It’s always gotta be something, right? If you are suffering from back pain you may have a much greater risk of suffering from insomnia at some point as well. Almost 65 percent of those in chronic pain have disrupted sleep, and each tends to aggravate the other.

It may seem obvious that when you’re in pain you might be tossing and turning a bit more than usual, but when that becomes an every-night occurrence, that becomes an even bigger problem. Your body needs sleep to heal and when you don’t sleep you become more susceptible to stress, fatigue, colds or all other kinds of added symptoms. When you can’t sleep you are more likely to turn to pain relieving drugs, which don’t have the best track record in workers’ comp either.

In workers’ comp, back pain is a big deal. In 2013, workers with back pain needed an average of just over 19 days off of work, though employees in industries like construction needed to be away from work an average of 62 days and utility employees needed an average of 73.3 days off. In all, employees needed to be out of work 212,080 days in 2013 for back problems. Strains or tears accounted for the majority of these kinds of injuries, while pain, contusions or fractures also accounted for a healthy number of time out of work due to back issues.

Back injuries or illnesses accounted for almost one fifth of workplace injuries in 2013. The total number of musculoskeletal disorders that required workers to take time off of work was 380,610 cases in just that year as well.

It may be harder to sleep when you are already feeling sensitive and insomnia tends to increase your sensitivity and the severity of the pain. Many insomniacs claim they have a high stress level, which could result in increased muscle tension and activity which affects back pain as well. Microarousals (when you can wake up several times a night because of changes in your sleep stage) don’t really affect the average person who can just fall back asleep, but when you are in pain that little awakening can turn into two more hours of tossing and turning, since all you have to focus on at night is how much pain you are in.

If you can treat the pain before the sleep disorder you might have a better shot at fixing both, rather than just masking them with sleeping aids at night. Doctors may recommend physical therapy, psychiatric treatment or even medication to help. Other “sleep-regulating” activities a person can do are not take naps during the day and establish a fairly regular wake-up/going to bed routine, as well as trying to do a relaxing activity before going to bed.