The Hidden Link Between Autism, ADHD, and Chronic Pain—What Doctors Are Missing

A groundbreaking study reveals that people with chronic pain and fatigue are significantly more likely to be neurodivergent, with rates of autism and ADHD far exceeding those in the general population. Researchers found that individuals with chronic pain or chronic fatigue (CP/CF) were 14 times more likely to meet criteria for autism and 13 times more likely to meet criteria for ADHD compared to people without these conditions. The discovery points to a biological connection that doctors have largely overlooked—and could transform how chronic pain is diagnosed and treated.

Why Are Neurodivergent Traits So Common in Chronic Pain Patients?

The connection between neurodivergence and chronic pain isn't random. Researchers conducting the study examined 83 adults with chronic pain or chronic fatigue and compared them to 91 people without these conditions. Both groups completed validated screening measures for autism, attention-deficit/hyperactivity disorder (ADHD), and joint hypermobility—a condition where joints bend more easily than normal.

The key finding: joint hypermobility appeared to be the biological bridge linking neurodivergent traits to chronic pain. In other words, people with autism or ADHD may be more prone to having flexible joints, which in turn contributes to chronic pain and fatigue. This variant connective tissue—the tissue that holds joints together—mediated the relationship between neurodivergence and CP/CF, meaning it explained why the connection exists.

What This Means for Pain Management and Diagnosis?

This discovery has major implications for how doctors approach chronic pain. Currently, many patients with autism or ADHD go undiagnosed, and their neurodivergence is never connected to their pain symptoms. The research suggests that screening for neurodivergence should become routine in chronic pain clinics—not as an afterthought, but as a core part of understanding each patient's pain profile.

The findings reveal what researchers call a "trans-diagnostic pattern of major clinical importance." This means the connection between neurodivergence, joint hypermobility, and chronic pain appears across multiple conditions and patient populations, suggesting it's a fundamental biological relationship rather than a coincidence.

Why does this matter? Because understanding the root cause of pain—whether it stems from neurodivergence and connective tissue differences—allows doctors to tailor treatment more effectively. A patient with autism and hypermobile joints may need different pain management strategies than someone with arthritis alone. They might benefit from physical therapy approaches that account for joint instability, or from pain management programs designed with neurodivergent sensory needs in mind.

The Broader Picture: What Experts Say About This Discovery

The research team emphasized the importance of recognizing this pattern. According to the study, "In patients with CP/CF, routine screening for neurodivergence should be considered to optimise fair access to appropriate support for improved quality of life". This recommendation signals a shift in how the medical community should approach chronic pain—not just treating the pain itself, but understanding the neurodivergent traits and connective tissue differences that may be driving it.

The implications extend beyond individual treatment. If neurodivergence is this common in chronic pain populations, it suggests that many patients have been missing out on support tailored to their specific needs. Someone with undiagnosed autism and chronic pain might struggle with sensory sensitivities during physical therapy, or have difficulty with traditional pain management programs that don't account for how autistic brains process pain differently.

Key takeaways from this research include:

• Screening Importance: Doctors should routinely screen chronic pain patients for autism and ADHD, as these conditions are far more prevalent in this population than previously recognized.
• Joint Hypermobility Connection: Variant connective tissue and joint flexibility appear to be a biological mechanism linking neurodivergence to chronic pain, suggesting that joint stability may be a treatment target.
• Personalized Pain Management: Understanding a patient's neurodivergent traits allows for more tailored pain management approaches that account for sensory sensitivities and cognitive differences.
• Quality of Life Impact: Identifying neurodivergence in chronic pain patients opens doors to support systems and accommodations that can significantly improve overall wellbeing.

The study involved a case-control design, comparing adults with chronic pain or fatigue to a non-clinical comparison group using validated screening tools. While the sample size was modest—174 total participants—the findings were statistically significant, meaning researchers can be confident the patterns they observed are real and not due to chance.

For anyone living with chronic pain, this research offers an important message: if you've ever wondered whether your pain might be connected to how your brain works, you're not alone. Millions of people with autism and ADHD experience chronic pain, and the medical community is finally beginning to understand why. If you haven't been screened for neurodivergence as part of your chronic pain evaluation, it may be worth asking your doctor about it. The answer could unlock better pain management strategies tailored specifically to your needs.