Imma Perfetto
Cosmos science journalist
Medical researchers are calling for changes in the treatment of chronic pain, with more routine screening for depression and anxiety among patients.
It comes after a systematic review of the literature found that about 40% of adults living with chronic pain also have clinical depression or anxiety.
They say their findings underscore the need for equitable access to specialty pain care, and the development of targeted treatments that address co-occurring chronic pain and depression and anxiety.
Associate Professor David Rice, from the Pain and Musculoskeletal Conditions Research Group at Auckland University of Technology in New Zealand, who was not involved in the research, says the findings confirms what many people living with chronic pain already know: there is a strong connection between pain and emotional well-being.
“We now have strong scientific evidence that people with chronic pain are significantly more likely to experience depression and anxiety,” he says.
“It’s not a personal failing, but a natural response to ongoing suffering.
“We should encourage open conversations about the emotional challenges of living with chronic pain, so people feel comfortable seeking help.”
Chronic pain is described as pain which persists for 3 months or more. The latest systematic review and meta-analysis of data from 376 studies representing almost 350,000 people from more than 50 countries.
It found that the prevalence of depression and anxiety was highest among women, younger people, and individuals with “nociplastic” chronic pain, like fibromyalgia, complex regional pain syndrome, and temporal mandibular disorder.
Nociplastic pain is thought to arise from altered function of pain-related sensory pathways in the peripheral and central nervous systems, causing increased sensitivity.
It is one of the 3 sources of chronic pain. The others include “nociceptive” pain, caused by ongoing inflammation and damage of tissues, and “neuropathic” pain, caused by nerve damage.
“Although underlying pain mechanisms are not mutually exclusive,” the authors write, “the overall pattern of findings aligns with evidence that psychological distress and adverse life experiences increase the risk for chronic nociplastic pain.”
Rice says the research highlights the need for a holistic approach to treatment.
“It is very important that health professionals assess and treat the whole person, not just the pain condition,” he says.
“This means that systematic screening for depression and anxiety and appropriate referral to mental health professionals should be a routine part of care for people with chronic pain.”
The research is published in the journal JAMA Netword Open.
