Six key risk factors found for chronic pain

Researchers from the University of Oulu and McGill University in Canada have published an extensive, AI-based study on the biopsychosocial risk factors that predict chronic pain. The longitudinal analyses involved a total of more than 48,000 subjects, who were followed for nine years. The study was published in the prestigious Nature Medicine journal.

Approximately one in five people worldwide suffer from chronic pain. Chronic pain is a key health challenge that impairs working and functional capacity, and often no clear individual cause can be found behind it. In contrast, many biological, psychological and social factors are known to predict pain and influence the experience of pain. This is referred to as the biopsychosocial model of chronic pain. However, there is no well-established understanding of the predisposing factors for chronic pain, as extensive research on this topic has never been done before.

Based on the UK Biobank material covering the data of nearly half a million people, the study identified six key predisposing factors for chronic pain among 99 potential risk factors. A high risk score predicted spreading of chronic pain during the nine-year follow-up period. When pain is present in more than one location of the body, it is called as multisite pain. Correspondingly, a low risk score predicted recovery from chronic pain during the follow-up period.

The factors identified were obesity (body mass index over 30 kg/m2), sleeplessness, tiredness, often feeling fed-up, seeing a doctor for mental health problems, and stressful life events such as divorce, unemployment or the death of a spouse. The results were confirmed using the 1966 Northern Finland birth cohort and the Canadian Prevent-AD data.

Pain is one of the most common reasons to seek health care. Therefore, pain patients form a significant group of patients in primary health care. In particular, multisite pain is more damaging and therapeutically challenging than pain in one anatomical location.

“The recent findings enable the identification of biopsychosocial risk factors for pain in a more systematic manner and may thus contribute to more intensive treatment and the direction of resources especially to high-risk patients. This is especially important when taking into account the limited resources of health care and the challenges related to multisite pain and its treatment,” says Professor Jaro Karppinen and Postdoctoral Researcher Eveliina Heikkala from the University of Oulu, who participated in the research. Jaro Karppinen also works as the Rehabilitation Director for the Wellbeing Services County of South Karelia.

Research article: Tanguay-Sabourin C, Fillingim M, Guglietti GV, Zare A, Parisien M, Norman J, Sweatman H, Da-Ano R, Heikkala E; PREVENT-AD Research Group; Perez J, Karppinen J, Villeneuve S, Thompson SJ, Martel MO, Roy M, Diatchenko L, Vachon-Presseau E. A prognostic risk score for development and spread of chronic pain. Nat Med. 2023 Jul;29(7):1821-1831. Link to the article.

Last updated: 1.8.2023