Amanda Relph LMT

🧠 Why Poor Sleep Makes Chronic Pain Worse 😴

Ever notice that after a bad night's sleep, everything hurts more?

That's not your imagination.

Researchers have found that poor sleep can actually increase pain sensitivity the next day. In some studies, sleep deprivation affected pain levels more than certain tissue injuries.

Think about that for a second.

Missing sleep doesn't just make you tired—it changes how your nervous system processes sensation, stress, and pain. ⚠️

When you're sleeping, your brain is busy regulating hormones, processing information, repairing tissues, and helping your nervous system reset.

When sleep quality drops, your nervous system doesn't get the same opportunity to "turn down the volume."

The result?

📈 More sensitivity

📈 More muscle tension

📈 More fatigue

📈 Lower pain tolerance

📈 More pain

This creates a frustrating cycle for many people living with chronic pain:

Pain disrupts sleep. 😩

Poor sleep increases pain. 😩

More pain disrupts sleep even further.

And around it goes.

This is one reason many pain specialists now view sleep as a treatment target—not just a symptom.

It's also one reason massage therapy can be helpful for some people with chronic pain. Beyond muscles and joints, massage may help calm the nervous system, reduce stress, and support the conditions needed for better sleep. 🤲

No, a massage isn't going to magically erase years of chronic pain.

But helping the nervous system feel safer and more relaxed may improve one of the most important factors in pain management: sleep.

Sometimes the most productive thing you can do for your pain isn't another stretch, exercise, or gadget.

Sometimes it's getting your nervous system to stop sending emails at 3 a.m. 😏

💚 If you'd like to see more chronic pain content, drop a green heart below. And if you have a question about chronic pain, ask it in the comments—we're always looking for topics to cover in future posts.

Ok, my chronic pain warriors, here we go!

Pain and damage are not always the same thing.

Read that again.

Most of us were taught that more pain means more damage and less pain means more healing. But when it comes to chronic pain, that relationship often falls apart.

Think about a paper cut. ✂️

It can hurt like crazy even though the tissue damage is tiny.

Now think about athletes who finish an entire game before realizing they broke a bone, tore a ligament, or suffered a serious injury. 🏃

The amount of pain someone feels isn't determined by tissue damage alone. Your brain is constantly evaluating information from your body and asking one question: "How much protection is needed right now?" 🚨

That decision is influenced by far more than tissues.

Sleep. 😴

Stress. 😬

Previous injuries. 🤕

Fear of movement. 😟

Past experiences. 🧠

Even your expectations can influence how much pain you feel.

That's why two people with nearly identical MRI findings can have completely different pain experiences.

One person may have severe pain. The other may have none at all.

This is also one reason massage and manual therapy can help some people with chronic pain.

A skilled therapist isn't just working with muscles. They're providing movement, touch, pressure, and sensory input that helps the nervous system gather more information about what's happening in the body.

Sometimes that information helps the brain realize, "Maybe this isn't as dangerous as I thought."

That doesn't mean pain is "all in your head." It means pain is produced by your nervous system—not just your tissues.

And that's an important distinction. 🤲🧠

The good news? If the nervous system can learn pain, it can also learn safety.

💚 If you'd like to see more chronic pain content, drop a green heart below. And if you have a question about chronic pain, ask it in the comments—we're always looking for topics to cover in future posts.

🧠🤲 Why Does Massage Help Chronic Pain If It Doesn't "Fix" The Injury?

This question has interested researchers for years.

If chronic pain were only about damaged tissues, massage shouldn't help very much. After all, many people living with chronic pain have tissues that healed months—or even years—ago. Yet they still experience pain, stiffness, muscle guarding, fatigue, and movement limitations.

So what's happening?

One theory is that manual therapy provides the nervous system with new, non-threatening sensory information.

Think about it: every second, your brain receives an enormous amount of input from your skin, muscles, fascia, joints, and nervous system. Its job is to sort through all that information and decide what is safe and what might be a threat.

When pain becomes chronic, the nervous system can become a little... overprotective. 🚨

A light touch feels uncomfortable. Movement feels risky. Muscles stay tense. The body begins acting as if danger is everywhere—even when no new injury is occurring.

This is where massage and manual therapy become interesting.

When a skilled therapist applies pressure, movement, stretching, or touch, thousands of sensory receptors start sending information back to the brain.

That information may help communicate:

📢 "This area can tolerate movement."
📢 "This area can tolerate pressure."
📢 "This area is stronger and more capable than you think."
📢 "Maybe we don't need a five-alarm response to putting on a sock."

Researchers now believe that one of the benefits of manual therapy may be its ability to influence how the nervous system interprets sensation, movement, and threat—not just what it does to muscles and connective tissue.

