Chronic pain evades common treatments and affects millions of people around the world. Pain is not a purely physical phenomenon, so treatments may involve multiple modes of intervention and need to be highly tailored to an individual. To aid this way of treating chronic pain, researchers look at it from different angles, including how specific groups of people may face it. This has led to some research on potential impacts of neurodevelopmental conditions such as ADHD.
“In our latest study, we looked at patients with severe chronic pain who were being treated at specialized pain centres across Japan, and examined how often ADHD- and autism-related traits were present in this population,” said Satoshi Kasahara from the Department of Anesthesiology and Pain Relief Center at the University of Tokyo Hospital.
“We found that ADHD-related traits were more common in these patients than in the general population, about 2.4 times higher. These traits were also closely linked to pain severity, as well as to psychological factors such as anxiety, depression and negative ways of thinking about pain.”
The findings support the idea that pain is not merely physical in nature, but that mental and neurological traits may play a bigger role than thought. There’s also a strong implication that ADHD has been overlooked in this context. Many adults with ADHD are undiagnosed and don’t often get diagnosed even when attending diagnosis for things like chronic pain. Kasahara and his team think their research could be useful for clinicians, as a positive or negative ADHD diagnosis may help narrow down avenues for treatment for chronic pain patients.
“This research began from everyday clinical experience. In our practice, we frequently encounter patients with chronic pain who do not respond well to conventional treatments. Among these patients, many show characteristics commonly seen in ADHD, such as inattention, hyperactivity or impulsivity, and difficulties with emotional regulation,” said Kasahara.
“This led us to consider whether ADHD-related traits might be more common in this population than previously recognized, and whether they could be contributing to the persistence and severity of pain.”
The team aims to move beyond simply identifying associations and examine if and how treating ADHD can help reduce chronic pain. They are considering conducting prospective and interventional studies for this. Appropriately identifying and addressing ADHD in patients with chronic pain may also help improve a patient’s overall condition.
“For example, approaches such as cognitive behavioural therapy and rehabilitation programs that include exercise have been widely used, and are considered effective in improving anxiety, depression and negative ways of thinking about pain, which in turn can help reduce chronic pain,” Kasahara said.
“In addition, some patients with ADHD-related traits may not fully recognize these traits themselves, and this can contribute to difficulties in daily life and interpersonal relationships. In such cases, psychoeducation, helping patients understand their own characteristics and learn how to better manage their behaviour, can also play an important role. These kinds of approaches may be just as important as medication, and a comprehensive approach that combines medical, psychological and rehabilitative care is likely to be the most effective.”