Morning back pain waking you up? Try these simple fixes. @ClevelandClinic. Pain relief from experienced Physical Therapists

Why Your Lower Back Pain Is Worse in the Morning (and What To Do About It)

Your sleep position, immobility, mattress and underlying conditions can all cause morning back pain

There’s nothing worse than waking up on the wrong side of the bed. But it can be hard to avoid when you wake with lower back pain in the morning. A back that throbs, aches or sends shooting pain down your legs can quickly set the tone for your day.

Most people experience lower back pain at some point, and more than 20% have chronic lower back discomfort. It’s the second most common reason people in the U.S. visit their primary care provider — behind colds and flu.

Whether you experience lower back pain all day or only in the morning, understanding what’s contributing to the pain may help you fix it. Pain management specialist Tara-Lin Hollins, MD, shares what might be behind your morning back pain and offers tips to help you wake up pain-free.

4 causes of lower back pain in the morning

Back pain and sleep have a complicated relationship. Pain can disrupt your sleep, and poor sleep can make you more likely to have higher pain. Getting to the bottom of your pain may help end the cycle.

Dr. Hollins says several factors can contribute to morning back pain.

1. The wrong sleep position

You spend a third of your life sleeping or resting, so if your spine is out of alignment while you sleep, it can have a significant impact on your body. Your sleep position affects your alignment and may (or may not) support the natural curvature of your spine.

“It’s common to be so tired at bedtime that you fall into bed and sleep however you hit the bed,” Dr. Hollins says. “But you may not be sleeping in the best position for your spine.”

The most beneficial sleep positions for your back are on your:

Side, with your knees partially bent
Back, as long as you don’t have sleep apnea (which worsens when sleeping on your back)

Sleeping on your stomach makes you more likely to twist your neck to the side — a quick way to throw your neck and spine out of alignment.

2. Lying down for hours

When you sit all day at your desk without moving, it can make you stiff. Similarly, when you sleep, you’re not moving much for seven to eight hours. Lying immobile for a long period could cause you to wake up with back or hip pain.

“Our bodies are not supposed to be stagnant for multiple hours,” Dr. Hollins explains. “Stiffness can settle in, and inflammation can build up. Then, when you try to move in the morning, releasing the inflammation can be painful.”

Tricky, right? After all, you want a good night’s sleep, and lying immobile while you doze is often a sign that you got all of your ZZZs. But to avoid lower back pain, Dr. Hollins advises taking some time to stretch before you jump out of bed.

3. An unsupportive mattress or pillow

Your mattress is your main source of back support while you sleep. And your pillow ensures proper neck alignment. A mattress that’s damaged, too soft or sagging can cause your lower abdomen to sink deeper than the rest of the spine, pulling your back out of alignment.

“All too often, people opt for a soft mattress, thinking it will be more comfortable,” Dr. Hollins notes. “You don’t want a hard mattress, but it should feel firm and supportive. You shouldn’t sink into it.”

Need tips for choosing the best mattress for your back? We can help.

4. An underlying condition or pregnancy

Some conditions or chronic diseases may put you at higher risk for morning back pain. Chronic conditions that affect both sleep and morning back pain include:

Degenerative disk disease, which occurs when your spine’s cushioning wears away with age
Fibromyalgia, which causes muscle pain and spasms throughout the body
Spinal arthritis, which affects up to 95% of people ages 60 and older
Spinal cord issues like sciatica, spinal stenosis or a herniated disk

Pregnancy can also bring back pain in the morning due to:

Additional strain on your lower back muscles
Shifting center of gravity
Increased weight

How to stop waking up with lower back pain

Lifestyle changes, like achieving a healthy weight and exercising every day, are always helpful for back pain. But Dr. Hollins also recommends actions related to sleeping that may additionally help reduce or eliminate your morning back pain.

Add supportive pillows

Pillows are a great way to support your back’s alignment. Your typical sleep position should guide the pillows you use:

Back sleepers. Choose a head pillow that supports your neck and lets your head sink in. Place a pillow under your knees to support your spine’s natural curvature.
Side sleepers. For your head, choose a thick pillow that keeps the top portion of your spine straight and parallel to the mattress. Place a small pillow between your knees to help even out your hips.
Stomach sleepers. Don’t use a pillow for your head, or choose a very thin one. Put a thin pillow under your lower abdomen to keep your spine aligned.

“Look for pillows that are specific to your sleep position,” Dr. Hollins advises. “But no matter which position you use, adding pillows strategically around your body can support your spine and reduce morning pain.”

Adjust your sleep position

If you’re used to sleeping in the same position every night, it can be challenging to change it. But small adjustments may help:

Place both arms in the same position if you sleep on your back — instead of flinging one arm over your head — to keep your spine aligned.
Bend your knees when sleeping on your side to help balance your body and reduce any pressure on your lower spine.
Put pillows in front of you if you sleep on your side so you don’t roll onto your stomach.
Sleep on your left side whenever possible to take pressure off your internal organs.

“You want to be as comfortable as possible when you go to sleep,” Dr. Hollins says. “That way, you’ll be more likely to stay in a supportive sleep position.”

Replace your mattress regularly

According to the Sleep Foundation, the general guideline is to replace your mattress every six to eight years. But you may need a new mattress sooner if yours is:

Making noise (if it’s an innerspring mattress)
Noticeably sagging or damaged
Causing muscle or joint stiffness, especially if you don’t have the same stiffness when you sleep at hotels or other homes

When choosing a new mattress, choose a “medium firm” mattress — level 6 out of 10 on the mattress firmness scale. It may reduce your back pain symptoms by nearly half.

