Treatment for chronic pain must address both physical and social pain

Physical pain and social pain may be more closely related than previously thought. Social pain, which typically results from interpersonal rejection or abuse, has been viewed as a non-medical response to external factors. However, recent research suggests that some physical and social stress responses may arise because of shared processing in the brain. Long-term usage of opioid medications could perpetuate a cycle of experiencing both physical and social pain and may increase risk of addiction. The authors, both of whom prescribe opioid medications, caution, "We must recognize that when physical and social pain coexist, long-term opioid therapy is more likely to harm than help." They advocate a move "toward chronic pain care models that do not separate physical pain (as a medical issue) from social pain (as a non-medical issue)."

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When Physical and Social Pain Coexist: Insights Into Opioid Therapy
Mark D. Sullivan, MD, PhD and Jane C. Ballantyne, MD
University of Washington, Seattle, Washington
https://www.annfammed.org/content/19/1/63