11/02/2025
Just published 🔥
Physical inactivity is the most important unhealthy lifestyle factor for pain severity in older adults with pain: A SHARE-based analysis of 27,528 cases from 28 countries.
👉 Recognised as a complex biopsychosocial condition, chronic pain is strongly influenced by the social and economic environment in which individuals work and live, making it a major global public health problem (https://pubmed.ncbi.nlm.nih.gov/34062143/). It is responsible for significant healthcare utilisation, lost productivity and reduced quality of life for patients (https://pubmed.ncbi.nlm.nih.gov/31079836/). Overall, pain is more prevalent in women and generally increases with age (https://pubmed.ncbi.nlm.nih.gov/32583713/). Specifically, among people over 50 years of age, the prevalence of episodes of musculoskeletal pain ranges from 20%-50% (https://pubmed.ncbi.nlm.nih.gov/37720912/).
👉 A brand-new cross-sectional study by Núñez-Cortés and colleagues used data from the SHARE Wave 9 survey (27,528 cases from 28 countries) to investigate associations between lifestyle factors – physical inactivity, sleep problems, smoking and inadequate diet and pain severity ((mild, moderate, severe) in adults aged over 50 years. Statistical models adjusted for demographic and health-related covariates were applied to quantify associations. (https://www.mskscienceandpractice.com/article/S2468-7812(25)00018-9/fulltext)
🔑 Key Findings
🏃♀️ Physical Inactivity:
Participants who hardly ever or never engaged in moderate physical activities were significantly more likely to report severe pain (Odds Ratio [OR]: 4.35; 95% Confidence Interval [CI]: 3.85–4.92). This association was the strongest among all variables studied.
Regular physical activity had a dose-response relationship with pain severity, reinforcing its importance in pain prevention and management.
👉 Other Lifestyle Factors:
😴 Sleep problems:
Associated with severe pain (OR: 1.83; 95% CI: 1.69–1.99), reflecting the bidirectional relationship between pain and sleep disturbances.
🚬 Smoking:
Weakly associated with severe pain (OR: 1.21; 95% CI: 1.13–1.34), with challenges in quitting smoking among those in pain
🥗 Diet:
Infrequent consumption of fruits and vegetables was linked to severe pain (OR: 1.78; 95% CI: 1.22–2.61). Healthy dietary habits may reduce pain through anti-inflammatory mechanisms
🤕 Pain Regions:
The associations were more pronounced in participants with pain in multiple body regions than those with pain in a single region
🔁 Bidirectionality:
The study notes potential bidirectional relationships, where pain may hinder physical activity and sleep, while inactivity and poor sleep exacerbate pain
⭕ Limitations
The study’s cross-sectional design prevents causal inference.
Self-reported data may be prone to recall bias.
Certain variables, such as obesity and psychological factors, were not included
💡 Clinical Implications:
✅ The results highlight the critical role of physical inactivity in pain severity, supported by findings from other studies. Sedentary behavior may exacerbate pain through mechanisms like systemic inflammation, reduced functionality, and fear-avoidance behaviors.
✅ Healthcare professionals should prioritize not only identifying key lifestyle factors but also addressing the barriers that hinder behavioral changes necessary for adopting a healthy lifestyle. Common barriers include biomedical beliefs, kinesiophobia, catastrophizing, perceived unfairness, and low levels of acceptance (https://pubmed.ncbi.nlm.nih.gov/37952339/). To overcome these challenges, interventions designed to reconceptualize pain and promote behavioral change are essential. Pain science education has demonstrated effectiveness in reducing catastrophic thinking and kinesiophobia (https://pubmed.ncbi.nlm.nih.gov/37516218/), thereby enhancing confidence in physical activity and adherence to exercise programs (https://pubmed.ncbi.nlm.nih.gov/33076759/).
✅Cognitive behavioral therapy for sleep issues and dietary interventions promoting anti-inflammatory foods were also recommended based on these results.
