Can Stress Cause Chronic Pain? A Study of Adults Over 50
Most people can tell when stress is wearing on them. Whether it can also leave them in pain is a harder question, because pain and stress so often arrive together that it's hard to tell which came first. A 2026 study from Northwestern University, published in Frontiers in Public Health, took that on by starting with 2,622 adults aged 50 and over who said they weren't often troubled with pain, and checking two years later who was.
The short answer
- Long-running life problems went with more new pain. Among people who said they weren't often troubled with pain in 2018, those carrying more ongoing stressors were more likely to say they were often troubled with pain in 2020. Each additional stressor raised the odds by 13%, after allowing for differences such as education, work and how healthy people rated themselves.
- The biggest single one was their own health. People with an ongoing health problem that upset them had 1.62 times the odds of new pain. Money trouble and health problems in a spouse or child were also linked to new pain, though not significantly once all those differences were allowed for.
- About 18% developed pain overall. 481 of the 2,622 people said they were often troubled with pain two years on.
- It shows a link, not proof. The study can't say stress caused the pain, and the researchers list what they couldn't measure, sleep and activity among them.
If pain has started getting in the way, you can book a first visit, or read on for how the study worked.
Dr. Jeff's walk-through of the study
Jeffrey T. Morrey, D.C., recorded this walk-through of the study. It's his take as a chiropractor, and the details further down follow the published paper. A few points in the video go beyond it. Of the 14,133 people surveyed, the analysis covered the 2,622 who said they weren't often troubled with pain at the start. The study measured new pain, not long-term health in general, and examples like a stressful day leading to drinks and a fall, or poor sleep slowing healing, are his illustrations rather than its results. Where he talks about what looking after yourself, or neurofeedback, does for people, that's his experience as a chiropractor, not something this study tested. Neurofeedback is a service separate from chiropractic that Dr. Cindy Morrey, D.C., provides here; our neurofeedback overview explains what it involves and the limits of the research on it.
Video: stress and chronic pain (4 min 5 s)
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Watch on YouTube (new tab) ↗Who was in the study?
The data comes from the Health and Retirement Study, a long-running University of Michigan survey of US adults over 50 that is designed to represent that whole population and asks the same people about their health, money and work every two years. The researchers used the 14,133 people who answered both the 2018 and 2020 rounds.
Pain was measured with one question: "Are you often troubled with pain?" The study looked at the 2,622 people who answered no in 2018, and counted someone as having new pain if they answered yes in 2020. Their average age was 68, and 56% were women.
What counted as a chronic stressor?
The survey asks about problems that are current and have lasted 12 months or longer, and how upsetting each one is. The researchers counted a stressor when someone rated it moderately or very upsetting, so these are problems people found upsetting, and their own health is one of them. There were eight:
- Their own health problems
- Physical or emotional problems in a spouse or child
- Alcohol or drug problems in a family member
- Difficulties at work
- Financial strain
- Housing problems
- Problems in a close relationship
- Regularly helping a family member or friend who is sick, limited or frail
They also added up how many of the eight each person had, from none to all eight.
Stress and pain: what the study found
The results are odds ratios, which compare the odds of new pain in people with a stressor against people without it. An odds ratio of 1.62 means 1.62 times the odds. Odds aren't the same as a percentage chance, so 13% higher odds doesn't mean a 13-point higher chance of pain.
The main results come from two models: one as it stood, and one allowing for gender, race and ethnicity, education, marital status, employment and how healthy people rated themselves. In a further check that left self-rated health out, financial strain and health problems in a spouse or child were significantly linked to new pain again.
| Stressor | Odds of new pain, as it stood | After allowing for other differences |
|---|---|---|
| Own health problems | 2.13 times | 1.62 times |
| Financial strain | 1.62 times | Not significant |
| Health problems in a spouse or child | 1.46 times | Not significant |
| Each additional stressor | 18% higher | 13% higher |
The other five stressors weren't significantly linked to new pain in either model. Housing problems came closest to the cutoff in the first model.
