A new study confirms that chronic pain that lasts for 3 months or longer can lead to a decline in brain function, shrinking the critical thinking center in the brain, the hippocampus, and hastening the onset of dementia. Research published in the Proceedings of the National Academy of Sciences (PNAS) found that a single site of chronic pain in a 60-year-old was sufficient to age the brain by a year.

Pain felt in two spots in the body shrank the brain even more — equivalent to over two years of aging. With five pain sites, the hippocampal volume was four times smaller than those with only two pain sites —equivalent to 8 years of aging.

“Asking people about any chronic pain conditions, and advocating for their care by a pain specialist, may be a modifiable risk factor that we can proactively address,” Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases of Florida, who was not involved with the new study, told CNN.

The study analyzed data from over 19,000 people who had undergone brain scans as part of the U.K. Biobank, a long-term government study of 500,000 participants between the ages of 40 and 59. People with multiple sites of body pain performed worse than people with no pain on seven of 11 cognitive tasks. Isaacson pointed out that while the study controlled for many contributory factors such as age, alcohol use, body mass, and smoking, the researchers did not include exercise.

“Exercise is the #1 most powerful tool in the fight against cognitive decline and dementia,” he said. “People affected by multisite chronic pain may be less able to adhere to regular physical activity as one potential mechanism for increased dementia risk.”

Chronic pain also causes inflammation in the brain, according to a 2019 review of studies that linked neuroinflammation with degenerative diseases such as Alzheimer’s. People with higher pain levels were also most likely to have reduced gray matter in brain areas that impact cognition such as the prefrontal cortex and frontal lobe — the same areas attacked by Alzheimer’s disease. According to CNN, more than 45% of Alzheimer’s patients live with chronic pain. 

Treating chronic pain should therefore be a priority as we age. There are a number of ways to treat pain, ranging from medications to pain management programs that offer not only physical therapies, but emotional and mental support.

According to chronic pain expert, board-certified internist Dr. Jacob Teitelbaum, 30% of people worldwide, and one in five Americans, struggle with chronic pain from arthritis, cancer, or back pain.

“Science has long correlated chronic pain with brain inflammation and neurodegeneration or brain shrinkage,” says Teitelbaum, whose landmark research on effective treatment for the chronic pain of fibromyalgia eliminated over 50 percent of the participants’ pain with a 90 percent improvement in quality of life, including reduced “brain fog.”

“The challenge we face today is that there’s no financial incentive for therapies to be developed that don’t involve expensive pharmaceuticals, so doctors aren’t introduced to lower-cost alternatives,” says Teitelbaum.  “Even proven therapies are overlooked — to the detriment of both patients and the physicians who care for them. By no fault of their own, clinicians and medical students never learn about viable therapies for chronic pain that are relatively inexpensive.”