by Lesli Hill, MS, BA – Volunteer Coordinator, PAINS Advisory Committee
While those who live with pain know too well the painful lumps and bumps of our emotional hearts, we may not fully understand the consequences of pain on our physiological hearts. We often want to wall off the painful body part and pretend that the harm is contained in that spot, leaving the rest of our body to blissfully carry on.
Ongoing research reminds us that is not true. A March 2014 landmark study carried out at Teeside University in the UK wanted to know if chronic pain, particularly musculoskeletal pain (CMP), causes cardiovascular disease (CVD). It conducted a review of more than 5000 adults over the age of 45 who had participated in a 2008 health survey in England. The results were significant.
For individuals who were 65 or older, one third reported experiencing CMP and almost half of those individuals had cardiovascular disease, while 28% of individuals without chronic pain reported heart disease.
Even the 45-65 age group showed an increased risk of heart disease if they experienced CMP, with 23% at risk for heart disease. Only 14% of that population without CMP developed cardiovascular disease.
“Our findings suggest that the appropriate management of chronic musculoskeletal pain should not simply be viewed as an intervention for chronic musculoskeletal pain in itself, but also a preventive strategy to reduce the risk of developing cardiovascular disease.”
–Dr. Cormac Ryan, Senior Lecturer in Research, School of Health and Social Care, Teeside University, UK
Cormac Ryan, MD, Principle Investigator for this study, said that these outcomes suggest that CMP can be a cause of cardiovascular disease. Many factors can contribute to this. Ryan discussed some of the major factors which are:
- CMP promotes sedentary behavior because of the pain.
- CMP is marked by inflammation in the body that contributes to hardening of the arteries.
- Obesity can result from sedentary lifestyle, a major risk factor in heart disease.
- Pain creates stress, which also can lead to CVD.
He is a strong advocate of aggressively treating CMP as a prevention of heart disease. He believes this issue should be a population health priority in England.
Additional studies have pointed to a high correlation between chronic pain and heart disease. A 2016 regression analysis of 8596 adults in an English population health study demonstrated that individuals with chronic pain experience more cardiac disease. The researchers specifically noted that individuals who experience severe chronic pain are at a significantly higher risk of heart disease. They called for future studies that look at how reducing chronic pain improves cardiac health.
This growing body of research is a sharp reminder that chronic pain does more than just hurt. It creates systemic damage and that complicates treatment decisions. As increasing numbers of people in the US experience pain that is seriously under-treated or not treated at all, what will be the outcomes of the current severe restriction of opioids for chronic pain? The impact of decisions that shove patients into boxes that don’t fit and stigmatize and criminalize them for resisting those decisions may impact generations to come.
The National Pain Strategy, a comprehensive balanced approach to chronic pain in America, is yet to be fully implemented. Without pressure from consumers, it may never have the impact intended by those who developed it. This means that Individuals with pain must become proactive advocates of their health care. It is vital to show your own heart a little love by doing what you can to reduce pain and to aggressively manage other risk factors for cardiovascular disease.