What it couldn't show. Pain was one yes or no question, so the study can't say where the pain was or whether it met a formal definition of chronic pain. Two years passed between surveys, so it can't see what happened in between, and the researchers say the design can't establish cause. Things they didn't measure, including activity, diet, sleep and resilience to stress, could play a part in the link. Allowing for self-rated health may also have hidden part of it, because health could be one of the ways stress leads to pain. And the findings are about US adults over 50.
So, can stress cause chronic pain?
In this study, people carrying more long-running life problems were more likely to develop pain over the next two years, and their own ongoing health problems mattered most. The researchers see these stressors as something that can be changed, and suggest that clinics and communities ask people about needs like money, housing and caregiving and connect them with support, as a way to head off pain before it starts.
Dr. Jeff's take: thoughts, the first of the three T's
This video picks up where his PACBACK walk-through left off, with the "three T's" of thoughts, toxins and traumas, an idea he traces back to chiropractic's founders. This one is about thoughts, and for him that mostly means stress.
His point is that stress rarely stays in your head. In his examples, after a hard day you might have a drink, maybe that turns into three, and then a fall, or stress wears you out so you sleep badly, and "if you're not sleeping well, you're not healing well." His advice is to take stock: work out which stress is healthy and which you can get rid of, then make a plan for handling the rest. He names prayer and exercise, "a huge one." His summary: "Pray, move, and eat right."
On moving, there's research for back pain: a 2016 review of 21 trials found that exercise combined with education reduced the risk of an episode of low back pain.
What a first visit looks like here
We start with an exam and tell you what we find before we recommend anything. Depending on what we find, care can include adjustments and exercises to keep up between visits, and we'll talk about the things outside the office that affect your pain, like stress, how much you move and your posture.
Stress that disrupts your mood or sleep for weeks is something your medical doctor assesses too. If you ever feel you can't keep yourself safe, call or text 988 any time, day or night.
Book a visit
Whether it's your back, your neck or somewhere else, and whether the pain started recently or has been building for a while, a first visit in Clarksville is where we start working out what's behind it. We'll tell you what we find, including when what we find isn't something we treat. If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider.
Book your first visit or see what's included in the new patient visit.
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Chronic life stressors and pain incidence in adults 50 and older: a longitudinal analysis with implications for pain prevention and public health promotion
2,622 US adults aged 50 and over in the Health and Retirement Study who were not often troubled by pain in 2018, asked again in 2020.
What it foundEach additional moderately or very upsetting long-running stressor raised the odds of new pain two years later by 13% after adjustment; ongoing problems with their own health had 1.62 times the odds. Financial strain and health problems in a spouse or child were linked before adjustment, and again in a check that left out self-rated health, but not in the fully adjusted model.
What it can't tell usPain was a single yes or no question with no location or chronic pain definition, the two-year gap between surveys rules out conclusions about cause, and activity, diet, sleep and resilience were not measured.
Publication details & citation
Spector et al. Chronic life stressors and pain incidence in adults 50 and older: a longitudinal analysis with implications for pain prevention and public health promotion. Frontiers in Public Health. 2026. DOI: 10.3389/fpubh.2026.1905906.
Read the publication recordPrevention of Low Back Pain: A Systematic Review and Meta-analysis
21 randomized trials involving 30,850 participants, examining interventions to prevent low-back pain.
What it foundExercise with education reduced the risk of a low-back-pain episode. Education alone, back belts and shoe insoles did not show a preventive effect.
What it can't tell usEvidence quality varied by intervention and outcome, and the search ended in 2014. It doesn't suggest every injury can be prevented, and it doesn't show that routine adjustments prevent back pain.
Publication details & citation
Steffens et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine. 2016. DOI: 10.1001/jamainternmed.2015.7431.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.