Understanding the overlap between neurodevelopment and pain processing
Have you ever wondered why some people seem to feel physical pain more intensely than others? Or why a long day of mental effort can leave your body feeling like it’s run a marathon? The answer might lie in a connection we rarely talk about, one that can quietly amplify both mental and physical strain: the link between ADHD and chronic pain.
It’s a topic that receives far less attention than it deserves, yet the numbers are staggering. Research suggests that between 29% and 66% of young people with ADHD experience chronic or clinically significant pain (Battison et al., 2023). That’s a large portion of people in the community navigating a double burden every day.
In this blog, we’ll explore how ADHD and the body’s pain systems interact, and more importantly, what can actually help.
What Is Chronic Pain?
Scientifically, chronic pain is defined as pain that persists beyond the typical healing time (lasting 12 weeks or more) and is often linked to changes in how the body processes pain signals (Levine & Phillips, 2012; Woolf, 2011).
Think of it like a smoke alarm that’s become too alert. Instead of going off only when there’s a real fire, it blares every time someone burns toast. For someone with ADHD, that alarm system is often already heightened. When both systems are dialled up, pain can feel louder, more persistent, and much harder to switch off (Ibrahim & Hefny, 2022).
This isn’t just theoretical, current literature shows it occurs in many everyday health conditions.
Common Conditions Linked to ADHD and Pain
There is a well-documented link between ADHD and several chronic pain conditions.
Take irritable bowel syndrome (IBS), for example, a gut-brain condition involving bloating, discomfort, and sensitivity. Gastrointestinal issues frequently co-occur with ADHD (Kedem et al., 2020), which makes sense given the constant communication between the gut and brain. When the body’s stress response system is dysregulated, the gut often becomes more reactive (Kennedy et al., 2014).
Then there’s fibromyalgia, characterised by widespread pain, fatigue, and heightened sensitivity. This reflects differences in how the body processes pain signals (Häuser et al., 2015). Add in sleep disruption and chronic stress, both common in ADHD, and the body may become more vulnerable to flare-ups and slower to recover.
People with ADHD are also more likely to experience neurological headaches. Research shows increased rates of migraine in this population (Salem et al., 2018), with factors like sensory sensitivity and stress reactivity playing a role.
Other common pain conditions linked to ADHD include:
- Chronic low back pain
- Pelvic pain, bladder pain, and endometriosis
- Temporomandibular joint (TMJ) dysfunction
- Chronic fatigue syndrome (ME/CFS)
In ADHD, increased muscle tension and difficulty regulating or pacing energy can place additional strain on the body. Over time, this may contribute to pain becoming more persistent and harder to shift (Barakou et al., 2023; Stray et al., 2013; Udal et al., 2024).
A Nervous System That Never Fully Rests
Chronic pain isn’t just about injury, it’s about regulation.
For people with ADHD, the body’s stress response system is often under continuous pressure, especially in environments that don’t align with how their brains work.
If you’re constantly masking symptoms or trying to keep up in neurotypical settings, like school or the workplace, your body can accumulate what’s known as allostatic load: the wear and tear of chronic stress (McEwen, 2007).
Over time, this can lead to:
- Pain feeling stronger
- Slower recovery
- More frequent flare-ups
If you’ve ever felt like your body is overreacting, or like you’re “not coping” the way others seem to, there may be more going on beneath the surface.
Dopamine and Pain Processing
Dopamine plays an important role in how the brain regulates pain (Taylor et al., 2016), and ADHD is associated with differences in dopamine signalling.
When one’s dopamine system is less consistent, pain signals may not be filtered as effectively. As a result, sensory experiences, including physical pain, can feel more intense, reflecting a real biological difference in how the brain processes and prioritises sensory information.
The Role of Physical Tension and Energy Patterns
Pain isn’t just processed in the brain, it’s expressed through the body.
Hyperactivity doesn’t always look obvious. Many people with ADHD don’t feel outwardly restless, but that doesn’t mean the body is relaxed. It can show up as internal tension: jaw clenching, muscle tightening, fidgeting, or holding the body rigid while concentrating.
Over time, this can contribute to headaches, TMJ issues, and musculoskeletal pain.
Then there’s the familiar ADHD “boom-and-bust” cycle, periods of intense activity followed by exhaustion. This pattern places additional strain on the body and is recognised as a contributor to chronic pain flare-ups (Nijs et al., 2010).
Can Treating ADHD Help Reduce Pain?
So, the big question is: can treating ADHD actually reduce pain?
Emerging research and clinical experience suggest that it can.
When ADHD is effectively supported through medication, therapy, lifestyle changes, or a combination of these, the body’s stress response may begin to stabilise.
Emerging research suggests that stimulant medication may improve pain thresholds and support more consistent pain processing (Bozkurt et al., 2023; Pud et al., 2017).
Therapy also plays an important role. Approaches such as Somatic Experiencing (SE) and Acceptance and Commitment Therapy (ACT) have been shown to improve pain-related functioning and distress (Williams et al., 2020; Ma et al., 2023). ADHD-focused therapy can further support emotional regulation and daily structure (Young et al., 2023).
Sleep is another key factor. Poor sleep is strongly linked to increased pain sensitivity and slower recovery (Finan et al., 2013). And importantly, receiving an ADHD diagnosis can reduce shame and self-blame. Greater understanding and acceptance of chronic conditions are associated with improved wellbeing and engagement in treatment (Hayes et al., 2012).
What Can You Do? Practical Strategies
Nutrition
Omega-3 fatty acids support brain health and may help reduce inflammation (Calder, 2013).
Nervous System Regulation
Simple practices like breathing exercises and gentle stretching can calm the body’s stress response and reduce pain sensitivity (Cherkin et al., 2016).
Movement
Gentle, consistent movement, such as walking or yoga, is linked to improved pain outcomes (Geneen et al., 2017).
Sleep
Improving sleep routines can significantly reduce pain sensitivity and support recovery (Finan et al., 2013).
Pacing
Breaking tasks into manageable steps and building in pockets of rest throughout the day can help prevent flare-ups and support long-term function (Nijs et al., 2010).
The Bigger Picture
Clinicians are increasingly recognising the link between ADHD and chronic pain, but it remains under-addressed in standard care. ADHD is not just about attention or motivation. It involves sensory processing, emotional regulation, dopamine differences, stress adaptation, and how the body responds to its environment, all of which influence pain.
Recognising this connection opens the door to more personalised, effective approaches to care.
If you’re living with both ADHD and chronic pain, you’re not alone, and there are ways to support both in ways that work with your brain and body, not against them. Most importantly, working with a professional who understands this connection can make a meaningful difference, not just in managing symptoms, but in helping your body finally feel safer.
References
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