Increased pain during Ramadan: Causes and management

During the holy month of Ramadan, many individuals experience an increase in various types of pain—particularly in the lower back, knees, neck, shoulders, and other joints. This tendency is more common among those who already suffer from arthritis, musculoskeletal disorders, or spinal conditions. Understanding the underlying causes and adopting appropriate management strategies can significantly reduce discomfort and help individuals observe fasting more comfortably.

Why does pain increase during Ramadan?

1. Dehydration: Prolonged abstinence from water during fasting hours can lead to dehydration. Reduced fluid levels may decrease joint lubrication and increase muscle stiffness, thereby intensifying pain. Individuals who do not consume adequate fluids during Suhoor and Iftar are particularly vulnerable.

2. Electrolyte imbalance: Deficiencies in essential minerals such as sodium, potassium, and magnesium can cause muscle cramps and discomfort. Excessive sweating, insufficient water intake, and inadequate nutrition may contribute to these imbalances.

3. Prolonged static posture: Many people spend long hours sitting at work or standing during prayers. Maintaining improper posture places additional strain on the spine and joints, leading to musculoskeletal pain. Poor ergonomic habits during daily activities can aggravate pre-existing conditions.

4. Changes in medication schedule: Individuals who regularly take pain medications may need to adjust their dosing schedule during Ramadan. Improper timing or missed doses can make pain control more challenging.

5. Sleep disturbances: Waking up early for Suhoor and staying up late for Taraweeh prayers may disrupt normal sleep patterns. Inadequate rest can lead to muscle fatigue, increased sensitivity to pain, and delayed recovery.

Treatment and preventive measures

1. Adequate hydration: From Iftar to Suhoor, it is advisable to drink at least 8–10 glasses of water, distributed evenly throughout the evening. Gradual hydration helps maintain the body’s fluid balance and supports joint health.

2. Balanced nutrition: Both Suhoor and Iftar should include adequate protein, vegetables, fruits, and calcium-rich foods. Items such as bananas, dates, yogurt, and nuts help replenish electrolytes and support muscle function.

3. Light exercise and stretching: Engaging in gentle free-hand exercises and stretching 1–2 hours after Iftar can improve blood circulation and maintain muscle flexibility. Individuals with arthritis or spinal disorders should follow exercise programs prescribed by a qualified physiotherapist.

4. Maintaining proper posture: Those who sit for prolonged periods should take short movement breaks every 30–40 minutes. Proper posture during daily activities and prayers is equally important to minimise strain on the spine and joints.

5. Proper medication planning: Patients should consult their physician to adjust medication schedules appropriately between Iftar and Suhoor, ensuring effective pain control without compromising fasting.

6. Importance of physiotherapy: For individuals with chronic joint or muscle pain, regular physiotherapy before and during Ramadan can be highly beneficial. Modalities such as ultrasound therapy, Transcutaneous Electrical Nerve Stimulation (TENS), and manual therapy are effective in reducing pain and improving mobility.

The writer is the chairman and chief consultant at Dhaka City Physiotherapy Hospital, Dhanmondi, Dhaka. Email: dreasin20@gmail.com