Persistent distressing pain presents a huge burden for both individuals and society. In the 2016 Global Burden of Disease Study, low back pain (LBP) without any diagnosed underlying medical condition is the leading cause for years lived with disability (YLDs) with an estimated cost of €57.6 million.
Pain is associated with various mental disorders, especially major depression, and there is growing evidence that social exclusion is associated with a higher likelihood of reporting and developing chronic pain. Emerging evidence also suggests that painful feelings associated with social disconnection share similar pathways in the brain to those which underpin physical pain. Persistent pain can lead to psychological problems, and psychological problems can make pain worse. Over half of pain patients suffer from sleep problems and up to 85% also report depression or anxiety. Persistent pain is also a major risk factor for suicide.
Social exclusion is a term which incorporates a number of factors including people’s social status, financial situation, roles within the community and access to services such as health services and education. Research has indicated that poor sleep can result from anxious feelings associated with social exclusion and elevated perceptions of loneliness, social disconnection and indices of deprivation are widely associated with both anxiety and depression.
Given the existing evidence that pain, social exclusion, and mental health are inherently linked, we decided that research was very much needed to examine how these factors interact and why chronic pain may develop and persist in socially excluded populations.
The purpose of this study is therefore to extend our knowledge of the complex relationships between pain, sleep, anxiety, depression, and social exclusion using data from the UkBiobank. We envisaged that the findings could help in the design and development of novel treatments for patients with persistent pain, particularly individuals who feel isolated from society.