A new study by researchers at University College London (UCL) has found that many middle-aged and older adults who experience pain may have had worsening depression for up to eight years before their pain began.
The study, published in the journal eClinicalMedicine, points to the importance of early mental health support to help prevent or lessen pain in later life.
Researchers analyzed survey data from 3,668 adults over 50 who often had moderate to severe pain. They compared this group to another 3,668 people of the same age who did not report pain.
The data came from the English Longitudinal Study of Ageing (ELSA), which tracks the health and wellbeing of a representative group of people in England every two years over a period of 21 years.
The results showed that those who later developed pain had increasing symptoms of depression for many years before their pain began. Their depression peaked when the pain started and remained high afterward. In contrast, those who didn’t experience pain had lower and more stable levels of depression.
The same trend was seen with feelings of loneliness. People who reported pain also felt lonelier both before and after their pain began, while loneliness remained low and steady for those who didn’t experience pain. These findings suggest that mental health problems can come long before physical pain shows up.
The study didn’t identify the exact causes of pain, but most people said their pain was in the back, knees, hips, or feet. A small number reported pain all over the body or in other places like the mouth.
Dr. Mikaela Bloomberg from UCL, who led the study, explained that pain and depression are closely linked, but little was known about which came first.
The study shows that emotional issues such as depression and loneliness may appear long before the pain starts. She said that improving mental health and offering social support early on might help prevent or delay pain later in life.
Depression and loneliness can affect the body in ways that increase pain. They can raise stress levels, which may lead to more inflammation, and they can change how our nerves and immune systems react, making people more sensitive to pain.
The researchers also found that the link between depression and pain was stronger for people with less education and lower incomes.
This group may not have access to good healthcare or support systems, making it harder for them to manage mental health and pain. This shows the need to give more attention and resources to people in more vulnerable situations.
Interestingly, the study found no strong link between pain and social isolation—meaning how often someone sees or speaks to others. Instead, it was the feeling of loneliness, not the amount of social contact, that seemed to matter most. This suggests that the quality of social relationships may be more important than the number of social interactions.
Most of the people in the study were white, reflecting the population of England in that age group, so the researchers note that more studies are needed in other age and ethnic groups. They also said that the study didn’t clearly separate chronic pain from other types of pain.
However, the results were consistent even when they looked only at people who reported pain in more than one survey, suggesting the findings do apply to long-term pain.
The study accounted for many possible outside factors like gender, age, education, income, other health conditions, exercise habits, drinking, and smoking.
This research was supported by the Nuffield Foundation’s Oliver Bird Fund and Versus Arthritis. The ELSA project is funded by the National Institute on Aging and several UK government departments.
If you care about mental health, please read studies about 6 foods you can eat to improve mental health, and B vitamins could help prevent depression and anxiety.
For more health information, please see recent studies about how dairy foods may influence depression risk, and results showing Omega-3 fats may help reduce depression.
The study is published in eClinicalMedicine.
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