Summary: Experts say poorly treated pain may cause worse problems than once thought. We know that poorly treated chronic pain raises blood pressure and harms the heart. But badly treated chronic pain also keeps insulin, cortisol, and adrenalin high all the time. That harms health in many more ways. Note this most of all: high cortisol changes how the body handles calcium. That significantly raises the risk of osteoporosis, arthritis, scoliosis, and other bone and joint problems.
Data suggests that almost one-fifth of US adults are living with high-impact chronic pain. Sadly, most of these patients never get full relief because their treatment falls short. Even the rise of opioid addiction in the US has a lot to do with this chronic pain.
But new studies suggest that pain is more than an unpleasant feeling. It is also a major stress that changes the body and leads to serious problems. Sudden pain causes sudden stress. Adrenaline surges, blood sugar rises, and the autonomic nervous system (the part that runs the body on autopilot) shifts. Most people feel a sudden jump in heart rate and blood pressure.
The body can more or less handle short-term stress. But it is not built to handle the long-term stress of chronic pain. So constant pain, even if mild, causes a long-term stress response. That harms the heart, blood vessels, and hormone system.
Some of the problems linked to high-impact pain, whether short-term or chronic, include:
- Increase in blood pressure
- Faster heart rate, which puts more load on the heart
- Increase in bad cholesterol
- Hardening of the arteries over the long run
- Cardiac arrhythmias
- Increased risk of heart attack, stroke, and sudden death.
Science has long known about these problems from severe pain. But it knows less about how pain affects other body functions over time. Pain is an alarm. It signals that something is wrong in a part of the body and something must be done. But if this alarm keeps ringing, as in chronic pain, it may badly damage health.
The body needs enough rest and pain-free time to recover and renew itself. Trouble may follow if it does not get those key pain-free hours. Often, the health problem causing the pain is hard to treat. Still, the right treatment can ease the symptoms. And that can give the body much-needed time to recover and recharge.
Can chronic pain cause osteoporosis and bone loss?
Problems like osteoporosis, arthritis, and poor dental health are more common in people with chronic pain. But until now, doctors did not realize these problems may come from the chronic pain itself. New studies suggest chronic pain causes bigger hormone changes than once thought. That leads to much more serious changes in the body. Chronic pain is like an alarm that never shuts off. So the body keeps releasing stress hormones like adrenalin, cortisol, and insulin (the big three). These hormones help the body a lot in an emergency. They give more energy, help lower inflammation, and boost repair.
But if these stress hormones stay high all the time, the body cannot cope. The body does not have endless reserves. Over time, stress hormones like cortisol lower calcium levels in the body. That causes problems with teeth, joints, and the spine. Many people with chronic pain may develop severe osteoporosis. Their bones get fragile and break easily, and other problems follow. These people face a higher risk of low back pain, arthritis, and more. But it does not stop there. High cortisol also lowers testosterone and estradiol. Falling sex hormones can cause more damage: poor health, mood problems, lower sex drive, anxiety, and more.
High cortisol means higher blood sugar. That raises insulin, which in the end leads to insulin resistance or diabetes. It also lowers vitamin D and magnesium, and more. As you can see, chronic, poorly treated pain can set off severe stress responses that lead to many problems. It is vital to understand how all body functions are linked. So experts suggest doctors test people with chronic pain more fully. Doctors should treat not only the chronic pain but also its problems. That means testing hormone function, bone health, vitamin D levels, and more.
Frequently asked questions
What happens if chronic pain is not treated?
Your body stays in a stress response it was never built to hold. Pain that never shuts off keeps adrenaline, cortisol and insulin high. Over time that strains the heart and blood vessels and weakens bones and joints. It lowers sex hormones. And it pushes blood sugar toward insulin resistance or diabetes. Even mild pain, if it is constant, sets off this chain.
Can chronic pain raise your blood pressure?
Yes. High-impact pain raises blood pressure and heart rate, which adds load on the heart. Over the long run it is also linked to higher bad cholesterol, hardened arteries, and heart rhythm problems. It is also linked to a higher risk of heart attack, stroke and sudden death. Your body can handle short bursts of pain-driven stress. It cannot handle that stress every day.
Can chronic pain cause diabetes?
It can push you there. Chronic pain keeps cortisol high, and high cortisol means higher blood sugar. Higher blood sugar drives insulin up. Constantly high insulin leads to insulin resistance or diabetes. That is one reason pain and metabolism cannot be treated as separate problems. The same stress hormones connect them.
Does chronic pain affect your hormones?
Yes. High cortisol from ongoing pain lowers testosterone and estradiol. Falling sex hormones can bring poor health, mood problems, lower sex drive and anxiety. Chronic pain is also linked to low vitamin D and low magnesium. These changes add up. That is why the body needs pain-free time to recover and rebuild.
What tests should people with chronic pain get?
Experts suggest fuller testing for anyone with chronic pain, because the pain is only part of the problem. Doctors should check hormone function, bone health and vitamin D levels. Then they should treat the problems they find along with the pain itself.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