Pause before you get up

Most people get out of bed as soon as they wake up, Dr. Hollins points out. But taking a few minutes to prepare your back for transitioning to sitting, standing and walking can help with morning back pain.

Stretch while you’re still in bed. While on your back, bring one knee to your chest. Hold it for three seconds, let it go and then, switch to the other leg.
Warm your muscles. Slide a heating pad under your back to warm your muscles. Use one that’s designated as safe for use in the bed and has an auto shut-off. Keep the sheet or your shirt between the pad and your skin.
Take your time getting up. First, sit on the edge of the bed and let your back adjust. Then, use your legs — not your back — to stand up.

See your healthcare provider if your back pain worsens or occurs most mornings for two or three months. They can check for underlying back issues and may prescribe physical therapy.

“Don’t wait six or eight months to see your provider,” Dr. Hollins urges. “They can provide guidance about the best stretches to do, and your back will thank you.”

October 13, 2025

Dr.Paddy Barrett – The Truth About Alcohol and Health

Why the idea that “a little red wine is good for your heart” doesn’t hold up anymore.

I used to drink.

A lot more than I should have.

And while I had some seriously good times when I was drinking, it came at a huge cost.

Brutal hangovers. Terrible sleep. Wrecked weekends.

Even a broken back.

(But that’s a story for another day.)

I still drink.

But just very little these days.

As a cardiologist, I am asked almost every day if ‘Alcohol is good or bad for your health?’.

Let’s find out.

Alcohol Is A Toxin.

There is no getting away from the fact that, at its most basic chemical foundation, alcohol is a toxin.

Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death¹².

Alcohol is a factor in³:

30% of suicides
40% of fatal burn injuries
50% of fatal drownings
50% of homicides
65% of fatal falls
29% of fatal road traffic accidents

Alcohol is a factor in 1 in 5 emergency department presentations⁴.

No pun intended, but these statistics make for some sober reading.

‘Red Wine Is Good For Your Heart.’

Now come on.

Did you really think that was true?

I have heard this phrase over and over again in my clinical practice.

High levels of exercise are good for your heart, but oddly enough, most people seem to be far less enthusiastic about this approach than regular alcohol consumption.

Let’s see what the data says.

Up until very recently, it was believed that drinking 1-2 drinks per day was actually protective when it came to dying prematurely⁵.

This data was based on observational studies that cannot fully control for all confounders and can therefore not infer causality.

When you examine the people who drink only 1 to 2 drinks per day, you consistently find that they are much less likely to smoke, be overweight or engage in any other risky health behaviours.

So in truth, it probably wasn’t the alcohol that was driving the effect.

More recent studies have attempted to control for this variable more carefully, and the relationship is clear.

The more you drink.

The higher the risk.

Take coronary artery disease. Higher alcohol intake equates to a higher risk.

The same applies to high blood pressure⁶.

The same applies to stroke⁷.

The list goes on⁸:

Atrial fibrillation – Higher risk.
Sudden death – Higher risk.
Heart failure – Higher risk.
Liver, Breast, Colorectal, Oropharyngeal Cancer – Higher Risk⁹.

You get the point.

With all this information to hand, why is it then that I and billions of others continue to drink alcohol?…

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June 24, 2025

Dr.Paddy Barrett – The Truth About Alcohol and Health

Why the idea that “a little red wine is good for your heart” doesn’t hold up anymore.

I used to drink.

A lot more than I should have.

And while I had some seriously good times when I was drinking, it came at a huge cost.

Brutal hangovers. Terrible sleep. Wrecked weekends.

Even a broken back.

(But that’s a story for another day.)

I still drink.

But just very little these days.

As a cardiologist, I am asked almost every day if ‘Alcohol is good or bad for your health?’.

Let’s find out.

Alcohol Is A Toxin.

There is no getting away from the fact that, at its most basic chemical foundation, alcohol is a toxin.

Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death¹².

Alcohol is a factor in³:

30% of suicides
40% of fatal burn injuries
50% of fatal drownings
50% of homicides
65% of fatal falls
29% of fatal road traffic accidents

Alcohol is a factor in 1 in 5 emergency department presentations⁴.

No pun intended, but these statistics make for some sober reading.

‘Red Wine Is Good For Your Heart.’

Now come on.

Did you really think that was true?

I have heard this phrase over and over again in my clinical practice.

High levels of exercise are good for your heart, but oddly enough, most people seem to be far less enthusiastic about this approach than regular alcohol consumption.

Let’s see what the data says.

Up until very recently, it was believed that drinking 1-2 drinks per day was actually protective when it came to dying prematurely⁵.

This data was based on observational studies that cannot fully control for all confounders and can therefore not infer causality.

When you examine the people who drink only 1 to 2 drinks per day, you consistently find that they are much less likely to smoke, be overweight or engage in any other risky health behaviours.

So in truth, it probably wasn’t the alcohol that was driving the effect.

More recent studies have attempted to control for this variable more carefully, and the relationship is clear.

The more you drink.

The higher the risk.

Take coronary artery disease. Higher alcohol intake equates to a higher risk.

The same applies to high blood pressure⁶.

The same applies to stroke⁷.

