Young adults are presumed to be healthy, vibrant and free of aches and pains. But in a not-yet-published study of undergraduates, University of Alabama researchers found that chronic pain in people ages 18 to 29 is common — and just as commonly ignored.

"We've got this silent minority," says psychology professor and department chair Beverly Thorn, PhD, who directs Alabama's Pain Management Team. She estimates that about 25 percent of young adults experience chronic pain due to sports injuries, accidents or other conditions such as migraines. "They are hiding out, they don't want people to know, they want to fit in, they want to be normal," she says.

In the study, Thorn and colleagues conducted focus groups with 44 undergraduates who reported experiencing chronic or recurring pain significant enough to interfere with daily activities. The researchers asked participants about the pain's effects on their relationships and schoolwork, as well as how they coped. When coding the discussions for common themes, the researchers found that the students' pain was often invalidated by family and friends. Participants also perceived a strong stigma associated with having pain at an age when chronic illness is not expected that made them feel isolated among their apparently healthy peers. At the same time, the students often over-achieved in school, pushed themselves to physical limits and were reluctant to seek medical or psychological help — all in an effort to mask their conditions.

"It's the opposite from older adults — they're actually running away from being labeled as having a chronic illness," says Shweta Kapoor, a doctoral candidate at Alabama who led the study as part of her dissertation. Participants rejected the idea of seeking accommodations from the university's Office of Disability Services due to a perceived stigma related to the word "disability," she says. They also endorsed the potential value of stress management for other students, but not for themselves.

In fact, says Kapoor, the participants rarely connected their stress to their pain. "We need to find more ways of reaching out to them because they really do need help," she says.

And college is an important time to intervene, adds Thorn. "If we can get to them now, maybe we can prevent all of the chronicity and disability that happens later."

— Anna Miller

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