Sleep Surface Tenderness and Sitting-Surface Tenderness (bum-itis)
Chronic compression - tissue being subject, on a chronic basis, to pressure which compresses it, interfering with circulation in the smallest channels and capillaries
Sub-dermopathy – the tissue most affected by the compression is the sub-dermal tissue (sub-cutaneous tissue). This is the tissue under the skin (dermis or cutis), between the skin and the muscles underneath.
-opathy – most of the usual indicators of inflammation, such as warmth, redness and localised swelling are not readily apparent, so the use of the term “itis” would produce a mis-leading mental image. Yet the involved tissue would not be functioning normally, would be “sick” in its functioning, and I am sure there would be evidence of damage if biopsies were taken, which is compatible with the ending “opathy”. (The term “panniculitis” describes inflammation of the sub-cutaneous tissue, but this term is in wide-spread use for known disorders of the sub-dermal tissue that are much more obvious and include more evident inflammation and tissue damage.)
I’m sure everyone would get these symptoms with enough pressure applied over enough percent of the time in a day, day after day. Like everything else about health, some people will be much more susceptible than others, and this will also change with different circumstances of their health.
I am very surprised that I can’t seem to find any medical discussion of this phenomenon. This is my made-up term for the condition, but I have over years repeatedly tried searching both the internet and the medical literature under any applicable words or combination of words that I can think of.
I am concerned that the chronic low-level inflammation inherent in this, which can involve very large areas of sub-cutaneous tissue, seems to be an absent topic from research and medical awareness.
If you have any significant degree of “bum-itis”, you probably know it. Your bottom (buttocks), gets sore when you sit for long. It may also be sore when lying down if the pressure of your body weight is on the same area. There seems to be nothing to show for this. The skin does not show damage. There is no sign of a rash. At other times of the day when you have not been sitting, if you put your hand over that area there is no redness or warmth suggesting inflammation. There is no noticeable thick swelling, like you would have, say , with the inflammation from a wasp bite. And yet the pain and tenderness clearly mean that chronic inflammation is present.
You may have this same inflammation present all along the body surfaces that you habitually sleep on, and yet be completely unaware of this. You can check for this very gently. If you are not gentle when checking for it, that is your choice, but it is not at all what I think is a good thing.
Consider how you lie when you are sleeping. For example, I sleep on my sides. Areas that receive pressure from the weight of my body when I sleep run along the outside edges of my arms (much more pressure on the upper arm than the lower arm) and the outside edges of my legs (much more pressure in the hip/thigh area than the lower leg). Also the inside edge of the knees. I can even find this tenderness on the sides of my neck and cheeks.
One symptom that you might notice even if you don’t notice anything else is tenderness and pain in the outer ears from the pressure of sleeping on them at night. In this case the ears can be very sensitive to touching, moving or massaging the ear even gently.
Other than with the ears, this tenderness is not very noticeable from simply touching the areas that receive chronic pressure. The key is to gently (there is that caution again!) use a wide grip (no pinching, that’s not going to give you any useful information because of course it will hurt) to slightly compress the tissue from the sides. For example, if you sleep on your side, check the outside edge along your thigh by gently gripping it with your hand using a wide grip of several inches, aiming to feel under the skin an inch or so – like you are trying to gently massage the tissue that is just below the skin. If you find tenderness below the skin, compare this to the front of your thigh if this is an area you don’t sleep on, which you will probably find much less tender. You can check other areas by comparing your sleep surfaces with body surfaces that do not receive chronic compression with sleep or sitting (perhaps, for example, the inner surface of the lower arms). If you cannot bring yourself to be gentle or are worried about how you are doing this, try only on one or two spots, then wait until the next day or so to see if you have accidentally been too vigorous and caused bruising, in which case there is no benefit to trying again unless you can use a more gentle approach. Bruising serves no point and provides no information.
Now, the troubling part is that I don’t know how to resolve this inflammation and I can’t find anyone else who is even mentioning it seriously, much less any research directed towards evaluating its medical meaning or finding a treatment. Obviously, prevention plays a part, so avoiding prolonged sitting will help. Research has shown that spending much of the day sitting is associated with poorer health outcomes. Perhaps this inflammation is one of the less-obvious contributors to this finding.
The only thing that I have found that is useful is gentle massage of the tender area – a slow cycle of gently compressing and holding, then releasing and waiting a moment, to encourage flow of blood and lymphatic fluid. This works very well to control pain and tenderness in the ears. It is also very helpful with other small areas of tissue, such as the face. I think this would also work for larger areas, such as the thighs, knees and outer arms, but it seems that these areas require consistent effort over a long time, and I have not had much sustained success.