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Experts say chronic pain needs to be treated at younger ages. Asia Vision/Getty Images
  • Researchers say study participants who had chronic pain in their 40s were more likely to experience pain later in life as well as poor health and mental health issues.
  • Experts say chronic pain can be the result of a painful condition, so both should be treated.
  • They note that mental health issues should also be treated along with chronic pain.

Chronic pain in your 40s can be a harbinger of not only future pain but also poor general health, mental health issues, and even joblessness in later years.

That’s according to a study published today in PLOS ONE by David Blanchflower of Dartmouth College in New Hampshire and Alex Bryson of University College London in the United Kingdom.

For the study, researchers examined the medical records of participants in the National Child Development Survey (NCDS), which included individuals born during a specific week in March 1958 in England, Scotland, and Wales. The researchers mainly collected the data from the Bio-Medical Survey conducted with NCDS participants in 2003. At that time, most of the 12,037 respondents were aged 44.

The researchers linked pain data collected from the Bio-Medical Survey to information from later in life (ages 50, 55, and 62).

About 40% of the study respondents reported having chronic pain at age 44.

The researchers also found:

  • Short-term and long-term chronic pain at age 44 was associated with pain and poor health later in life. Chronic pain had a stronger association than other types of pain.
  • Of those who reported chronic pain at the start of the study in 2003, 84 percent indicated very severe pain at age 50.
  • Chronic pain at age 44 was associated with poor mental health outcomes, lower life satisfaction, pessimism about the future, poor sleep, and joblessness later in life (ages 50 to 62).
  • Chronic pain at 44 was a predictor of whether a respondent became infected with COVID-19 in 2021.

Based on their findings, the scientists suggest that chronic pain is associated with broader health vulnerabilities.

For the study, chronic pain was defined as pain lasting at least three months. It can be on, off, or continuous.

In the United States, 50 million adults report pain on most or every day.

Chronic pain is considered a primary medical condition.

Still, it can also be a symptom of other conditions, such as spinal stenosis.

“It is a separate diagnosis because it comes with its issues,” says Dr. Christopher G. Gharibo, the director of pain medicine in the Department of Anesthesiology, Perioperative Care and Pain Medicine at NYU Langone Health.

“It often has components of muscular, skeletal, and psycho-social components,” Gharibo told Healthline. “In the case of spinal stenosis, we can’t look at it as only a spinal issue. We need to treat both – separately and together.”

There are many causes of chronic pain. It can start because of illness or injury and last well past the healing process. It can also be an ongoing condition, such as arthritis.

“As physicians, we are acutely aware that lack of exercise, poor diet habits, and lack of sleep can result in multiple consequences that lead to chronic pain,” says Dr. Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in California.

“More specifically, some of these associations, such as weight gain, will be harmful and destructive to joints like the knees and hips, cause major strain on the spinal ligaments and discs — where minor falls or injures can result in a major insult to the spine and the development of chronic pain,” Mikhael told Healthline. “Eating unhealthy high-sugar and high-fat diets and a lack of exercise can result in metabolic diseases like diabetes, which can cause chronic pain due to the development of neuropathy — both peripheral and central.”

“Tracking a birth cohort across their life course, we find that chronic pain is highly persistent. It is associated with poor mental health outcomes later in life, including depression, leading to poorer general health and joblessness,” the study authors wrote in a press statement. “We hope the study highlights the need for academics and policymakers to focus more attention on the problems of chronic pain.”

Chronic pain and mental health issues often occur together, according to the American Psychiatric Association. It is estimated that between 35 and 45% of people with chronic pain experience depression.

“Mental health issues, particularly depression and anxiety can make treating chronic pain conditions extremely challenging, especially if mental health issues are not acknowledged and included in the treatment plan,” Dr. Pooja Chopra, a physiatrist and chronic pain specialist with Hoag Orthopedic Institute in Southern California, told Healthline.

Experts also note that persistent pain can affect every aspect of a person’s life and can result in lower life satisfaction.

“Chronic pain could result in altered self-care, sleep, exercise, diet, and likely socialization – all important factors to emotional well-being and physical health,” Dr. Alex Dimitriu, the founder of Menlo Park Psychiatry & Sleep Medicine and BrainfoodMD, told Healthline. “Chronic pain, mental health, and self-care likely come together to result in diminished health outcomes and a greater likelihood of illnesses, such as COVID.”

“Often chronic pain conditions result in a sedentary lifestyle due to decreased mobility and there are coexisting mental health conditions such as depression and anxiety,” says Chopra.

“Furthermore, it is well known there is an association between sedentary lifestyles and multiple comorbidities, specifically obesity and cardiovascular disease, and COVID-19. Patients with chronic pain, especially with onset at a younger age, are more susceptible to also suffer from poor overall health, sleep issues, and depression which may be potential risk factors for COVID-19 susceptibility,” she added.

The treatment for chronic pain is as varied. It can include medications along with

  • Physical therapy
  • Exercise
  • Acupuncture
  • Relaxation techniques
  • Psychological counseling

“Based on this paper, I believe physicians can take a more multi-disciplinary approach to treat chronic pain more thoroughly,” Dimitriu said. “Rather than pain medication alone, lifestyle habits, such as exercise, diet, and sleep should be optimized. Improving moods and mental states can also play a key role in reducing the actual sensation of pain and minimizing negative health impacts.”

For people in their 30s or 40s, there are preventative measures they can take to lessen their risk of disease in later life.

Mikhael suggests:

  • Seek medical care early to prevent the development of the chronic status as it might get or become too late as your central nervous system becomes sensitized and acclimatized to that pain and hard to change.
  • Eat healthily and exercise regularly.
  • Learn about your genetic risks and work on them early on to prevent the early development of conditions such as diabetes, hypertension, hyperlipidemia, rheumatological diseases, and certain types of cancer.
  • Manage your weight early on before it becomes harder to control, resulting in chronic diseases and associated chronic pain.
  • Seek psychological and psychiatric help in cases of significant stress related to work or personal related issues. Untreated psychiatric conditions such as bipolar disorders, personality disorders, and major depression can lead to the development of abnormal central nervous diseases and chronic pain.

When chronic pain and mental health issues occur together, it is essential to treat both conditions, according to the American Psychiatric Association.

Some treatments benefit emotional well-being and chronic pain, such as psychotherapy, relaxation techniques, antidepressants, and lifestyle changes, such as exercise, nutrition, and getting enough sleep.

“Treating the underlying condition and the chronic pain is sometimes inconvenient,” Gharibo said. “Patients do not want to spend all their time at doctor’s appointments. But, when focusing on chronic pain, sometimes treatment for the underlying condition gets lost. We need to remember to treat both.”

“One of the good things that came from COVID is telehealth,” Gharibo added. “More people are accepting of seeing their doctor through alternate methods. It makes seeing multiple doctors more convenient and practical.”