Bidirectional association between disturbed sleep and neuropathic pain symptoms: a prospective cohort study in post-total joint replacement participants

  • Joanne Stocks, Nicole Tang, David Walsh, Sophie C Warner, Hollie Harvey, Wendy Jenkins, Abhishek Abhishek, Michael Doherty, Ana Valdes
  • Journal of Pain Research, June 2018, Dove Medical Press
  • DOI: 10.2147/jpr.s149830

Relationship between sleep and pain after joint replacement surgery.

What is it about?

People experiencing long-term pain commonly complain of disturbed and insufficient quality sleep, which is associated with high blood pressure, type 2 diabetes and obesity. This study aimed to discover a possible link between sleep and long-term knee and hip pain.

Why is it important?

Changes in the nervous system can cause neuropathic-like pain symptoms, and 25–30% of people with painful osteoarthritis, who have had a total joint replacement, still report symptoms of neuropathic pain. In these people, a strong link was found between long-term joint pain and disturbed sleep. This increased incidence of disturbed sleep linked specifically to neuropathic-like pain symptoms and not merely to the presence of pain. We also found that disturbed sleep increases the risk of developing new long-term pain in previously pain-free individuals.


Dr Joanne Stocks
University of Nottingham

In people with osteoarthritis who have undergone total joint replacement, neuropathic pain can predict poor sleep and vice versa. Improving sleep disturbance and joint pain has the potential to improve outcomes after joint replacement surgery, particularly if pain-relieving strategies target neuropathic joint pain.

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The following have contributed to this page: Dr Joanne Stocks