Dealing with long-term pain, depression, and high blood pressureNew research shows how these three conditions are related to each other. Treatments that don't involve drugs might help.
Chronic pain makes life harder every day, both physically and mentally. Chronic pain is pain that lasts for more than three months and usually affects the muscles, bones, joints, or tissues nearby.
But this common problem, which affects at least a quarter of adults in the US, could also be bad for your heart. New research indicates a potential link between pain and high blood pressure (hypertension), with depression possibly playing a role.
New evidence indicating
The study, which was published in the January 2026 issue of Hypertension, looked at health data from more than 200,000 adults (average age 54) who were followed for about 14 years. People with chronic, widespread pain were 75% more likely to get high blood pressure than people who said they didn't have any pain. People with short-term pain had a 10% higher risk. The study was only an observation, so it can't prove that pain was the real cause of high blood pressure.
Dr. Danielle Sarno, an assistant professor of physical medicine and rehabilitation at Harvard Medical School, says, "Chronic pain and depression often go hand in hand, and both conditions are linked to physiological stress responses that can raise blood pressure." The results suggest that adults should be regularly checked for both depression and high blood pressure because they have chronic pain.
Drugs for long-term pain
Some medications can help with chronic pain, but it's important to know that oral anti-inflammatory drugs like ibuprofen (Advil, Motrin) may raise blood pressure and have other side effects. Topical anti-inflammatory drugs like diclofenac gel (Voltaren) that are put directly on the joint often work well for arthritis and have fewer side effects than pills. Gabapentin (Neurontin) and pregabalin (Lyrica) are two other medicines that don't affect blood pressure as much and work well for nerve pain.
People who have both depression and chronic pain may find that antidepressant drugs like amitriptyline or duloxetine (Cymbalta) are especially helpful.
Ways to treat pain without drugs
Even if medications help with chronic pain, they may have side effects that are too bad to handle or raise the risk of complications, especially if they are taken for a long time.
Non-drug therapies can help, either by themselves or with other treatments. "Exercise is one of the treatments that works the best most of the time. Dr. Sarno says, "For many people, it's helpful to work with a physical therapist, who can help you safely build your strength, mobility, and confidence and make an exercise program you can do at home." She also says that other helpful lifestyle changes include eating well, getting enough sleep, managing stress, staying away from drugs and alcohol, and building strong social connections.
Psychological methods
Psychological therapies that target negative thoughts and pain perceptions have demonstrated efficacy. Cognitive behavioral therapy for chronic pain is one option. It teaches you how to change the way you think, feel, and react to pain. That helps people feel better and work better, especially those who have depression or other mood disorders.
Mindfulness-based stress reduction (MBSR) is another option. It's an eight-week program of meditation and mindfulness techniques that helps lower stress and emotional reactions to pain. This method lets people take more responsibility for their care and has been shown to lower pain and stress levels.
Dr. Sarno says that more and more evidence supports pain reprocessing therapy, which helps you deal with pain by changing how your brain interprets pain signals and lowering fear-based pain responses. People with nociplastic pain conditions, like fibromyalgia, that come from the brain's different interpretation of pain signals may find this therapy very helpful.
Yoga, acupuncture, massage, and osteopathic manipulative treatment (a hands-on therapy done by osteopathic doctors) are other strategies that might help.
A multi-faceted approach
Dr. Sarno says that making a personalized plan that includes different types of non-drug therapies (and drugs if necessary) is a beneficial way to deal with pain. Dr. Jennifer Kurz, an assistant professor of physical medicine and rehabilitation at Harvard Medical School, and Dr. Sarno worked together to create the virtual Functional Integrative Restoration (FINER) program. You can find pain management resources and educational sessions online through this program.