Young people with chronic pain face heightened risk of self-harm thoughts and actions, Oxford study finds

Research from Oxford University reveals that adolescents undergoing specialist care for chronic pain are significantly more likely to experience self-harm thoughts and behaviours, especially in mid-adolescence, highlighting the need for targeted emotional support.

Teenagers receiving specialist care for chronic pain may face a much higher risk of thinking about self-harm, and of acting on those thoughts, than young people in the wider population, according to new research from the University of Oxford and Oxford University Hospitals NHS Foundation Trust.

The study, published in Paediatric & Neonatal Pain, surveyed 77 patients aged 12 to 18 at the Oxford Centre for Children and Young People in Pain, a specialist NHS service. Researchers said it is the first study in the UK to look directly at self-harm thoughts and behaviour within a paediatric chronic pain clinic, rather than in a general adolescent sample.

Among the young people surveyed, 27% said they had thought about self-harm in the previous two weeks, while 7% said they had self-harmed during that period. Looking across their lifetimes, 58% reported self-harm thoughts and 47% reported self-harming behaviour. The Oxford team said the figures rose sharply in mid-adolescence, suggesting that older teenagers attending pain services may be particularly vulnerable.

The researchers compared those findings with earlier work in the general teenage population, where lifetime rates of self-harm thoughts have been estimated at 14% to 23% and lifetime self-harm behaviour at 5% to 16%. That contrast, they said, points to the possibility that chronic pain is not only a physical burden but also a significant psychological risk factor for some young people.

The study linked self-harm risk most strongly to two experiences often associated with ongoing pain: feeling like a burden to family or friends, and a sense of hopelessness about the future. Both were closely tied to self-harm thoughts and behaviour, both recently and over the course of the participants’ lives.

Dr Verena Hinze, the lead researcher, has previously said the work is intended to help identify which young people with chronic pain are most at risk, when that risk may be highest and why it develops. The Medical Research Foundation said the findings will be summarised in a simple diagram for healthcare professionals, with the aim of supporting quicker and more effective care.

The broader context is worrying. Oxford researchers have separately found that self-harm content is widely seen by adolescents online, often through algorithmic recommendation systems rather than active searching, underscoring the wider pressures faced by young people who are already struggling with emotional distress. Together, the findings suggest that clinicians, families and schools may need to pay closer attention to the emotional strain experienced by teenagers living with persistent pain.