PainSupportLink · New frontiers in chronic pain management: A personalised support package targeting the mechanistic links between social disadvantage and pain sensitisation

This project will advance chronic pain treatment by developing a personalised support package tailored to patients' uniqu. e social, biological, and psychological drivers of pain. Chronic pain affects billions and costs Europe €440 billion annually. Socially disadvantaged individuals, especially those of low socioeconomic status, are disproportionately affected, but current treatments primarily target biological and psychological factors, overlooking social elements. This gap may explain the modest and short-lived effects of current treatments, particularly in vulnerable groups. I hypothesise that adding personalised community support—an approach not yet explored for pain—will enhance outcomes and propose four work packages: WP1 Identify causal pathways through which biological, psychological, and social factors mediate the effects of social disadvantage on pain to identify support targets, using latent class mediation analysis of longitudinal cohort data. WP2 Build a personalised support package tailored to individuals' needs and targets identified in WP1, using a scoping review, qualitative study, and feasibility trial. WP3 Evaluate the support package's effects on pain, disability and quality of life through a randomised clinical trial. WP4 Investigate whether selected biological (inflammation, nervous system sensitisation, physical activity), psychological (mental health, self-efficacy), and social (support, isolation) mechanisms mediate the support package’s effect on clinical outcomes using a causal mediation analysis. Multiomics blood profiling, computerised cuff pressure algometry, activity accelerometers, and questionnaires will be employed. This project will advance understanding of how bio-psycho-social mechanisms link social disadvantage to pain and transform pain outcomes through a personalised, socially sensitive, equity-driven framework that addresses the full range of social, biological, and psychological factors, surpassing current treatments.