Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth?

Abstract

Chronic pain has a tremendous personal and socioeconomic impact and remains difficult to treat. Therefore, it is important to provide an update on the current understanding regarding lifestyle factors in people with chronic pain across the lifespan. Lifestyle factors such as physical (in)activity, sedentary behavior, stress, poor sleep, unhealthy diet, and smoking are associated with chronic pain severity and sustainment. This applies to all age categories, that is, chronic pain across the lifespan. Yet current treatment options often do not or only partly address the many lifestyle factors associated with chronic pain or attempt to address them in a standard format rather than providing an individually tailored multimodal lifestyle intervention. The evidence regarding lifestyle factors is available in adults, but limited in children and older adults having chronic pain, providing important avenues for future research. In conclusion, it is proposed that treatment approaches for people with chronic pain should address all relevant lifestyle factors concomitantly in an individually‐tailored multimodal intervention. Ultimately, this should lead to improved outcomes and decrease the psychological and socioeconomic burden of chronic pain. Level of Evidence: IV.

Feasibility assessment of an occupational therapy lifestyle intervention added to multidisciplinary chronic pain treatment at a Danish pain centre: a qualitative evaluation from the perspectives of patients and clinicians

“…Moreover, the REVEAL(OT) would bring a lifestyle-oriented focus into the existing chronic pain management, which international studies have previously proposed (Lagueux et al, 2018 ; van Hecke et al, 2013 ). Particularly, interventions targeting multiple (≥ 2) lifestyle factors within the same intervention has been urged (Nijs et al, 2020 ). The REVEAL(OT) explored how several relevant lifestyle factors can be tackled within chronic pain treatment at a Danish outpatient clinic, assisted by occupational therapists.…”

“…Secondly, conducting the REVEAL(OT) after the compulsory psycho-education course, i.e., in parallel with the individual consultations at the MPC, could also release more surplus in the patients. Decreasing cognitive demands during the intervention would add energy surplus to the patients which is necessary to accommodate lifestyle changes (Nijs et al, 2020 ). Lower cognitive load also positively influences the group dynamics by releasing working memory, which is beneficial for communication skills such as the ability to take others’ perspectives (Cane et al, 2017 ).…”

“…Lately, the need for comprehensive programmes focusing on lifestyle in chronic pain patients has been highlighted (Nijs et al, 2020 ). A vicious circle of chronic pain often leads to improper lifestyle choices such as inactivity, improper nutrition and isolation, and impairs the everyday life in work, leisure and self-care.…”

An update on the management of chronic pelvic pain in women

“…There is little evidence specific to chronic pelvic pain regarding lifestyle changes. However, there is no reason to suspect that the impact would be different from that of other chronic pain conditions [57] and our advice regarding sleep, pacing and stress reduction is based on this literature. Exercise is known to be beneficial for chronic pain, though it may also exacerbate/flare pain and therefore is usually guided by our physiotherapists in those women where a specific musculoskeletal component has been identified.…”

Rehabilitation Succeeds Where Technology and Pharmacology Failed: Effective Treatment of Persistent Pain across the Lifespan

“…In addition, addressing multiple unfavorable lifestyle factors, such as physical inactivity, sedentary behavior, stress, smoking, unhealthy diet, and poor sleep concomitantly, seems to be a challenge for which such interdisciplinary pain rehabilitation programs may offer a comprehensive framework. Indeed, unfavorable lifestyle factors and pain have been shown to be interconnected [11]. This suggests that multimodal lifestyle-centered approaches may be effective for chronic pain.…”