If you’re living with chronic (long-term) pain, you already know that it can affect your daily life in ways big and small. Maybe it limits how far you can walk, how well you sleep, or how much quality time you can spend with family and friends. Sometimes, it has a clear, single cause, like arthritis or nerve damage. Other times, doctors can’t figure out what’s causing it, yet the pain remains.

In this article, we’ll explore the most common causes and the factors that raise your risk. We’ll also look at how age, lifestyle, and other health conditions play a role. Understanding these causes and risk factors can help you and your healthcare team find better ways to manage pain and enjoy life.

Risk Factors for Chronic Pain

Chronic pain is pain that lasts for three months or longer. It may start after an illness, injury, or surgery, or as a result of health problems that affect joints, nerves, or muscles. In some cases, the nervous system keeps sending pain signals long after the body has healed.

Here, we’ll cover 10 of the most common causes and risk factors, though other potential causes exist, too.

1. Certain Health Conditions

Many long-term health conditions can cause chronic pain. Rheumatoid arthritis, for example, causes inflammation in the joints, leading to stiffness, swelling, and ongoing joint pain.

Diabetes can damage nerves — a problem called neuropathy — which leads to burning or tingling in the feet and hands. People with fibromyalgia often feel widespread muscle and joint pain, along with fatigue (extreme tiredness that doesn’t improve with rest) and poor sleep.

Other common conditions that cause chronic pain include:

• Cancer
• Endometriosis
• Migraine
• Autoimmune conditions, such as lupus
• Multiple sclerosis
• Trigeminal neuralgia
• Osteoarthritis
• Low back pain

Because these conditions affect the body in different ways, the type of pain can vary, from aching and throbbing to sharp, tingling sensations caused by nerve involvement.

2. Injuries or Surgeries

Past injuries and surgeries are among the leading causes of chronic pain. When tissues, nerves, or joints are damaged, the body sometimes continues to send pain signals, even after the original wound has healed.

Fractures, back injuries, and sports-related trauma can all leave lingering pain, especially if nerves are involved. Some surgeries also carry an elevated risk of persistent pain, such as:

• Hernia repair
• Breast surgery
• Certain joint replacements

Poorly managed postsurgical pain can raise the likelihood of long-term discomfort. Pain may feel sharp, burning, or aching, depending on whether nerves, muscles, or scar tissue are involved.

3. Age and Weight

As people get older, joints naturally wear down. This can lead to osteoarthritis, spinal problems, and other types of musculoskeletal pain (pain that affects the muscles and joints). Older adults are also more likely to have multiple medical conditions that may contribute to pain disorders.

Extra body weight also adds stress to the spine, hips, and knees. Over time, this speeds up joint damage and makes pain harder to manage. Obesity is also linked to higher levels of inflammation in the body. This can worsen pain signals and reduce the effectiveness of certain treatments.

4. Sex and Hormones

According to the University of Colorado Anschutz, women are more likely to develop certain chronic conditions, such as fibromyalgia, migraine, and certain types of arthritis.

Studies suggest that certain sex hormones — especially estrogen — affect how pain signals are processed in the brain and nervous system. Pain levels may also change across the menstrual cycle, during pregnancy, or after menopause. These hormonal shifts can make pain more intense or harder to manage. While the exact reasons are still being studied, it’s clear that hormonal biology plays an important role in how chronic pain syndromes develop.

5. Mental Health Conditions

Mental health conditions, such as depression and anxiety, are extremely common among people with chronic pain. One large review found that about 39 percent of adults with chronic pain had symptoms of depression. Similarly, around 40 percent had symptoms of anxiety. According to JAMA Network Open, these symptoms were particularly common in conditions like fibromyalgia and among women and younger adults.

People with both chronic pain and mental health conditions often experience worse pain, more disability, and lower quality of life. These conditions can feed into each other, making both pain and emotional distress harder to manage.

6. Lifestyle Factors

Several lifestyle factors can contribute to the risk of developing chronic pain. Smoking is a big one — it reduces blood flow, slows healing, and can worsen back pain and arthritis symptoms. Additionally, heavy alcohol use is linked to nerve damage, increasing the chance of painful neuropathy.

Lack of exercise may lead to weakened muscles and joints, raising the risk of injury and long-term discomfort. Poor diet and stress can also increase inflammation, making pain harder to control. Addressing these habits by staying active, eating well, and avoiding tobacco and excess alcohol can lower the risk of chronic pain.

7. Family History and Genetics

While there isn’t a single “chronic pain gene,” studies show that pain sensitivity and the way the body processes pain can run in families. If a parent or sibling has a condition like fibromyalgia, headaches, or inflammatory diseases, your chances of developing chronic pain may be higher.

Family history also plays a role in the chances of developing mental health conditions, such as depression or anxiety, which can add additional risk. Understanding your family background can help healthcare providers spot patterns, guide chronic pain treatment, and offer earlier interventions.

8. Sleep Problems

For many people, poor sleep and chronic pain often go hand in hand. Research shows that short or disrupted sleep lowers pain thresholds and can trigger hyperalgesia (the body becoming more sensitive to pain).

This relationship works both ways: Pain interferes with sleep, and poor sleep heightens pain, creating a vicious cycle. Lack of sleep has also been shown to raise levels of inflammatory markers, such as interleukin-6 (IL-6), which can amplify pain signals.

9. History of Trauma or Abuse

A history of trauma, including childhood abuse or exposure to violence, is strongly linked to chronic pain symptoms in adulthood. This may be because trauma can change how the central nervous system handles stress. Studies show that trauma can alter something called the hypothalamic–pituitary–adrenal (HPA) axis — the system that controls stress hormones like cortisol. Trauma can also disrupt the immune system and raise inflammation, which may worsen pain.

People with a history of trauma or abuse may also be more likely to use opioids long-term for pain management. In addition to raising the risk of opioid use disorder (OUD), this can lead to worse chronic pain over time.

10. Social and Economic Factors

A U.S. survey found that adults with family incomes below the poverty line had much higher rates of high-impact pain than those with higher incomes. Another study published in 2024 found that people from disadvantaged backgrounds were twice as likely to develop chronic musculoskeletal pain.

Key economic factors include housing instability, job and food insecurity, and fewer financial resources for healthcare. Low socioeconomic status often means more stress, less access to pain medicine or physical therapy, and delayed treatment, all of which can worsen chronic pain outcomes.

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On MyChronicPainTeam, people share their experiences with chronic pain, get advice, and find support from others who understand.

What health conditions have contributed to your chronic pain, and how does it affect you? Let others know in the comments below.