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Pain That Wakes You Up At Night Should Scare You

It could be nothing. Or it could be cancer.

One moment, you’re shooting through the waves of the Pacific Ocean with your new mermaid tail, high-fiving dolphin flippers left and right. The next, you’re jolted from your lovely (and strangely erotic) dream by a shooting pain down your spine that feels like you’re being impaled by the trident of Poseidon himself.

What in the actual fuuu —

“Pain is a sensation you feel when nerves are stimulated to an intense degree,” explains Michael Port, a board-certified pain management doctor. “Pain is subjective: The most common pain scale is the 10-point visual analog scale, with ‘0’ being no pain and ‘10’ being unbearable pain.”

That’s why, according to Port, there’s no such thing as a “universal level of pain” that can jolt someone awake from their sleep. “Pain is subjective,” says Port. “Individual differences in pain sensitivity have long remained a perplexing and challenging clinical problem. My job then is to focus pain treatment on an individual-by-individual basis.”

The rest of the medical community agrees, and researchers focus their approach accordingly.

Still, wherever it lands on the scale, pain that wakes you up at night is definitely a cause for concern. “Pain affects everyone differently, but the kind that wakes you up should be taken seriously,” explains Port. “It scares me.”

Why?

Because according to Port, there are two different types of pain: Rest pain and activity pain. “Mechanical pain or motion-based pain tends to get better at night. But malignant types of pain, like bone cancer pain, get worse at night,” says Port. “People who spike fevers from infections tend to see spikes at 2:30 in the morning.” A recent patient of Port’s, in fact, who’d seemed to be in perfect health, ended up being diagnosed with an infection in his spine after repeatedly waking up at 2 a.m.

All of which sounds pretty terrifying, but Port is quick to point out that not all pain that appears when the body is at rest is of the life-threatening sort. “When you lay down and go to sleep, in some instances, you have less things to distract you, and you can become more aware of the pain,” says Port.

That’s why a person’s mood can deeply impact their personal assessment of pain. “A football player who’s hurt during a game isn’t going to feel the pain from a sprained ankle nearly as severely as a person who’s depressed,” says Port. “And beyond a person’s mood, other things that influence pain are genetics, gender, cultural background and even socioeconomic status. In some societies, it’s more acceptable to express your pain.”

The takeaway being, the level of pain that’s enough to wake you up is personal to you — but you should pay attention to it.

Now, go back to sleep, if you can. The dolphins are waiting.