That doesn't mean massage "cures" chronic pain. But, it DOES mean that it may help create an environment where the nervous system can become less protective, less reactive, and more willing to allow normal movement. 🧩

In other words, massage may be doing more than working on muscles. Sometimes it's a conversation with the nervous system.
And if your nervous system has been convinced for years that your neck, back, hip, or shoulder is a full-scale emergency, that conversation can be incredibly important. 😏

💚 If you'd like to see more chronic pain content, drop a green heart below. And if you have a question about chronic pain, ask it in the comments—we're always looking for topics to cover in future posts.

If you’ve had pain for months or years, your brain may have literally changed the way it “sees” part of your body.

Yep. That’s a thing. 😳

Research has shown that chronic pain can alter the brain’s body map—the internal representation of where your body parts are and how they move. In some people, painful areas can actually become “blurred” in the brain’s perception. 🧩

Why does that matter? Because the brain relies on these maps to accurately interpret sensation, movement, and potential threats. When the map becomes less precise, the nervous system may become more protective. That can contribute to increased pain, stiffness, movement hesitation, poor coordination, or the feeling that a body part just doesn’t move quite right—even when the tissues themselves have healed.

Imagine you injured your low back a few years ago. The disc healed. The inflammation settled down. The tissues recovered as much as they’re going to. But your nervous system has spent years watching that area like a hawk. 👀

Now every little twinge, movement, position change, or sensation gets flagged for review.

In other words, your brain has been responding to the same alarm for so long that it has started treating every input as an emergency. 🚨

This doesn’t mean the pain is imaginary. It means pain is more complex than damaged tissues. The nervous system, the brain, and the body are all part of the conversation. 🧠💬

Sometimes chronic pain isn’t a sign that something is still broken. Sometimes it’s a very dedicated alarm system that missed the memo that the crisis ended a long time ago. 😏

One of the hardest parts of chronic pain is that the experience often doesn’t match what people are told to expect.

💚 If you’d like to see more chronic pain content, drop a green heart below. And if you have a question about chronic pain or suffer from chronic pain and want to tell your story, ask/tell it in the comments—we’re always looking for topics to cover in future posts!👇

🚫 Fun fact: massage therapists are occasionally supposed to say “absolutely not.” 😅

People are always shocked when I say there are times massage can actually be a BAD idea. A good therapist isn’t just there to make muscles happy — they’re also supposed to know when your body needs rest, medical care, or just less chaos in general. 🙃

For example:

⚠️ Fever or contagious illness — Your immune system is already in battle mode, and massage increases circulation and lymphatic flow. That can actually worsen symptoms and make you feel even more awful afterward… while also generously sharing your plague with everyone else. 🤧

⚠️ Blood clots/DVT — Deep massage can potentially dislodge a clot. Translation: this can become a horrifying ER field trip. 🚑

⚠️ Open wounds or skin infections — This one speaks for itself, right? 😩🦠

⚠️ Recent surgeries or acute injuries — Your tissues are in “under construction” mode. Massage before you have been medically cleared by your physician can irritate already angry nerves and tissues, and muscles can become hypersensitive and begin to guard unnecessarily. 😫

⚠️ Severe osteoporosis — Fragile bones and deep pressure are not exactly a dream team. 🫠

⚠️ Uncontrolled high blood pressure — Massage affects circulation and the nervous system, so unstable BP needs caution first. ❤️

⚠️ Active shingles outbreak — If the nerve pain wasn’t bad enough already, massage over active shingles can irritate tissues even more. Hard pass. 😬

⚠️ Certain autoimmune flares — During a major flare, some people’s nervous systems and tissues are already hypersensitive. What normally feels relaxing can suddenly feel like your muscles are filing a complaint with HR.

⚠️ Severe sunburn — You know that scene where someone lightly touches a sunburned shoulder and the person levitates? Yeah. That. ☀️🔥

⚠️ Recent steroid injections or fillers — Sometimes tissues need time to settle before we go mashing around in there like we’re kneading bread dough.

⚠️ Extreme dehydration or hangovers — Massage can sometimes make you feel worse when your body already resembles a raisin internally. 💀

A good massage therapist should know the difference between “this will help” and “this is how we accidentally create a medical anecdote.” 💆‍♀️✨

Turns out massage isn’t just for humans trying to survive their stress levels—your arthritic dog can benefit too 🐶💆‍♀️

When dogs have arthritis (like my pup here) their joints get stiff, inflamed, and honestly… pretty cranky. Gentle massage helps increase blood flow, loosen tight muscles around those joints, and can actually reduce pain and improve mobility. Think: less struggling to get up, more tail wags.

Bonus? It also helps calm their nervous system, which matters because chronic pain and stress love to hang out together.