The list goes on⁸:

Atrial fibrillation – Higher risk.
Sudden death – Higher risk.
Heart failure – Higher risk.
Liver, Breast, Colorectal, Oropharyngeal Cancer – Higher Risk⁹.

You get the point.

With all this information to hand, why is it then that I and billions of others continue to drink alcohol?…

Subscribe to Dr Paddy Barrett to unlock the rest.

Become a paying subscriber of Dr Paddy Barrett to get access to this post and other subscriber-only content.

Upgrade to paid

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June 22, 2025

Dr.Paddy Barrett – The Truth About Alcohol and Health

Why the idea that “a little red wine is good for your heart” doesn’t hold up anymore.

I used to drink.

A lot more than I should have.

And while I had some seriously good times when I was drinking, it came at a huge cost.

Brutal hangovers. Terrible sleep. Wrecked weekends.

Even a broken back.

(But that’s a story for another day.)

I still drink.

But just very little these days.

As a cardiologist, I am asked almost every day if ‘Alcohol is good or bad for your health?’.

Let’s find out.

Alcohol Is A Toxin.

There is no getting away from the fact that, at its most basic chemical foundation, alcohol is a toxin.

Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death¹².

Alcohol is a factor in³:

30% of suicides
40% of fatal burn injuries
50% of fatal drownings
50% of homicides
65% of fatal falls
29% of fatal road traffic accidents

Alcohol is a factor in 1 in 5 emergency department presentations⁴.

No pun intended, but these statistics make for some sober reading.

‘Red Wine Is Good For Your Heart.’

Now come on.

Did you really think that was true?

I have heard this phrase over and over again in my clinical practice.

High levels of exercise are good for your heart, but oddly enough, most people seem to be far less enthusiastic about this approach than regular alcohol consumption.

Let’s see what the data says.

Up until very recently, it was believed that drinking 1-2 drinks per day was actually protective when it came to dying prematurely⁵.

This data was based on observational studies that cannot fully control for all confounders and can therefore not infer causality.

When you examine the people who drink only 1 to 2 drinks per day, you consistently find that they are much less likely to smoke, be overweight or engage in any other risky health behaviours.

So in truth, it probably wasn’t the alcohol that was driving the effect.

More recent studies have attempted to control for this variable more carefully, and the relationship is clear.

The more you drink.

The higher the risk.

Take coronary artery disease. Higher alcohol intake equates to a higher risk.

The same applies to high blood pressure⁶.

The same applies to stroke⁷.

The list goes on⁸:

Atrial fibrillation – Higher risk.
Sudden death – Higher risk.
Heart failure – Higher risk.
Liver, Breast, Colorectal, Oropharyngeal Cancer – Higher Risk⁹.

You get the point.

With all this information to hand, why is it then that I and billions of others continue to drink alcohol?…

Subscribe to Dr Paddy Barrett to unlock the rest.

Become a paying subscriber of Dr Paddy Barrett to get access to this post and other subscriber-only content.

Upgrade to paid

A subscription gets you:

	Subscriber Only Posts & Access To Full Archive
	25% Discount On Live Education Sessions & AMA’s
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May 21, 2025

How Alcohol Affects Your Heart @ClevelandClinic #heartaware

You likely know that drinking alcohol too often or to excess isn’t a good idea, health-wise. But when it comes to alcohol and heart health, you may have heard different sides. Is drinking all that bad for your heart? Can a glass of wine help reduce your risk of heart disease — or make it worse?

First things first: If you drink alcohol, you should do so in moderation to avoid alcohol-related heart issues. And you should never intentionally use alcohol to try to reduce your risk of heart disease.

To further explore the relationship between your ticker and your favorite glass of merlot or IPA, we chatted with cardiologist Leslie Cho, MD.

Ways alcohol can impact heart health

Here are some of the effects of alcohol on your heart:

Increased heart rate

One of the most important things your heart does is keep a rhythm. On average, a regular heart rate is about 60 to 100 beats per minute when your body is at rest. But alcohol can lead to your heart rate temporarily jumping up in speed, and if it goes over 100 beats per minute, it can cause a condition called tachycardia. Too many episodes of tachycardia could lead to more serious issues like heart failure or going into irregular rhythms, which can cause heart attack and stroke.

Raises blood pressure

That fourth drink at the bar may feel like it’s relaxing you, but it’s actually affecting your body differently than you might think. Alcohol can affect your blood pressure, causing it to go up temporarily. This is especially true when you engage in binge drinking (that’s defined as four or more drinks within two hours for women and people assigned female at birth, and five or more drinks within two hours for men and people assigned male at birth).

And sure, we’ve all had a night here or there where we’ve had one too many and we know it. But it’s important to make sure those nights of overindulgence are the exception and not the rule. If you’re not sure, make a note to tune into how much you’re having over the course of the next month or so. If it’s more than recommended, try to consciously pace your drinking to help reduce the spike in your blood pressure that excessive alcohol causes.

And if you have a history of high blood pressure, it’s best to avoid alcohol completely or drink only occasionally, and in moderation.

Irregular heartbeat

Whether it’s a glass of red wine with your turkey or toasting champagne for the new year, alcohol definitely becomes more present during the holiday season. And while enjoying celebratory spirits in moderation is alright for most people, it’s important to be aware you can fall victim to holiday heart syndrome if you overdo it. This is when overeating and overindulging in alcohol lead to an irregular heartbeat.

