies are remarkable, performing countless functions beyond our awareness. Understanding how our environment influences our health, particularly concerning low back pain, empowers us to make informed choices.

The biopsychosocial model considers how biological, psychological, and social factors all work together in both health and illness. By recognizing these connections, we can develop effective strategies to mitigate negative impacts and enhance our well-being.