Holiday Aches and Pains: Why You Come Home Sore

By Leslie Budzynski DC, GCC-registered chiropractor (GCC No. 00043) with 39 years’ experience. Here he explains what causes holiday aches and pains and the simple things that help you come home feeling like you have had a holiday.

You save all year for a break and then spend the first three days of it with a stiff neck, a sore lower back and a type of headache that you cannot shift. It’s is one of those things almost everyone experiences and almost nobody expects and it is not simply bad luck. Unfamiliar beds, bare feet on hard floors, a little more wine than usual and the peculiar way the body reacts to finally stopping all conspire against you.

The good news is that once you understand what is going on, most of these holiday aches and pains are avoidable. Here is what

Here is what I see repeatedly in patients coming back through Bournemouth Airport, off the Poole ferry or down the A31 from a cruise out of Southampton, and what you can do that actually helps.

The unfamiliar bed and the first-night effect

There is a real reason you sleep badly the first night away on holiday and it has a name: the first-night effect. Using advanced brain imaging, researchers found that when we sleep somewhere new, one hemisphere of the brain stays in a lighter state of sleep than the other, acting as a kind of overnight night-watchman that keeps us alert to unfamiliar surroundings, much as some birds and marine mammals do (Tamaki and colleagues, 2016). The result is fragmented sleep architecture, the normal cycle through light, deep and dream (REM) sleep and more time spent shallow phases rather than restorative.

Why does that leave you aching? Because sleep and pain are tightly linked. Poor or insufficient sleep lowers your pain threshold, meaning the same stiff shoulder simply hurts more the next day (Finan and colleagues, 2013). Add a mattress that is too soft and some lumpy unfamiliar pillows that throw your neck into an awkward angle all night and you have a recipe for the cervicogenic headache, one that originates in the neck, that so many people bring home. Packing your own pillow is not fussy. It is one of the most effective things you can do.

Tamaki M, Bang JW, Watanabe T, Sasaki Y. Night watch in one brain hemisphere during sleep associated with the first-night effect in humans. Curr Biol. 2016;26(9):1190–1194. doi:10.1016/j.cub.2016.02.063

Wine, dehydration and the recovery you did not get

A glass of something in the evening feels like it helps you sleep and in one sense it does: alcohol shortens the time it takes to drop off. The problem is the second half of the night. A detailed review of the evidence shows that alcohol suppresses REM sleep and increases disruption later in the night as it is metabolised, so you wake more and recover less, even if you dropped off quickly (Ebrahim and colleagues, 2013). Combine that with dehydration due to the heat and weather and made worse by alcohol and your tissues are simply not repairing overnight the way they should. Your intervertebral discs are roughly 80 per cent water and it explains why a well-hydrated, well-rested body copes with a day of walking and sightseeing far better than a tired, dry one.

Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013;37(4):539–549. doi:10.1111/acer.12006

Bare feet, flip-flops and hard floors

Holiday footwear deserves a lot of blame for holiday aches and pains. Flip-flops give your foot almost nothing to work with and no cushioning and to keep them on your foot you unconsciously grip with your toes and that alters your stride. Three-dimensional gait analysis has shown that walking in flip-flops measurably changes lower-limb movement compared with proper shoes (Sharpe and colleagues, 2016). If you wear those solidly for a fortnight the strain travels upwards, from an irritated plantar fascia, the thick band under the arch, through the Achilles tendon and calf and often into the knees, hips and lower back.

Hard floors do not help either. Padding around a villa on marble or tile in bare feet removes the cushioning your joints are used to and if you tend to overpronate, where the arch rolls inwards, an unsupportive surface exaggerates this. None of this means you cannot enjoy the pool. It means a supportive sandal with a back strap for the walking days goes a long way.

Sharpe T, Malone A, French H, Kiernan D, O’Brien T. Effect of flip-flops on lower limb kinematics during walking: a cross-sectional study using three-dimensional gait analysis. Ir J Med Sci. 2016;185(2):493–501. doi:10.1007/s11845-016-1421-y

The stress crash: why you fall apart the moment you relax

Perhaps the strangest pattern is the person who works flat out, races to finish everything before their holiday deadline and then gets ill or achy the instant they stop. There is a name for this too. Dutch researchers described leisure sickness, the tendency for some people, particularly those with demanding jobs and a strong sense of responsibility, to develop symptoms such as headaches, fatigue and muscular aches during weekends and holidays (Vingerhoets and colleagues, 2002). The likely mechanism is the sudden drop in the stress hormone cortisol, produced by the hypothalamic-pituitary-adrenal axis that keeps you keyed up under pressure. Wound tight for months, the body does not simply switch off gracefully. Muscular tension that you had been ignoring makes itself known and a run-down immune system leaves you vulnerable to that classic first-week-of-holiday cold.

