Shockingly strong link found between loneliness and physical pain

A new global study suggests that loneliness is strongly associated with physical pain, and this link appears to be largely explained by psychological distress. Published in Scientific Reports, the findings highlight the potential health burden of loneliness across the adult lifespan and raise questions about how cultural and social factors may shape this experience.

Loneliness has been linked in previous research to a range of health issues, from depression and anxiety to cardiovascular disease and early mortality. Yet it remains unclear how loneliness relates to physical pain in particular, and whether this connection differs by age, sex, or cultural context.

Some scientists have proposed that loneliness may act as a kind of psychological pain, signaling unmet social needs. Others have argued that loneliness may trigger physical pain indirectly, through stress, disrupted sleep, or immune system changes.

Despite these theories, few studies have examined the relationship between loneliness and physical pain on a global scale. There has also been limited research on how psychological distress and physical health problems might explain—or statistically account for—the association between loneliness and pain. The current study was designed to address these gaps using a large, cross-cultural dataset.

“We observed a growing concern worldwide about loneliness as a public health issue and wondered how it might contribute to physical pain,” said study author Lucía Macchia, a lecturer in psychology at City St George’s, University of London.

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“The existing literature highlighted the link between loneliness and poor mental health, but few studies examined how loneliness relates to physical pain across diverse cultural contexts. This led us to investigate global data from 256,760 participants across 139 countries to understand these relationships and underlying mechanisms.”

The researchers used data from the Gallup World Poll collected in 2023 and 2024. This dataset includes responses from 256,760 people aged 15 to 100 across 139 countries. Participants answered a series of questions about their physical and mental health, social relationships, and feelings experienced during the previous day.

Loneliness was assessed with a single question: whether the person felt lonely for much of the previous day. About 22.7% of respondents said yes. Physical pain was measured by asking whether the person had experienced physical pain during much of the previous day. Health problems were defined as any conditions that limited daily functioning, and psychological distress was calculated based on whether the person reported sadness, anger, stress, or worry.

In fully adjusted statistical models, the researchers found that individuals who reported feeling lonely had higher odds of experiencing physical pain, were more likely to report health problems, and faced a greater likelihood of experiencing psychological distress compared to those who did not report feeling lonely.

“Lonely people have 2.1 times higher odds of experiencing physical pain, 1.8 times higher odds of having health problems, and are 25.8% more likely to experience psychological distress,” Macchia told PsyPost.

These associations held even after accounting for demographic factors such as age, sex, education, income, marital status, and employment status, as well as social support indicators like whether the respondent had friends or relatives to rely on or felt satisfied with opportunities to meet people.

When the researchers explored why loneliness was linked to pain, they found that distress accounted for the largest portion of this relationship.

“The extent to which psychological distress mediates the link between loneliness and pain was striking,” Macchia said. “Psychological distress accounted for 60.2% of the loneliness–pain link, with physical health accounting for another 18.9%.. The fact that distress is a stronger mechanism of the link between loneliness and pain than physical health is a big finding.

Women in the sample were more likely than men to report loneliness, pain, and distress. The association between loneliness and pain was also slightly stronger among women. By contrast, the relationship between loneliness and pain did not vary much across different age groups. Whether young or old, people who reported feeling lonely were more likely to report pain.

Lonely individuals also tended to experience more social disadvantages. They were more likely to be single, divorced, widowed, unemployed, underemployed, or living with lower income. They were also less likely to have completed higher levels of education. While many lonely people did report having someone to rely on, they were still significantly less likely than non-lonely individuals to say they had strong social support or opportunities to connect with others.

Cross-cultural analyses revealed considerable variation in how loneliness, pain, and distress were experienced around the world. While high levels were observed in some low-income countries, the pattern did not follow simple lines of economic development. In some countries, the link between loneliness and pain was nearly nonexistent, while in others it was more pronounced.

“Also compelling was the global variability of these associations, underscoring the strong influence of cultural contexts,” Macchia remarked.

Although the study’s sample size and global coverage were extensive, the researchers emphasized that their findings cannot establish cause and effect. Because the data were cross-sectional, it is unclear whether loneliness causes pain, pain leads to loneliness, or whether the two are mutually reinforcing. Future studies using longitudinal data will be needed to examine these temporal dynamics more closely.

Another limitation is that all measures were based on self-report, and the survey used single-item questions to assess complex experiences like loneliness and pain. While common in large-scale surveys, this approach may introduce bias or measurement error. People who feel lonely may also be more likely to rate their health or pain more negatively, which could exaggerate some of the associations.

Still, the findings point to several promising directions for future research. The authors hope to conduct follow-up studies that track participants over time to better understand the causal pathways linking loneliness and pain. They also aim to explore interventions that target psychological distress to see whether reducing distress might also reduce physical pain.

Finally, they plan to investigate more closely why these relationships vary across countries, with an eye toward identifying cultural or social policies that might buffer against loneliness and its effects.

“Loneliness is not just an emotional burden—it has real physical consequences, on a global scale,” Macchia explained. “Addressing societal loneliness might have unexpected benefits for reducing physical pain and enhancing overall wellbeing. And the sheer scale of this study (nearly a quarter-million participants across 139 countries) adds weight to the urgency of tackling social disconnection as a health priority.”

The study, “The association between loneliness and pain, and the role of physical health and distress: an analysis in 139 countries,” was authored by Lucía Macchia and Anne-Kathrin Fett.