Holiday heart syndrome can happen if you don’t typically drink alcohol, but then have a few at a holiday party or if you binge drink. This can cause you to develop an irregular heartbeat, called atrial fibrillation, which can increase your risk of stroke, heart attack and heart failure.

Prolonged drinking can cause alcoholic cardiomyopathy

The short-term effects of alcohol (headache, nausea, you know the rest) are easy to pinpoint. But there are ways that alcohol affects your body over time that are important to understand. One of the long-term effects of alcohol on your heart is alcoholic cardiomyopathy. This is when your heart-pumping function gets weaker and your heart gets larger due to changes from heavy alcohol use over a long period of time.

OK, don’t panic. If you’re an occasional drinker, there’s no cause for worry. But it may be worthwhile learning about what counts as binge drinking and whether or not you may be drinking too much and don’t even know it.

Is some level of alcohol safe or beneficial?

It’s true, red wine is a better choice than hard liquor. But can a trip to the wine bar boost your heart health?

You should never consider wine or any other alcohol as a way to lower your heart disease risk. And, in fact, the study also showed that drinking one or fewer drinks per day was related to the lowest likelihood of dying from a stroke. However, Dr. Cho points out that more recent data shows that there may be no amount of alcohol that is truly safe. “The myth that wine is beneficial for heart health is no longer true,” she states.

“It’s not a good idea to start drinking alcohol in an effort to lower your risk of heart disease,” Dr. Cho continues. “It’s better not to drink any alcohol at all.”

The American Heart Association recommends the same.

Other factors to keep in mind

It’s also important to know that the ways in which alcohol affects your heart will vary from person to person, depending on your age and other conditions you may have.

Age

Let’s face it, a hangover in your mid-40s doesn’t feel the same as one in your early 20s. This is because your age plays a factor in how well you tolerate alcohol. While some people develop a tolerance to alcohol over time, this isn’t true for everyone — and this ability doesn’t last forever, Dr. Cho notes.

“As we get older, our ability to clear alcohol definitely decreases and our sensitivity to alcohol probably increases,” she explains. “Also as we get older, we end up having more diseases, so we could be on medicines that can interfere with the way our bodies metabolize alcohol.”

Other medical conditions

In many ways, your medical history (and present) can tell you a lot about your future with alcohol. That means, if you’re living with other medical conditions and/or taking certain medications, this will all have an impact on how alcohol affects you.

“Certain health conditions can make drinking alcohol more dangerous,” Dr. Cho says.

For example, some people who are on cholesterol-lowering medicines may experience muscle aches when they drink alcohol. Because alcohol and cholesterol medicine both are processed through your liver, they are, in a sense, competing for clearance. So, it’s important to think about your overall health and talk to a healthcare provider about your personal risk factors.

“Alcohol is made out of sugar,” Dr. Cho points out. “So, if you’re predisposed to diabetes or if high triglycerides are one of your issues, it’s not a good idea to drink alcohol.”

Dr. Cho also warns that if you have liver dysfunction or take other medicines that are processed through the liver, your risks might be different. Talk to your healthcare provider about how alcohol might interact with your prescription medicines.

The last thing you want is for that casual drink after work or glass of wine at dinner to negatively impact your heart health. There’s a way to have a healthy, balanced relationship with alcohol that lets you enjoy a drink occasionally and celebrate with friends and family. But your heart is an important organ that should also be cared for, so be sure to drink in moderation, learn about binge drinking and know what your body can (and can’t) tolerate before opening that tab.FACEBOOK TWITTER LINKEDIN PINTERESTEmailalcohol alcohol and health alcoholic beverages binge drinking heart health

May 9, 2025

Alcohol is a Group-1 carcinogen—but one that happens to be woven into our daily lives @PsychToday

Psychology Today

@PsychToday

Alcohol is a Group-1 carcinogen—but one that happens to be woven into our daily lives and often viewed as a go-to way to cope with stress or disappointment. Here are 5 ways to change that mindset, writes

@shailiJainMd

The Hidden Cost of an Evening Glass of Wine

Key points

Alcohol is a Group 1 carcinogen—putting it in the same category as asbestos, radiation, and tobacco.
Alcohol is woven into our daily lives and often viewed as a go-to way to cope with stress and disappointment.
Less than half of Americans are aware that drinking alcohol increases their risk of cancer.
There are healthier, more sustainable ways to manage stress.

“I need a stiff drink!” “Let’s drown our sorrows.” “I just need to unwind with a glass of wine.”

Phrases like these are so common, we barely think twice about them. Alcohol has become deeply woven into our daily lives and culture. It’s often seen as a go-to way to cope with stress, disappointment, or just the pressures of everyday life. Got bad news? Feeling overwhelmed? Need to relax? Society has taught us that it’s totally normal—even expected—to pour a big glass of wine, toss back a couple of tequila shots, or order a double whiskey.

In fact, using alcohol to handle stress is often not only accepted but actively encouraged by friends, coworkers, and the media. Movies and TV shows constantly show characters doing the same, reinforcing the idea that this is just how we deal with life.

But here’s the truth: alcohol is the one of the most widely used drugs in the world. And the way we’ve normalized it’s use as a coping mechanism deserves a closer look.

