New study sheds light on pain and depression

Experts said that early psychological therapies could potentially help alleviate pain for some people.

Depression and loneliness are more profound in people with chronic pain years before their pain starts, according to a new study.

Researchers said that chronic pain is a “major public health concern” as it affects up to 40% of people in the UK and Europe and is a leading cause of disability.

It has been linked to problems including depression and loneliness, but academics wanted to understand more about the connection, particularly in the period before pain starts.

A team from University College London (UCL) examined 21 years of data from a long-term study tracking the health and wellbeing of patients.

In the new study, published in the journal eClinicalMedicine, experts examined data on more than 7,300 adults in England aged 50 and older.

Half of these went on to suffer pain, including aches and pains of the back, knee, hip or foot, while the others did not.

Researchers found that middle-aged and older adults who experience pain are more likely to have had worsening symptoms of depression up to eight years before the onset of pain.

These symptoms got worse in the years leading up to pain, appeared to peak when the pain was first noticed and remained high in the years after the pain started.

Symptoms of depression were less common, less severe and relatively constant among people who did not suffer pain.

They also found that loneliness increased both in the years before and years after the onset of pain but stayed low and relatively constant among the group who did not suffer pain.

As a result, the researchers suggested that treatment for depression might help to prevent or reduce later aches and pains.

Lead author Dr Mikaela Bloomberg, from UCL’s research department of epidemiology and public health, said: “Pain and depression are known to be linked, with each exacerbating the other. But we don’t know about the timing of these related conditions.

“Our study shows that depressive symptoms and loneliness worsen long before pain begins.

“This is important as it suggests the potential for early mental health and social support to reduce or delay later pain.

“Factors such as depression and loneliness can contribute to pain through several mechanisms – by inducing stress, they may increase inflammation, which can lead to pain; they also may increase sensitivity to pain by changing immune responses and by dysregulating our autonomic nervous system, the network of nerves that control unconscious processes such as the ‘flight or fight’ response.

“Our findings highlight the importance of approaching pain not just from a biological perspective, mental health interventions may be important too.”

The team found that depressive symptoms were most pronounced in people with lower levels of education and among less wealthy patients.

“This study provides further evidence supporting the importance of targeting loneliness and mental health in older people,” the authors wrote.

“Proactive mental health and social support is needed in the decade preceding onset of pain and should be integrated into long-term pain management strategies, particularly for individuals with fewer socioeconomic resources.”