So yes—your dog might not book their own appointment, but their joints would absolutely thank you if they could 🐾

💪 Muscle of the Week: The Levator Scapulae 🙃🔥

Ah yes… the levator scapulae.
Also known as: “Why can’t I turn my head without immediate regret?” 😌

This little troublemaker runs from the top of your shoulder blade up into your neck. Its job?
👉 Elevate your scapula (10/10 naming effort)
👉 Help rotate your neck
👉 Assist with posture… theoretically

Sounds innocent. It is not.

When it gets tight or overworked, you might notice:
• That sharp, stabby pain when turning your head 😵‍💫
• A constant knot at the top of your shoulder blade 🎯
• Neck stiffness that refuses to cooperate 🙃
• Pain when looking down (hello, phone addiction 📱)
• Headaches creeping up from the base of your skull 🤯

And let’s be honest—this muscle THRIVES on stress, poor posture, and “just five more minutes” on your phone (which is never five minutes). It’s basically running on caffeine and bad decisions ☕️

✨ Quick check: look down toward your armpit. If it feels like a deep pull—or mild personal betrayal—your levator scapulae is very involved.

From a therapy standpoint, this one loves targeted release, gentle stretching, and you maybe not living on your phone 24/7 (again… rude, I know).

And no—rolling your shoulders twice and hoping for the best is not a treatment plan. 😉

🔥 Quick Fix

Grab a lacrosse ball, place it at the top inner corner of your shoulder blade, and lean into the wall until you find that spicy knot 😌 Hold pressure for 30–60 seconds and breathe—yes, it’s uncomfortable, but it should feel like a “good hurt,” not sharp pain.

If you’re feeling bold, slowly turn your head side to side while holding pressure. Finish with a quick stretch (look into your armpit) and try not to go right back to your phone hunch 📱😜

The piriformis. A tiny muscle buried deep in your butt that somehow thinks it’s the CEO of your entire lower body. 🫠🍑

It externally rotates your hip, helps with abduction when your hip is flexed, and stabilizes the joint… which is impressive, considering it’s about the size of your patience after sitting too long. 🙃

And because it lives right next to the sciatic nerve, when it gets irritated it’s like, “Cool, let’s involve the entire leg.” 🔥⚡️ Cue the classic “sciatica” symptoms that may or may not actually be your piriformis—but don’t worry, it will absolutely take the blame anyway.

But here’s the part nobody loves: it’s usually not just “tight.” It’s often overworking because your hips aren’t doing their job, your glutes are on vacation, and your nervous system is a little… spicy. 🌶️ So maybe—just maybe—aggressively trying to destroy it with a lacrosse ball isn’t the personality trait you think it is.

👉 Try this:
Seated piriformis stretch (aka “office-friendly regret”):
Sit tall, place one ankle over the opposite knee, then hinge forward at your hips (not your spine) until you feel a stretch deep in the glute. Keep your chest lifted, go slow, and stop before your body files a complaint. 🪑😌

Chronic pain isn’t just your body being dramatic for fun (even though it really feels like it) 😅
Over time, the system itself changes—central sensitization, increased dorsal horn excitability, glial cell activation, and reduced descending inhibition all make pain signals louder and easier to trigger 🔥🧠

So no… it’s not always about “tight muscles” or something needing to be aggressively bullied into submission 💪
Pain is an output shaped by the brain, not a direct readout of tissue damage. Nociception ≠ pain. Your brain is constantly weighing input, context, and prediction—and sometimes it gets a little… overprotective 🤖⚠️

Massage can help—but not because we’re out here breaking up mythical knots 🫠
It provides novel, non-threatening sensory input that can modulate dorsal horn activity, reduce temporal summation, shift autonomic balance toward parasympathetic dominance, and update cortical maps and threat perception 🌿

Less “fixing tissue,” more “changing how the system processes input.”
Wild concept, I know 😌

Muscle of the Week: The Palmaris Longus 🖐️💪

Meet the palmaris longus — the overachiever that our bodies apparently decided we didn’t really need anymore. 🧬

About 10–15% of people don’t even have this muscle, and the rest of us are just walking around pretending it matters. 🤷‍♀️

Touch your thumb and pinky together and flex your wrist. 🤏

If a little tendon pops up… congratulations, you have a palmaris longus. 🎉

If nothing shows up… congratulations, you’re also perfectly fine. 😆

About 10–15% of people don’t even have this muscle, and the rest of us are just walking around pretending it matters.

Surgeons actually harvest this tendon for grafts all the time because your body basically shrugs and goes, “Yeah… we weren’t really using that anyway.”

So the palmaris longus is kind of like the office employee who still technically works there… but nobody can remember what their job is.

Anatomy is weird.

Bodies are weird.

And yet somehow everything still works.