The Hidden Cost of Your Evening Glass of Wine

Alcohol is a toxic, psychoactive substance that can lead to dependence. It’s also been officially classified as a Group 1 carcinogen by the International Agency for Research on Cancer—putting it in the same category as asbestos, radiation, and tobacco. Research shows that alcohol contributes to at least seven different types of cancer, including some of the most common, like colon cancer and breast cancer. In fact, earlier this year, former U.S. Surgeon General Vivek H. Murthy issued a public health advisory warning about the clear link between alcohol use and cancer risk.

What’s concerning is that less than half of Americans are aware that drinking alcohol increases their risk of cancer. As a psychiatrist who often discusses alcohol use with patients, this lines up with what I see in practice. Many people simply don’t know that alcohol is a carcinogen. Even more common is the belief that low levels of alcohol—like a glass of wine a day—are actually good for your health, especially for the heart and brain. But that idea is being seriously questioned. In January 2023, the World Health Organization published a statement in The Lancet Public Health making it clear: When it comes to alcohol, there is no safe amount that doesn’t affect your health.

5 Things to Think About Before Reaching for a Drink to Cope With Stress

Alcohol is a known carcinogen—and a cancer diagnosis can deeply affect your mental health. Depression and anxiety are incredibly common among people with cancer. Research shows that up to 1 in 5 cancer patients experience depression, and 1 in 10 struggle with anxiety—regardless of where they are in their treatment or disease process. In fact, according to international diagnostic guidelines, about 35–40% of cancer patients meet the criteria for a psychiatric disorder. These mental health challenges don’t just impact emotional well-being—they can significantly reduce the overall quality of life for persons living with cancer. The global rate of depression among cancer patients is currently estimated at 27%. This is a noticeable increase compared to earlier data, and this trend appears to be on the rise.
That “relaxing” drink may be increasing your anxiety. While alcohol can feel calming in the moment, it’s a short-lived effect. Once the pleasurable effects of alcohol wear off, anxiety can rebound—often worse than before. Over time, this can make stress and mood disorders more difficult to manage.
Regular drinking can sneak up on you—building tolerance, dependence, and emotional numbness. What starts as the occasional glass of wine to unwind can quickly become a nightly ritual. Your body builds tolerance, meaning you need more to feel the same effects. Emotionally, alcohol can dull not just stress but joy, connection, and motivation—leaving you feeling more flat than relaxed.
Alcohol disrupts sleep, even if it helps you fall asleep. Many people use alcohol to wind down at night, but it actually interferes with sleep architecture. It may help you fall asleep faster, but it reduces the quality of your rest—leading to more fatigue, irritability, and difficulty coping with stress the next day.
There are healthier, more sustainable ways to manage stress. Whether it’s exercise, deep breathing, journaling, therapy, or connecting with others, there are countless tools for managing stress that don’t carry the risks alcohol does. Exploring these options might not provide the instant hit that a drink does—but they build resilience, not reliance.

Facebook image: Just Life/Shutterstock

March 29, 2025

Alcohol has risks. We must all aim to minimise those risks. @DrPaddy_Barrett preventative cardiologist @HealthBlackrock

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. *Arch Intern Med.*2006

In the study shown above, females start to accrue an increased risk at greater than two drinks per day on average and males at greater than four drinks per day.

These findings shouldn’t come as a surprise to anyone.

Surprisingly, on average, individuals who consume less than two drinks per day appear to have better outcomes than those who do not drink at all. This is where things start to get a little counterintuitive, and the story of alcohol being beneficial for you starts to appear.

This relationship is known as a ‘U’ shaped curve where those in the middle have the best outcomes, and those on the edges have worse outcomes. A kind of ‘Goldilocks’ relationship; “Not too hot. Not too cold. Just right.”

How might we explain this?

Enter the darling of the 1990s, Resveratrol. This compound in red wine spawned the mantra that red wine was ‘good for your heart’. This was based on research that suggested that it might reduce cholesterol levels, among other things.

But to consume the levels of Resveratrol tested in some of the animal studies that demonstrated benefit, you would have to drink 40 litres of wine…… Per day.

Not exactly a feasible strategy. Even with the best will in the world.

Let’s look at a more plausible explanation.

Data on alcohol consumption and outcomes are almost always based on observational data, not randomised controlled trials. This means that other factors or ‘confounders’ may explain the difference between the groups, not the alcohol consumption alone.

When you look at the trials that suggest a benefit of modest alcohol consumption, you will often find that this group tend to exercise more, smoke less, be in a higher socioeconomic bracket etc. This is referred to as a ‘healthy user bias’ and is likely to explain the difference between the groups.

Most trials try to correct or adjust for these confounders, but in truth, it is very hard to do. A recent publication looked at this problem and attempted to (as much as possible) correct for these ‘healthy user’ bias factors and then compare outcomes between alcohol consumption groups. The results were a little more in line with what we might expect.

Those in the lowest alcohol consumption category had the best lifestyle factors overall. When these healthy factors were corrected for, any benefit seen with modest alcohol consumption disappeared. What remained was a linear relationship between alcohol consumption and coronary artery disease5. Much more what you might expect.

Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. *JAMA Netw Open.* 2022

Research like this and other studies is where the more recent media reports of ‘any’ alcohol being bad for you have come.

So, alcohol is a toxin. But, as Paracelsus notes:

“The dose makes the poison.”

Even water consumed to excess can be lethal.

We know that excess alcohol consumption is harmful. But I don’t think there was any great uncertainty around that point.

