The Enduring Mystery of Pain in a Social Context

Chronic pain has become a health epidemic, with one in five US adults suffering from chronic pain and an estimated annual cost of $560 billion in medical care, lost productivity, or disability services. Understanding pain has never been more crucial. Here, Karos discusses a study by Fales and Noel which investigates the effects of social exclusion on pain for the very first time in a sample of healthy adolescents rather than adults. This is an important first step because it is arguably in childhood and adolescence that experiences of social exclusion are the most impactful and can pose a serious risk factor for the development of psychosocial and psychosomatic problems in adulthood. Although this study is a first step in the right direction, it also highlights the challenges of the field and raises new questions. First and foremost, there is a clear lack of a comprehensive theoretical framework, which outlines the effects of different social factors on the perception of pain, which makes it difficult to generate specific and testable hypotheses. There is a whole range of interpersonal processes, which have been implicated in the exacerbation of pain, such as social isolation, exclusion, invalidation, injustice, and stigmatization.