Chronic pain and depression: a hidden link that's important to know

Do you often have back or joint pain and doctors can't find the exact cause? Perhaps it's not just the body, but also the psyche. A new study by scientists from University College London (UCL) has found that people over 50 who suffer from pain begin to show symptoms of depression long before the pain appears - as much as eight years before the pain.

Details: Mikaela Bloomberg et al, Trajectories of loneliness, social isolation, and depressive symptoms before and after onset of pain in middle-aged and older adults, eClinicalMedicine (2025). DOI: 10.1016/j.eclinm.2025.103209

The study covered more than two decades of data collected as part of the English Longitudinal Study of Ageing (ELSA). Nearly 7,500 people participated - half had frequent moderate to severe pain, the other half did not.

📈 Depression is a precursor to pain

The scientists noticed an interesting pattern: in those who were later onset pain sufferers, levels of depressive symptoms rose markedly well before pain onset, peaked with the onset of pain, and remained high afterwards. The group without pain had consistently low levels of depression.

The data on loneliness showed a similar pattern. People who subsequently suffered from pain felt more lonely several years before - and continued to feel this way afterwards.

Interestingly, social isolation (objective lack of communication) showed no clear link to pain, unlike subjective feelings of loneliness. Conclusion: it' s not the number of friends that matters, it's the feeling of being understood and supported.

🧬 The psyche and pain: what the science says

According to the study's lead author Dr Michaela Blumberg, depression and pain often go hand in hand - one reinforces the other. "The stress associated with depression and loneliness can trigger inflammatory processes in the body, increase sensitivity to pain, and disrupt the nervous system," she says.

Most alarmingly, the "depressive trajectory" was most pronounced among people with low income and education. These groups are more likely to be left without access to good psychological and medical care.

💡 What does this mean in practice?

The researchers urge: if a person complains of pain, we need to look wider than just MRIs and tests. He may need the help of a psychologist first and foremost. Early diagnosis of depression and working with loneliness can actually reduce the risk of developing chronic pain.

Cognitive Behavioural Therapy (CBT) for insomnia and depression is now considered the gold standard of treatment, but such specialists, especially in budget medicine, are still in short supply.