The key takeaway is that modest alcohol consumption is unlikely to be ‘beneficial’ to you. As much as you loved the idea that red wine was good for your heart, we can say with reasonable confidence that this is not the case.

The real question we need to answer is whether consuming modest amounts of alcohol is considerably worse for you when it comes to heart disease and death from any cause.

Based on the literature to date, it seems that the incremental risk for modest amounts of weekly alcohol consumption is likely to be small. But that doesn’t mean there are no downsides.

Sleep

One of the main reasons I significantly reduced my alcohol consumption was its effect on my sleep. If I drink more than one drink, I find that the quality of my sleep gets worse. I am much more likely to wake in the middle of the night and feel the effects the following day. But that’s just my personal experience.

Although alcohol is likely to make you fall asleep faster, it impacts your sleep quality6. Additionally, alcohol also reduces the percentage of REM sleep a person gets overnight7.

A workaround for me is to consume any alcohol during the daytime, so my sleep is unlikely to be affected, and if I am going to have a drink, I make sure it is worthwhile. I.e. I am with friends, or it is a high-quality drink. No more drinks on airplanes for me. Mainly because you lose about 30% of your sense of smell and taste in a pressurised cabin and therefore you are less likely to enjoy your drink8. Why do you think they serve you tomato juice and the fact that you think it’s tolerable?!

Humans have been consuming alcohol as far back as the ancient Egyptians, and some evidence suggests the Chinese were consuming alcohol as far back as 7000 B.C. So I don’t see alcohol disappearing any time soon.

The question we all need to ask is:

How much are we realistically drinking on a daily or weekly basis &

Is it likely to be doing us harm?

Only you can answer that question.

The only way to be certain you are doing no harm is to eliminate alcohol entirely. But life is full of risks, some of which we can control, some we cannot.

And some risks are worth taking.

Want to eliminate all road traffic accidents worldwide?

Simple.

Ban cars.

But at what cost?

The risks of driving are a risk most of us are willing to take.

Alcohol has risks.

We must all aim to minimise those risks.

Whatever that means for you, only you can decide.

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-The-Consequences.aspx

Mokdad, A.H.; Marks, J.S.; Stroup, D.F.; and Gerberding, J.L. Actual causes of death in the United States, 2000. JAMA 291(10):1238–1245, 2004. Erratum in JAMA 293(3):298, 2005.

Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Annual Average for United States 2011–2015 Alcohol-Attributable Deaths Due to Excessive Alcohol Use, All Ages.

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006;166(22):2437–2445. doi:10.1001/archinte.166.22.2437

Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849

Britton, A., Fat, L.N. & Neligan, A. The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep 10, 5275 (2020). https://doi.org/10.1038/s41598-020-62227-0

Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013 Apr;37(4):539-49. doi: 10.1111/acer.12006.

Burdack-Freitag, Andrea & Bullinger, Dino & Mayer, Florian & Breuer, Klaus. (2010). Odor and taste perception at normal and low atmospheric pressure in a simulated aircraft cabin. Journal für Verbraucherschutz und Lebensmittelsicherheit. 6. 95-109. 10.1007/s00003-010-0630-y.

February 26, 2025

Morning back pain waking you up? Try these simple fixes. @ClevelandClinic

Why Your Lower Back Pain Is Worse in the Morning (and What To Do About It)

Your sleep position, immobility, mattress and underlying conditions can all cause morning back pain

4 causes of lower back pain in the morning

Dr. Hollins says several factors can contribute to morning back pain.

1. The wrong sleep position

“It’s common to be so tired at bedtime that you fall into bed and sleep however you hit the bed,” Dr. Hollins says. “But you may not be sleeping in the best position for your spine.”

The most beneficial sleep positions for your back are on your:

Side, with your knees partially bent
Back, as long as you don’t have sleep apnea (which worsens when sleeping on your back)

Sleeping on your stomach makes you more likely to twist your neck to the side — a quick way to throw your neck and spine out of alignment.

2. Lying down for hours

3. An unsupportive mattress or pillow

Need tips for choosing the best mattress for your back? We can help.

4. An underlying condition or pregnancy

Some conditions or chronic diseases may put you at higher risk for morning back pain. Chronic conditions that affect both sleep and morning back pain include:

Degenerative disk disease, which occurs when your spine’s cushioning wears away with age
Fibromyalgia, which causes muscle pain and spasms throughout the body
Spinal arthritis, which affects up to 95% of people ages 60 and older
Spinal cord issues like sciatica, spinal stenosis or a herniated disk

Pregnancy can also bring back pain in the morning due to:

Additional strain on your lower back muscles
Shifting center of gravity
Increased weight

How to stop waking up with lower back pain

Add supportive pillows

Pillows are a great way to support your back’s alignment. Your typical sleep position should guide the pillows you use:

Back sleepers. Choose a head pillow that supports your neck and lets your head sink in. Place a pillow under your knees to support your spine’s natural curvature.
Side sleepers. For your head, choose a thick pillow that keeps the top portion of your spine straight and parallel to the mattress. Place a small pillow between your knees to help even out your hips.
Stomach sleepers. Don’t use a pillow for your head, or choose a very thin one. Put a thin pillow under your lower abdomen to keep your spine aligned.

