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Multisite chronic pain and incident multiple sclerosis: A prospective cohort study
Fatemeh Vazirian1, Jing Tian1, Jane Alty2
1Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia.
Brain, Behavior, and Immunity
|March 25, 2026
Summary
Chronic musculoskeletal pain is linked to a higher risk of developing multiple sclerosis (MS). This association, particularly with widespread pain, is partly explained by inflammation, suggesting a shared neuroimmune process.
Area of Science:
- Neuroimmunology
- Epidemiology
- Pain Medicine
Background:
- Chronic musculoskeletal pain is prevalent in multiple sclerosis (MS) and may influence neurodegeneration.
- The relationship between chronic pain and the subsequent development of MS is not well understood.
Purpose of the Study:
- To investigate the association between chronic pain and the incidence of MS.
- To determine if systemic inflammation mediates the relationship between chronic pain and MS.
Main Methods:
- Analysis of UK Biobank data from 356,010 participants without MS at baseline.
- Categorization of participants based on the number of chronic pain sites (≥3 months).
- Cox regression and mediation analysis to assess associations and the role of inflammation.
Main Results:
- Chronic pain was associated with a 26% increased risk of developing MS.
- A dose-response relationship was observed, with pain in multiple sites significantly increasing MS risk.
- Inflammation partially mediated the association, with varying effects across inflammatory markers.
Conclusions:
- Chronic musculoskeletal pain is a significant predictor of later MS diagnosis, especially when widespread.
- Peripheral inflammation plays a partial role in this association.
- Chronic pain may indicate an early risk for MS, reflecting shared neuroimmune pathways.
