The authors of a research letter published in Pain Medicine found that nearly three-quarters of adults with attention-deficit/hyperactivity disorder (ADHD) experienced noncancer pain compared with fewer than half of age-matched adults without ADHD.
Investigators from Saint Louis University School of Medicine sourced data for this study from the Optum® Electronic Health Record database. A random sample of more than 5 million adults with data collected between 2010 and 2018 were evaluated for arthritis, musculoskeletal pain, neuropathic pain, headache or migraine, back or neck pain, fibromyalgia, and chronic pain with or without a diagnosis of ADHD diagnosis. To balance for cohort differences, patients with ADHD were age-matched with patients in a control group.
The mean age of patients in the final study population (N=3,544,292) was 50.0±0.01 years, 67.4% were White, 56.4% were women, 32.1% had obesity, and 1.2% had ADHD.
Adults with ADHD had higher rates of musculoskeletal pain (42.8% vs 24.4%), arthritis (40.2% vs 25.0%), back or neck pain (35.7% vs 18.5%), headache (22.7% vs 8.6%), chronic pain (15.9% vs 6.2%), neuropathic pain (9.2% vs 5.1%), and fibromyalgia (7.7% vs 2.6%) compared with adults in the control group, respectively.
After adjusting for age, gender, ethnicity, obesity, depression, anxiety, nicotine use, and substance use disorder, ADHD was associated with increased risk for arthritis (adjusted odds ratio [aOR], 1.69; 95% CI, 1.65-1.72), back or neck pain (aOR, 1.69; 95% CI, 1.65-1.73), fibromyalgia (aOR, 1.68; 95% CI, 1.61-1.75), musculoskeletal pain (aOR, 1.67; 95% CI, 1.63-1.71), chronic pain (aOR, 1.52; 95% CI, 1.47-1.57), headache (aOR, 1.49; 95% CI, 1.45-1.53), and neuropathic pain (aOR, 1.41; 95% CI, 1.36-1.46) compared with adults without ADHD.
A major limitation of this study was its cross-sectional design, which did not allow for the evaluation of causal associations.
These data indicate that adults with ADHD reported experiencing more common noncancer pain conditions than individuals without ADHD. Further research is needed to evaluate potential neurophysiological relationships between ADHD and pain. In addition, the investigators comment, “First, risk of undertreated pain may occur if adults with ADHD are primarily treated in specialty mental health care. Second, ADHD is associated with increased risk for substance use disorders and studies of prescription opioid outcomes in ADHD are warranted.”
Chruciel T, Quinn PD, Salas J, Scherrer JF. The prevalence of noncancer pain diagnoses in adults with ADHD. Pain Med. Published online October 22, 2022. doi:10.1093/pm/pnac159