Adjust your sleep position

If you’re used to sleeping in the same position every night, it can be challenging to change it. But small adjustments may help:

Place both arms in the same position if you sleep on your back — instead of flinging one arm over your head — to keep your spine aligned.
Bend your knees when sleeping on your side to help balance your body and reduce any pressure on your lower spine.
Put pillows in front of you if you sleep on your side so you don’t roll onto your stomach.
Sleep on your left side whenever possible to take pressure off your internal organs.

“You want to be as comfortable as possible when you go to sleep,” Dr. Hollins says. “That way, you’ll be more likely to stay in a supportive sleep position.”

Replace your mattress regularly

According to the Sleep Foundation, the general guideline is to replace your mattress every six to eight years. But you may need a new mattress sooner if yours is:

Making noise (if it’s an innerspring mattress)
Noticeably sagging or damaged
Causing muscle or joint stiffness, especially if you don’t have the same stiffness when you sleep at hotels or other homes

When choosing a new mattress, choose a “medium firm” mattress — level 6 out of 10 on the mattress firmness scale. It may reduce your back pain symptoms by nearly half.

Pause before you get up

Stretch while you’re still in bed. While on your back, bring one knee to your chest. Hold it for three seconds, let it go and then, switch to the other leg.
Warm your muscles. Slide a heating pad under your back to warm your muscles. Use one that’s designated as safe for use in the bed and has an auto shut-off. Keep the sheet or your shirt between the pad and your skin.
Take your time getting up. First, sit on the edge of the bed and let your back adjust. Then, use your legs — not your back — to stand up.

See your healthcare provider if your back pain worsens or occurs most mornings for two or three months. They can check for underlying back issues and may prescribe physical therapy.

“Don’t wait six or eight months to see your provider,” Dr. Hollins urges. “They can provide guidance about the best stretches to do, and your back will thank you.”

February 18, 2025

9 Ways Alcohol Affects Your Health @ClevelandClinic

February 15, 2024

What Does Alcohol Do to Your Body? 9 Ways Alcohol Affects Your Health

Alcohol affects your whole body, from your liver and immune system to your brain and mental health

You probably already know that excessive drinking can affect you in more ways than one.

There are the empty calories that can lead to weight gain. There’s the potential for injury and regrettable choices. And don’t forget about the hangovers of course.

Heavy drinking can also lead to a host of health concerns, like brain damage, heart disease, cirrhosis of the liver and even certain kinds of cancer.

And that’s on top of the toll that alcohol use can take on relationships, not to mention the potential for financial strain and legal troubles.

But even moderate alcohol use changes the way your body functions.

We talked with hepatologist Shreya Sengupta, MD, about how alcohol use affects your body and your emotional health.

“Some people think of the effects of alcohol as only something to be worried about if you’re living with alcohol use disorder, which was formerly called alcoholism,” Dr. Sengupta says.

“But when you consider how alcohol is metabolized and used by your body, we can start to see that even moderate and social drinking affects our health to some degree.”

Dr. Sengupta shares some of the not-so-obvious effects that alcohol has on your body.

Liver

Your liver detoxifies and removes alcohol from your blood through a process known as oxidation. When your liver finishes that process, alcohol gets turned into water and carbon dioxide.

But when you ingest too much alcohol for your liver to process in a timely manner, a buildup of toxic substances begins to take a toll on your liver.

If alcohol continues to accumulate in your system, it can destroy cells and, eventually, damage your organs.

“When your liver is overwhelmed by oxidizing alcohol, it generates molecules that inhibit fat oxidation,” Dr. Sengupta explains. “The fats build up. Over time, it can lead to a condition known as steatotic liver disease.”

Steatotic liver disease used to go by the name fatty liver disease.

Steatotic liver disease develops in about 90% of people who drink more than 1.5 to 2 ounces of alcohol per day. That’s about one shot glass worth.

With continued alcohol use, steatotic liver disease can lead to liver fibrosis. Eventually, you can develop permanent and irreversible scarring in your liver, which is called cirrhosis.

“The good news is that earlier stages of steatotic liver disease are usually completely reversible in about four to six weeks if you abstain from drinking alcohol,” Dr. Sengupta assures.

Cirrhosis, on the other hand, is irreversible and can lead to liver failure and liver cancer, even if you abstain from alcohol.

Metabolism

You probably are keenly aware of the so-called “beer belly.” That’s shorthand for a round midsection that some people associate with drinking too much beer.

In reality, there’s no evidence that drinking beer (or your alcoholic beverages of choice) actually contributes to belly fat.

But there’s plenty of research to back up the notion that alcohol does lead to weight gain in general. Even for people who aren’t particularly heavy drinkers.

“Drinking gives your body work to do that keeps it from going about its other processes,” Dr. Sengupta notes. “Alcohol distracts your system from its regularly scheduled duties, including things like metabolizing carbohydrates and fats.”

Once you take a drink, your body makes metabolizing alcohol a priority — above processing anything else.

That’s because your body already has processes in place that allow it to store excess proteins, carbohydrates and fats. But there isn’t a storage tank for alcohol. So, your system prioritizes getting rid of alcohol before it can turn its attention to its other work.

That allows excess calories from the foods you eat to sit around, leading to weight gain.

Gut health

Your gut microbiome is a hotbed of bacteria that help keep your digestive system happy and healthy. The trillions of microbes in your colon and large and small intestines are critical to proper digestion. They also help fend off inflammation and support healthy metabolism.

When you drink too much alcohol, it can throw off the balance of good and bad bacteria in your gut.