If this is you, a gentle wind-down helps more than a hard abrupt stop: some light exercise in the days before you travel, staying hydrated and not treating the first day as a chance to catch up on a fortnight of missed sleep in one go. If you tend to arrive on holiday already carrying tension in your neck and upper back, it is far better to deal with it before you go. If you are experiencing that build-up of pain and stiffness now before you even depart, I would be happy to help before you leave for your holiday. Call me on 01202 937568, or book a free 15-minute consultation 

Vingerhoets AJJM, Van Huijgevoort M, Van Heck GL. Leisure sickness: a pilot study on its prevalence, phenomenology, and background. Psychother Psychosom. 2002;71(6):311–317. doi:10.1159/000065992

Before and after your trip

The theme running through all of this is that a holiday asks your body to do unfamiliar things while often giving it less good sleep to recover on. You cannot control the hotel mattress, but you can set off in good shape and set off on the right foot.

How can I help, as a chiropractor? I recommend a chiropractic check up before you travel which will settle any potential restriction in your neck and lower back and send you off in the best possible condition, moving freely. Then, I suggest a chiropractic session when you return with your predicted holiday aches and pains which can help unwind the myofascial tension, the tightness in muscle and its surrounding tissue, that builds up over a fortnight of soft beds and hard floors.

If a long drive is part of your trip, the journey has its own set of issues, which I have covered separately in a long car journeys and your back blog post that you might identify with. Between the drive to get there and the stay itself, you have the whole holiday covered. You can read more about how we work with back and neck problems on our back pain and neck pain and headaches pages and what to expect on your first visit.

The clinic is at 42 Branksome Hill Road on the boundary between Bournemouth and Poole, which makes a pre-holiday or post-holiday appointment easy to fit in nearby Westbourne and  Canford Cliffs, Sandbanks and Poole. You will find the full picture on the areas we cover page.

A walk along the seafront at Branksome Chine or a slow loop of Poole Park in the days before you fly is exactly the kind of gentle wind-down I mean and it costs you nothing.

Frequently asked questions about holiday aches and pains

Why do I always get a stiff neck on holiday?

Usually it is the pillows and the bed that give you a stiff neck. Unfamiliar, over-soft or over-firm bedding can hold your neck at an awkward angle all night and the poor sleep that comes with a new environment lowers your pain threshold. Packing your own pillow is an effective fix.

Can flip-flops really cause back pain?

Indirectly, yes, your footwear can play havoc with your back and hips. Flip-flops change how you walk and over a fortnight or so that altered stride puts extra strain on the feet, calves, knees and lower back. Wearing a supportive sandal with a back strap for the walking days makes a noticeable difference.

Why do I feel worse the moment my holiday starts?

This is sometimes called leisure sickness. After a stressful run-up of preparing, packing, winding up work issues, cortisol levels drop suddenly when you finally relax and muscular tension and fatigue you had been overriding come to the surface, sometimes alongside a cold. A gentle more gradual wind-down before you travel helps you avoid it.

Does drinking on holiday affect my back and joints?

Alcohol helps you fall asleep but disrupts the second half of the night and suppresses restorative REM sleep, so you recover less. Combined with dehydration in the heat, your muscles and joints are not repairing overnight as well as they should.

Should I see a chiropractor before or after a holiday?

Both seeing a chiropractor before and after your holiday can help. A check beforehand means you travel moving freely rather than carrying tension and a treatment session afterwards helps unwind the stiffness that builds up from soft beds, hard floors and long days on your feet. Chiropractic is a good lifestyle maintenance option.

How soon after getting home should I book an appointment?

There is no rush and no wrong answer, though most people find a few days after landing works well, once the travel fatigue has settled and they can tell what is stiffness that has set in rather than simple tiredness. The clinic is a short drive from Bournemouth Airport and easy to reach from Parkstone, Penn Hill, Whitecliff, Ashley Cross, Branksome Westbourne and Poole, with weekday appointments from 7.30am and Saturday mornings available. If the ache has not shifted after a fortnight home, that is the point at which it is worth having it looked at properly.

More questions that you can’t find the answer to? Our FAQ’s page should be useful.

Written by Leslie Budzynski DC, GCC-registered chiropractor (GCC No. 00043) with 39 years of clinical experience. Principal chiropractor at Bournemouth Chiropractic, 42 Branksome Hill Road, Bournemouth BH4 9LE.

References on holiday aches and pains:

1. Tamaki M, Bang JW, Watanabe T, Sasaki Y. Night watch in one brain hemisphere during sleep associated with the first-night effect in humans. Curr Biol. 2016;26(9):1190–1194. doi:10.1016/j.cub.2016.02.063
2. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539–1552. doi:10.1016/j.jpain.2013.08.007
3. Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013;37(4):539–549. doi:10.1111/acer.12006
4. Sharpe T, Malone A, French H, Kiernan D, O’Brien T. Effect of flip-flops on lower limb kinematics during walking: a cross-sectional study using three-dimensional gait analysis. Ir J Med Sci. 2016;185(2):493–501. doi:10.1007/s11845-016-1421-y
5. Vingerhoets AJJM, Van Huijgevoort M, Van Heck GL. Leisure sickness: a pilot study on its prevalence, phenomenology, and background. Psychother Psychosom. 2002;71(6):311–317. doi:10.1159/000065992