Chronic Pain, Emotions and Professional Football

Chronic pain is now widely recognized as a complex biopsychosocial condition rather than a purely physical phenomenon. The International Association for the Study of Pain (IASP) defines pain as an "unpleasant sensory and emotional experience," and neuroimaging studies reveal that chronic pain involves shifting brain activation from nociceptive to cognitive and emotional circuits over time. This evolving understanding underscores the role of emotions, cognitions, and psychosocial factors in shaping the pain experience and contributes to the clinical difficulty of managing chronic pain.

Psychological factors-including fear-avoidance, catastrophizing, and depression-are known to strongly influence pain severity and disability. While these constructs are often tied to biomedical explanations (e.g., structural imaging findings), such explanations may increase fear or negative expectations and do not fully account for pain severity in many individuals. Social factors also interact with psychological processes to shape pain experiences, yet they remain understudied. One such social factor may be the emotional impact of a chronic pain sufferer's favorite sports team performance.

Sports fandom research demonstrates that strong fan identification provides psychological benefits such as belonging, self-esteem, and life satisfaction. Neuroimaging evidence suggests that sports-related wins activate reward networks, while losses trigger introspective and negative emotional states. Despite these findings, the potential link between weekly sports team performance and symptom fluctuations in people living with chronic pain has not been directly investigated.

This longitudinal observational study will examine whether weekly changes in the performance of participants' preferred NFL football team correlate with changes in self-reported chronic pain intensity (Numeric Pain Rating Scale), depressive symptoms (PHQ-2), and pain catastrophization (Pain Catastrophizing Scale). Participants will be adults aged 18 or older with chronic pain lasting more than one year and who meet predefined criteria for being avid fans of a current NFL team.

Following informed consent, participants will complete baseline demographic and clinical questionnaires. Each week throughout the NFL regular season, participants will receive a brief online survey assessing their pain and depressive symptoms. Independent of participant responses, the research team will document whether the participant's team played, whether they won or lost, and the performance of the team's primary rival.

Data will be analyzed descriptively and through inferential statistics to determine whether emotional changes associated with team performance are associated with clinically meaningful weekly changes in pain, depression, or catastrophizing. This study aims to generate preliminary evidence regarding the interaction between sports-related emotional experiences and chronic pain, potentially identifying a novel social component relevant to understanding pain variability.

Inclusion criteria

• Age 18 and above
• Chronic pain > 1 year
• Provide written consent
• Proficient in reading and understanding English
• Identify as an avid football fan of a current US professional football team (NFL). Criteria include:
• Watching all/most of their team's games during the season
• Watching games of their main competitor
• Engage in social media regarding their team during and outside of the season
• Wears team apparel during and outside of the season

Exclusion criteria

• Not willing to participate in the study
• Not willing to comply with weekly data collection requirements
• Do not meet the criteria for being classified as an avid football fan.