[The relational component of pain: perceived loneliness and current pain in six European countries]

To analyse the association between perceived loneliness and current pain in six European countries, describe their distribution by sex, country and socioeconomic position, and assess the role of pain duration as an approximation to chronicity.

A comparative cross-sectional study was conducted in the adult population living in Germany, Spain, Greece, Ireland, Poland and Sweden (n=4800; 800 per country), based on an online survey. Loneliness was measured using the UCLA-3 scale, and current pain was operationalized as a dichotomous variable. Bivariate analyses and nested binary logistic regressions were performed, adjusted for country, sex, age, educational level, economic situation, employment status, living arrangement and pain duration.

Participants with current pain reported higher loneliness than those without pain (mean: 5.60 vs. 4.65; p<0.001). Pain was more frequent among women (65% vs. 56%) and showed a clear socioeconomic gradient. In the final model, loneliness remained independently associated with current pain (OR: 1.23; 95%CI: 1.18-1.29), after adjustment for covariates and pain duration. Longer pain duration was associated with a higher probability of pain, with increasing ORs up to 26.68 among those reporting pain for more than 3 years. Differences between countries persisted, as did a higher probability of pain among women.

Although its magnitude is moderate, perceived loneliness maintains an independent and consistent association with current pain after adjustment for sociodemographic variables and pain duration. The results support a biopsychosocial and relational understanding of pain and underline the relevance of incorporating the social dimension into public health.