Among a group of 215 patients with low back pain, researchers observed an association between poor sleep quality and higher pain intensity six months later. On the other hand, participants with higher pain intensity at the start of the study were more likely to have poor sleep 24 weeks later. The findings support the concept that back pain and poor sleep have a bi-directional relationship, and concurrent treatment to address both sleep and back pain may be necessary for some patients to achieve lasting relief. Archives of Physical Medicine and Rehabilitation, December 2021