Chronic Pain Tied to Poor Health, Increased COVID Risk

Individuals who have chronic pain at age 44 are more likely to report poor general health, poor mental health, and joblessness when they are in their 50s and 60s, new research shows.

Chronic pain at age 44 (in 2002) was also predictive of SARS-CoV-2 infection nearly two decades later, in 2021.

“We speculate that pain earlier in life predicts a higher likelihood of COVID infection because it may be picking up health vulnerabilities,” study investigator Prof Alex Bryson, with University College London (UCL) Social Research Institute, told Medscape Medical News.

The study was published online November 2 in PLOS ONE.

A Vicious Cycle

The findings are based on data from the National Child Development Survey (NCDS), which is the following all individuals born during one week in March 1958 in England, Scotland, and Wales.

The researchers focused mainly on data collected in 2003, when most of the roughly 12,000 respondents were aged 44, as well as data collected in 2008, 2013, and 2021, when they were roughly 50, 55, and 62 years old, respectively.

At age 44, about 41% of the cohort reported having chronic pain (lasting at least 3 months), while 13% had short-term pain (lasting less than 3 months).

Chronic pain at age 44 was significantly associated with increased probability of having bodily pain at 50 and backache at 55 years. Of those who reported chronic pain at age 44, 84% said their pain was very severe at age 50.

Chronic pain at age 44 was also associated with lower life satisfaction at age 50; lower general health and attitudes toward life at age 55; unhappiness at age 50; depression at age 55; lower likelihood of working at age 55; sleep trouble; and increased probability of having had COVID-19 in 2021.

Chronic pain needs to be taken “seriously in that it has sizable and persistent effects on a whole range of health and wellbeing outcomes for people,” say Bryson and co-author David Blanchflower, PhD, with Dartmouth College, Hanover, New Hampshire.

Data from the 2019 edition of the National Health Interview Survey suggest that 50.2 million adults (20.5%) experience pain on most days or every day. The pain often co-occurs with mental health problems, including depression.

No Surprises

Reached for comment, Christopher Gharibo, MD, director of pain medicine, Department of Anesthesiology, Perioperative Care and Pain Medicine at NYU Langone Health, said the findings are fairly “predictable and support the existing body of literature.”

“People with chronic pain earlier in life have a higher incidence of chronic pain and poor mentally health and being pessimistic and so on later in life ― and the earlier the pain starts, the worse it is later,” Gharibo told Medscape Medical News.

Part of the problem, said Gharibo, has to do with “neuroplasticity and how our brain maladapts to chronic pain, which probably has a lot of secondary consequences on our medical health and mental outlook. Both kind of feed into each other ― the worse you do medically, the worse the mental outlook, anxiety and depression and so on.”

Gharibo is also not surprised that chronic pain may increase vulnerability to COVID-19.

“If you have medical problems and can’t take care of yourself, you’re not going to be as with it in protecting yourself, and you could be more exposed to COVID as a result,” he said.

Joseph Marino, MD, anesthesiologist and pain management physician at Northwell Health in New York, is also not surprised by the findings.

Increased stress due to COVID-19 may “exacerbate chronic pain, and COVID-19 may have created a barrier to patients receiving chronic pain treatment,” Marino, who also wasn’t involved in the study, told Medscape Medical News.

Marino also noted that patients who report disruptions in mood and sleep quality because of COVID-19 are more likely to report increased pain interference.

The study had no commercial funding. Bryson, Gharibo, and Marino have disclosed no relevant financial relationships.

PLoS One. Published online November 2, 2022. Full text

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