Deprivation linked to heavier burden of chronic pain in Northern Ireland, study finds

People living with chronic pain in Northern Ireland’s most deprived communities are experiencing substantially greater levels of depression, disability and disruption to everyday life, according to new research.

The study of 491 patients found the burden associated with chronic pain became progressively worse as deprivation increased, with researchers warning that people in the most deprived areas can face up to three times the level of pain-related problems affecting mental health, social functioning and physical disability compared with those in the least deprived areas.

Researchers from Queen’s University Belfast and the Belfast Health and Social Care Trust’s Centre for Pain Rehabilitation say the findings expose a significant health inequality and strengthen the case for pain services which address psychological and social pressures alongside physical symptoms.

42% of patients from most deprived areas

Of the 491 people with chronic pain whose data was analysed, 42% were living in the most socio-economically deprived areas.

Those patients reported much higher levels of distress, disability and overall pain-related burden.

Researchers also identified a clear pattern for depression and anxiety, with both increasing in proportion to deprivation levels.

Professor Kevin Vowles, lead researcher of the study

Professor Kevin Vowles, from the School of Psychology at Queen’s University Belfast, who led the study, described the effect as a “double jeopardy”.

He said:

“Chronic pain costs the UK £10 billion annually in healthcare and lost productivity. This study reveals that deprivation doesn’t just increase the risk of chronic pain. Those living in the most deprived areas are facing double jeopardy as it also increases the risk of pain that is more disabling, distressing, and disruptive.

“The findings are stark. Those in the most deprived areas face more pain-related issues and burdens, with the severity increasing in step with deprivation.

“This inequality deserves to be addressed urgently. Our research shows that deprivation is not only a risk factor for chronic pain but also amplifies its impact across every aspect of life.

“The message is clear, we need a biopsychosocial approach to chronic pain care that tackles the root causes of this disparity.”

A ‘perfect storm’ for patients

The findings matter beyond the severity of pain itself. They suggest deprivation can compound the wider consequences of living with a long-term pain condition — affecting a person’s mental health, ability to function physically, relationships, work and participation in everyday life.

Dr Jason Brooks, Lead Clinician and Consultant Anaesthesiologist at the Belfast Centre for Pain Rehabilitation, said the research reflected what clinicians were already seeing among patients.

“These findings mirror what we see daily in our clinics,” he said.

“Patients from deprived communities often struggle with a perfect storm of physical pain, psychological distress, and social disadvantage, all of which are exacerbated by limited access to support.

“The impact of pain ripples through every aspect of their lives, from family and work to education and mental health.

“This study confirms what we’ve long suspected, chronic pain cannot be treated in isolation. We need integrated rehabilitation that addresses the physical, psychological, and social dimensions of pain, particularly for those in the most deprived areas.

“Our goal isn’t just to reduce pain, it’s to help people reclaim their lives.”

Researchers call for change in pain care

The researchers say healthcare systems should prioritise what is known as a biopsychosocial approach — treating chronic pain by considering the interaction between a patient’s physical condition, psychological wellbeing and social circumstances rather than focusing on physical symptoms alone.

That could include pain education and rehabilitation alongside appropriate support for the wider effects of living with persistent pain.

They are also calling for policy action addressing underlying social factors associated with poorer health, including poverty, education and access to services.

Researchers argue that reducing those inequalities could not only improve patients’ quality of life and their ability to return to work and everyday activities, but could also reduce the wider economic cost associated with chronic pain.

The study ultimately points to deprivation as more than simply a factor in who develops chronic pain: among the Northern Ireland patients studied, greater deprivation was also associated with a progressively heavier burden once people were living with it — making where and how patients live an important consideration in how chronic pain services are designed and delivered.