A new UCL study finds a strong link between depression and the onset of physical pain in middle-aged and older adults. The research suggests early mental health support could reduce or delay pain.
Middle-aged and older adults who suffer from moderate to severe pain are more likely to have experienced worsening symptoms of depression up to eight years prior to the onset of their pain, according to a study by researchers at University College London (UCL).
Published in the journal eClinicalMedicine, the study indicates that early treatment of depression in this age group might mitigate future physical aches and pains.
The researchers compared data from 3,668 adults over 50 who reported frequent pain with an equal number of pain-free adults, revealing a significant prelude of depressive symptoms in the pain group.
“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,” lead author Mikaela Bloomberg, a senior research fellow in the Department of Epidemiology and Public Health at UCL, said in a news release. “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.”
Understanding the Pain Connection
The longitudinal data derived from the English Longitudinal Study of Ageing (ELSA), which spans 21 years, highlighted that depressive symptoms in participants who experienced pain peaked around the onset of pain and remained elevated thereafter. In contrast, those in the non-pain group exhibited relatively stable and lower levels of depressive symptoms.
The study also noted a similar trend with loneliness, which increased both before and after the onset of pain, whereas it remained low and constant in those without pain.
However, social isolation did not show a significant difference between the two groups, underscoring that the quality of social connections, rather than the quantity, plays a pivotal role in mitigating pain and depression.
The majority of participants reported pain in the back, knee, hip or foot, but the precise cause of the pain was not identified.
Mechanisms and Implications
“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,” added Bloomberg. “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 ‘fight or flight’ response.”
These findings underscore the need for a holistic approach to pain management that includes mental health interventions.
The study found that participants with lower education and wealth experienced a more significant increase in depressive symptoms, pointing to the necessity of prioritizing accessible mental health and community support programs for vulnerable populations.
Limitations and Future Research
While comprehensive, the study’s demographic was predominantly white, reflecting the population in England for that age group. Future studies should aim to include more diverse racial and ethnic groups and consider younger populations, according to the researchers..
Additionally, the study did not differentiate between acute and chronic pain, though consistent results in participants reporting pain over successive years suggest the findings are applicable to chronic pain conditions.
Source: University College London