Chronic Pain and Your Immune System


August 6, 2020

Chronic pain can cause so many frustrations for people. Aching, burning, discomfort, limited mobility, emotional frustration, all of these are side effects of chronic pain. Chronic pain is a worldwide problem and the most common disability in the United States. However, people may not be aware of the immune system’s role in regards to chronic pain. 

There are two essential sides of the immune system: the innate system and the adaptive system. These systems work together to fight off infection, protect the body, and notify the body if and when an injury occurs. The innate system is the system we are all born with that recognizes pathogens or injuries and generates an immediate general response. Phagocytes, T cells, and cytokines are responsible for the immediate response from this system.

The other half of the immune system, the adaptive system, is an acquired and specific immunity. The adaptive system responds to pathogens but creates an enhanced response to future attacks based on memory. In other words, the adaptive system responds to attacks and remembers the attackers (pathogens) so it is better prepared to fight them off in the future. This system involves T cells as the innate system does, but it also involves antibodies that are produced by B cells. 

Some studies show that chronic pain can actually reprogram the way that genes in the immune system work. When chronic pain is present, there seems to be a change in the way DNA is marked in T cells immune cells which changes their ability to fight infections. In addition, ongoing pain triggers a stress response within the body. Long-term stress within the body causes neurological, endocrine, and immune system changes as they are heightened to fight off a perceived threat. This stress response can cause an increase in cortisol levels, also known as the stress hormone. Higher levels of cortical are connected to a decline in immune system functions. 

Immune System and Chronic Pain Conditions 

Rheumatoid arthritis

Rheumatoid arthritis (RA)  is a chronic inflammatory condition that primarily affects the joints. Tender, swollen, painful joints are some of the primary markers for RA although other parts of the body could be affected. RA is classified as an autoimmune disease because there is a higher presence of antibodies within the body than normal. These antibodies stem from the immune system and can be present for an extended period of time before someone is diagnosed with RA. 


Osteoarthritis (OA) has been identified as the most prevalent chronic, degenerative joint disease. The most commonly affected joints include the hand, knee, neck, hips, and lower back sacroiliac joints. OA causes a breakdown of cartilage and increase in synovial inflammation. The presence of T cells and B cells infiltrate macrophages in the synovial membrane. T cells and B cells come from the immune system creating a link between the immune system and OA. 


The most common cause of generalized pain in middle-aged women, Fibromyalgia is a mysterious chronic pain syndrome that involves widespread musculoskeletal pain. Many doctors and researchers believe that patients with this form of chronic pain have problems processing pain and not just a localized pain experience. One study suggested that patients with fibromyalgia have higher levels of pro-inflammatory cytokines which is a direct correlation between fibromyalgia and the immune system. 

Everyone should seek to support their immune system to maintain optimal overall health, but those with chronic pain conditions may want to consider prioritizing immune strengthening strategies. Consuming a healthy, balanced diet that focuses on whole foods such as fruits and vegetables is extremely nourishing. Regular exercise, reducing stress, avoiding alcohol and tobacco, and getting quality sleep are all actions that play an important role in strengthening the immune system. In addition, individuals can consider introducing supplements to support their immune systems such as probiotics, zinc, vitamin C, and vitamin D.