“Alcohol can kill the good bacteria that live in your gut, allowing bad bacteria to grow unchecked,” Dr. Sengupta explains. “That can lead to problems with digestion, inflammation and even organ damage.”

Having a glass of wine with dinner or a beer at a party here and there isn’t going to destroy your gut. But even low amounts of daily drinking and prolonged and heavy use of alcohol can lead to significant problems for your digestive system.

Heart health

Too much alcohol is bad for your heart. Alcohol can cause:

Increased heart rate.
Spikes in blood pressure.
Irregular heartbeats (arrhythmia).
A weakening in your heart (cardiomyopathy).

Warnings from the World Heart Federation go so far as to state that no amount of alcohol is safe for your ticker.

But wait, you may be thinking, what about those headlines that claim red wine is supposed to be good for my heart?

There are a few studies that associate red wine with improved heart health in lab tests. But no research proves that red wine causes any improvements in heart health in people.

“The reality is that alcohol causes more health troubles than it could ever help,” Dr. Sengupta reinforces. “And that goes for your heart, as well as the rest of your body.”

Pancreas

Your pancreas helps your body digest food and manage your blood sugar. Drinking alcohol changes how your pancreas works.

“Your pancreas secretes fluids. Alcohol use can thicken those fluids, which can clog the ducts that those fluids flow out of,” Dr. Sengupta explains.

Like a clog in a drain, those thickened fluids can jam up your ducts. That can lead to pancreatitis, which is inflammation of the pancreas.

Pancreatitis can be a short-term (acute) condition that clears up in a few days. But prolonged alcohol abuse can lead to chronic (long-term) pancreatitis, which can be severe.

Cancer risk

The U.S. Centers for Disease Control and Prevention (CDC) has a clear warning regarding the connection between drinking and cancer: “The less alcohol you drink, the lower your risk for cancer.”

Why?

Your body breaks alcohol down into a chemical called acetaldehyde, which damages your DNA. Damaged DNA can cause a cell to grow out of control, which results in cancerous tumors.

Alcohol use has been shown to raise your risk for several kinds of cancer. That includes cancers of the:

Mouth.
Esophagus.
Throat.
Liver.
Breast.
Colon and rectum.

Immune system

If you drink every day, or almost every day, you might notice that you catch colds, flu or other illnesses more frequently than people who don’t drink. That’s because alcohol can weaken your immune system and make your body more susceptible to infection.

“We see lower levels of a specific kind of white blood cells called lymphocytes in people who drink heavily for long periods of time,” Dr. Sengupta reports. “That can leave them more vulnerable to infectious diseases.”

Brain

The morning after a night of over-imbibing can cause some temporary effects on your brain. Things like trouble concentration, slow reflexes and sensitivity to bright lights and loud sounds are standard signs of a hangover, and evidence of alcohol’s effects on your brain.

Long-term alcohol use can change your brain’s wiring in much more significant ways. Ways that your standard hangover cures won’t even begin to touch.

“Excessive alcohol consumption can cause nerve damage and irreversible forms of dementia,” Dr. Sengupta warns.

Mental health

Alcohol is a depressant. And prolonged alcohol use can lead to mental health conditions like anxiety and depression. Chronic misuse can also lead to paranoia and hallucinations.

Even drinking a little too much (binge drinking) on occasion can set off a chain reaction that affects your well-being. Lowered inhibitions can lead to poor choices with lasting repercussions — like the end of a relationship, an accident or legal woes. Each of those consequences can cause turmoil that can negatively affect your long-term emotional health.

“Alcohol tends to cause more problems than it solves for a lot of people,” Dr. Sengupta emphasizes. “If drinking is affecting your health, your relationships, your work, your finances, it’s time to make some serious changes.”

Ready to stop drinking and improve your health? These tips may help.

If you need more guidance to quit drinking, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a hotline, 24/7, 365 days a year. Call 1.800.662.HELP (4357).

Alcoholics Anonymous is available almost everywhere and provides a place to openly and nonjudgmentally discuss alcohol issues with others who have alcohol use disorder.

February 12, 2025

How Alcohol Affects Your Heart @ClevelandClinic #heartaware

To further explore the relationship between your ticker and your favorite glass of merlot or IPA, we chatted with cardiologist Leslie Cho, MD.

Ways alcohol can impact heart health

Here are some of the effects of alcohol on your heart:

Increased heart rate

Raises blood pressure

And if you have a history of high blood pressure, it’s best to avoid alcohol completely or drink only occasionally, and in moderation.

Irregular heartbeat

Prolonged drinking can cause alcoholic cardiomyopathy

Is some level of alcohol safe or beneficial?

It’s true, red wine is a better choice than hard liquor. But can a trip to the wine bar boost your heart health?

“It’s not a good idea to start drinking alcohol in an effort to lower your risk of heart disease,” Dr. Cho continues. “It’s better not to drink any alcohol at all.”

The American Heart Association recommends the same.

Other factors to keep in mind

It’s also important to know that the ways in which alcohol affects your heart will vary from person to person, depending on your age and other conditions you may have.

Age

Other medical conditions

“Certain health conditions can make drinking alcohol more dangerous,” Dr. Cho says.

“Alcohol is made out of sugar,” Dr. Cho points out. “So, if you’re predisposed to diabetes or if high triglycerides are one of your issues, it’s not a good idea to drink alcohol.”