The interplay of stress, pain, and lifestyle: a Danish cross-sectional study of young adults

High perceived stress is associated with increased pain intensity in patients with chronic pain. Stressful experiences can alter pain perception and cause stress-induced hyperalgesia. While the relationship between stress, pain, lifestyle, and sleep represents a complex network of interactions, limited studies have investigated these interactions in young populations. Four validated questionnaires were used to assess sleep, physical activity, lifestyle, and stress: The Pittsburgh Sleep Quality Index (PSQI), Rapid Assessment of Physical Activity (RAPA), Fantastic Lifestyle Checklist (FLC), and Perceived Stress Scale (PSS). Additional information about pain and mental illnesses was obtained. The respondents were grouped based on their PSS scores into high, moderate, and low stress. A total of 126 respondents were included for analysis. High-stress respondents had significantly lower FLC scores (p < 0.001), poorer PSQI scores (p < 0.001), and were more likely to report mental health diagnoses (p < 0.05) compared to low- and moderate-stress respondents. They also reported higher pain intensities (p < 0.01) and higher multisite pain occurrence (p < 0.001) compared to respondents with low stress. Lastly, 27.2% of the variability in pain intensities was explained by diet, physical activity level, and stress. High perceived stress has significant negative impacts on psychophysical health and pain, with poorer lifestyle, poor quality of sleep, multisite pain, and increased pain intensities. This highlights the potential benefits of addressing lifestyle factors concomitantly when managing chronic pain.