This Overlooked Factor May Make Chronic Pain Harder To Live With

If you live with chronic pain, you've probably tried a lot of things to manage it: medications, physical therapy, lifestyle changes. But there's one factor that often gets overlooked—how well you process your emotions.

In a recent study, researchers found that difficulty identifying and expressing emotions doesn't directly make pain worse, but it does set off a chain reaction that makes pain more disruptive to daily life. Here's what the study found and what it could mean for you.

What is alexithymia & why study it?

Alexithymia is a term used to describe difficulty identifying and describing your own feelings. It's more common among people with chronic pain, and previous research has linked it to worse pain outcomes. But until now, researchers weren't sure whether alexithymia directly affects pain or whether something else is happening in between.

To find out, researchers followed 1,453 adults with chronic pain conditions across the United States over two years. Participants completed assessments at the start, at 12 months, and again at 24 months. The assessments measured alexithymia, psychological distress (symptoms of depression and anxiety), pain severity, and pain interference (how much pain gets in the way of work, focus, and daily life).

The chain reaction from emotional difficulty to daily disruption

Alexithymia had a significant indirect effect on pain interference through psychological distress. In simpler terms, difficulty processing emotions led to more anxiety and depression, which then made pain more disruptive to daily life.

Alexithymia didn't directly increase pain severity itself. It wasn't that emotional disconnect made pain physically worse; it's that it amplified how much pain interfered with everyday functioning.

The researchers also tested the reverse: Does pain interference lead to alexithymia over time? It did not. This finding strengthens confidence that difficulty processing emotions is a risk factor for worse outcomes, not simply a consequence of living with chronic pain.

Where emotional awareness fits into pain management

These findings point to a missing piece in chronic pain management—addressing emotional processing and mental health alongside physical treatment. Here are some places to start:

The takeaway

Chronic pain management isn't just about treating the body. This study shows that difficulty processing emotions can lead to psychological distress, which makes pain more disruptive to daily life. Building emotional awareness and addressing mental health may help improve how you function day to day.