Chronic Pain and Mental Health

Everyone has experienced pain at some point in their lives. While unavoidable, pain is not supposed to last for extended periods. However, for some, it can persist for months and even years. Chronic pain doesn’t just cause physical discomfort either, it can also cause mental health difficulties and damage emotional and physical well-being.

Experiencing pain daily can take over our lives. It can interfere with sleep, relationships, work, hobbies, and many other aspects of life.

What Is Chronic Pain?

Around one in every five adults in the US struggle with a chronic pain condition. Chronic pain is defined as pain lasting for three months or more and can include migraines, arthritis, or back and neck problems.

Pain signals are received by nerves that have been damaged, for example, from a paper cut or burn. The brain processes the signal and turns it into a painful sensation. When wounds heal or are treated, the pain usually stops, but with chronic pain, the brain continues to receive pain signals.

The symptoms of chronic pain can include:

  • Aches
  • Burning
  • Stinging
  • Shooting pains
  • Stiffness
  • Fatigue
  • Appetite changes

Pain and Mental Health Effects

Pain can interfere with everyday activities, such as work, general task management, or child care. It is also associated with opioid dependence, decreased quality of life, and poor mental health.[1] Some of the mental health issues that can occur include:

  • Depression – depression has a close relationship with chronic pain. It is estimated that around 85% of those with chronic pain also struggle with depression.[2] Experts consider the relationship between pain and depression to be bidirectional – depression can be caused by chronic pain and can also contribute to chronic pain symptoms.
  • Anxiety – pain causes significant anxiety spikes for many people. Like depression, pain and anxiety are bidirectional. Studies suggest that people who are more anxious about pain are more likely to develop chronic pain.[3]
  • Stress – constant pain can be a big source of stress. However, this pain can also make it challenging to deal with stress, as traditional sources of stress relief, such as exercise, can be difficult. When under stress, the body releases hormones, including adrenaline and cortisol. Prolonged exposure to stress hormones is detrimental to the brain and body and can contribute to mental health conditions such as anxiety and diseases like diabetes and cancer. It also plays a significant role in how people perceive pain – the more stressed someone is, the worse their pain becomes.[4]
  • Post-traumatic stress disorder – people with chronic pain report high levels of past trauma. 58% of those with migraines report histories of abuse or neglect, and those with chronic pain often report twice the levels of trauma than the general population.[5] Traumatic events that involve violence or injury can also lead to chronic pain in the future. Trauma is not a prerequisite for developing chronic pain, but it may be a contributing factor.

Months, and even years, of living with chronic pain can take an enormous toll on mental health and overall well-being. People can avoid going out or meeting up with friends for fear of a flare-up, contributing to greater social isolation and loneliness. When chronic pain makes it difficult to take part in everyday life, people can experience shame and low self-esteem.

Improving Chronic Pain and Mental Health

Treating chronic pain can sometimes be challenging as it is incredibly subjective, and there is no way to measure it precisely. Sometimes, doctors prescribe opioid painkillers to help manage pain, although they can be highly addictive, so some people avoid taking them.

Alternative ways to manage pain include:

  • Low-impact exercise – while being active can be difficult when living with chronic pain, it can have many physical and mental health benefits. Low-impact exercise such as walking or swimming can help reduce pain as exercise releases endorphins and dopamine, which can boost mood and support mental health. Easing into a new routine can be daunting, but small steps and increasing daily activity can produce positive results quickly.
  • Good sleep hygiene – a lack of sleep is detrimental to physical and mental health. Although chronic pain can affect sleep, there are ways to help improve sleep quality and get a more restful night. If chronic pain affects your sleep, you can source mattresses and pillows that accommodate certain conditions or try different sleeping positions to alleviate pain. Good evening routines, such as avoiding caffeine eight hours before bedtime and leaving phones and screens outside the bedroom, can also boost sleep quality.
  • Pet therapy – interacting with animals boosts oxytocin, the love hormone, and research has shown that when people attend pet therapy, they report reduced pain and mental distress levels. If you don’t want the commitment or cannot cope with a pet full-time, you could ask friends or family if you can borrow theirs or join one of the many pet-sharing groups listed online.

Though people often seek medical interventions for chronic pain, and practitioners can prescribe painkillers, a full-body approach to healing that addresses the mind and body is often the most effective approach. If chronic pain is negatively affecting your life, speak to a medical professional.


Sources:

[1] Centers for Disease Control and Prevention. Chronic pain and high-impact chronic pain among U.S. adults, 2019.

[2] Sheng J, Liu S, Wang Y, Cui R, Zhang X. The link between depression and chronic pain: Neural mechanisms in the brain. Neural Plast. 2017;2017:9724371. doi:10.1155/2017/9724371

[3] Macfarlane GJ, Beasley M, Smith BH, Jones GT, Macfarlane TV. Can large surveys conducted on highly selected populations provide valid information on the epidemiology of common health conditions? An analysis of UK Biobank data on musculoskeletal pain. Br J Pain. 2015 Nov;9(4):203-12. doi:10.1177/2049463715569806

[4] Ahmad AH, Zakaria R. Pain in times of stress. Malays J Med Sci. 2015;22(Spec Issue):52-61.

[5] ​​Tietjen, G. E., Brandes, J. L., Peterlin, B. L., et al. (2010). Childhood maltreatment and migraine (part I). Prevalence and adult revictimization: A multicenter headache clinic survey. Headache, 50, 20-31.

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