How to Prevent Chronic Pain After 50
- Edward Walsh
- Feb 23
- 3 min read
(What a 10-Year Study of 2,631 Adults Taught Us) Chronic pain becomes more common as people get older (Fayaz et al., 2016). It becomes one of the most common drivers of disability, low mood, fatigue and reduced quality of life.
This begs the question:
Is chronic pain in later life unavoidable, or can it be prevented?
A large longitudinal study by Fancourt and Steptoe (2018) tracking 2,631 adults aged 50+ who were pain-free at baseline over 10 years gives us some surprisingly hopeful answers.
Let’s break it down.
What the Study Actually Did
Researchers followed adults aged 50+ from the English Longitudinal Study of Ageing over a decade. Importantly:
All participants were free from pain at the start
They were tracked over 10 years
Researchers controlled for:
Age
Sex
Wealth
Education
Employment
Existing health conditions
Depression
Sleep
Social isolation
Sedentary behaviour
Across the decade, 42.5% of participants developed moderate to severe chronic pain
So what correlated with reduced the risk?
1️⃣ Vigorous Activity (But Not Moderate)
Here’s the first key finding:
Doing vigorous physical activity more than once per week was associated with reduced risk of developing chronic pain by 26%
Moderate activity? No protective effect. The authors suggest vigorous activity may reduce the chance of persistent pain by reducing whole body inflammation, improving relief from the body's own pain reducing chemicals and keeping the body's DNA, proteins and cells healthy
What counts as “vigorous”?
For most adults over 50, that might mean:
Brisk uphill walking
Jogging
Swimming laps
Cycling at effort
Resistance training with meaningful load
Competitive sport
2️⃣ Cultural Engagement
Now here’s the part most clinicians miss.
Doing cultural activities more than every other month was associated with reduced risk of developing chronic pain by 25%
Cultural activities studied included going to:
Museums
Art galleries
Exhibitions
Concerts
Theatre
Opera
The authors suggested these activities help by improving mood and broadening attention.
Interestingly these effects were independent of physical activity and social isolation.
So it wasn’t just “getting out of the house.”
Who Was Most at Risk of Developing Persistent Pain?
Over the decade, chronic pain was more likely to start in:
Women
Those not living with a partner
Lower educational attainment
Lower wealth
Those no longer working
Those with chronic health conditions
Those with depression
Those experiencing restless sleep
Those meeting up socially more often
That last one is intriguing.
Frequent social contact doesn’t automatically equal emotional nourishment.
Quality > frequency.
Important Research Methodology Caveats
This was observational research, so the correlation effects found do not necessarily imply causation.
However, the research was longitudinal, excluded people with pain at baseline, controlled for extensive confounders and sensitivity analyses confirmed the results.
Also, moderate activity didn’t show an effect, which argues against a generic healthy-person bias explanation.
So If You’re 50+ and Want to Reduce Your Risk?
Start here:
Do something that genuinely elevates your heart rate for at least 20 minutes, twice a week
Put something cultural in your calendar every month
Treat sleep seriously
Address low mood early
Build a life that is physiologically and psychologically demanding in healthy ways
Pain risk rises with age, but inevitability is not the same as probability, and probability is modifiable.
References
Fancourt, D., & Steptoe, A. (2018). Physical and Psychosocial Factors in the Prevention of Chronic Pain in Older Age. The journal of pain, 19(12), 1385–1391. https://doi.org/10.1016/j.jpain.2018.06.001
Fayaz, A., Croft, P., Langford, R. M., Donaldson, L. J., & Jones, G. T. (2016). Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ open, 6(6), e010364. https://doi.org/10.1136/bmjopen-2015-010364
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