Chronic Pain, Emotions and Professional Football

May 6, 2026 updated by: Evidence In Motion
Chronic pain is influenced by biological, psychological, and social factors, including emotions and environmental context. Prior research demonstrates that emotional states and psychosocial processes such as depression, fear-avoidance, and catastrophizing significantly shape the pain experience. Professional sports fandom is known to influence emotional well-being, but its relationship to chronic pain has not yet been examined. This longitudinal observational study aims to evaluate whether weekly performance outcomes of participants' favorite U.S. professional football (NFL) teams are associated with fluctuations in self-reported pain intensity, depression, and pain catastrophization among adults with chronic pain who identify as avid football fans. Participants will complete weekly online surveys throughout the NFL regular season, reporting pain ratings (NPRS) and depressive symptoms (PHQ-2). Team performance (win/loss, played/did not play, rival results) will be recorded by the research team. The study seeks to determine whether sports-related emotional fluctuations correlate with changes in chronic pain experiences.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Observational

Enrollment (Actual)

32

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Iowa
      • Story City, Iowa, United States, 50248
        • Evidence in Motion

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study will include self-identified adults aged 18 and above who have experienced chronic pain (>1 year) and meet the criteria for avid professional football fans.

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Cohort 1: Avid NFL Fans with Chronic Pain

Participants in this cohort are adults aged 18 or older who have experienced chronic pain for more than one year and meet predefined criteria for being avid fans of an active U.S. professional football (NFL) team. All participants will complete baseline demographic and clinical questionnaires and will provide weekly self-reported measures of pain intensity (NPRS) and depressive symptoms (PHQ-2) throughout the NFL regular season. Team performance variables (game played, win/loss outcome, rival results) will be collected by the research team.

Study Activities:

Baseline demographic and football-related fan profile questionnaire Baseline Pain Catastrophizing Scale (PCS) Weekly NPRS and PHQ-2 surveys End-of-season PCS Research team documentation of weekly team performance and rival performance

Purpose:

To evaluate whether weekly NFL team performance is associated with fluctuations in pain intensity, depressive symptoms, and catastrophizing in individuals living with chronic pain
Other: No Intervention: Observational Cohort
No Intervention: Observational Cohort

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity (Numeric Pain Rating Scale - NPRS)
Time Frame: Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Self-reported musculoskeletal pain intensity will be measured using the 0-10 Numeric Pain Rating Scale (NPRS), where 0 indicates "no pain" and 10 indicates "worst pain imaginable." Participants will report their average pain over the past week.
Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Depressive Symptoms (Patient Health Questionnaire-2 - PHQ-2)
Time Frame: Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Depressive symptoms will be measured using the 2-item PHQ-2, assessing anhedonia and depressed mood. Each item is rated 0 (not at all) to 3 (nearly every day), generating a score from 0-6.
Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Catastrophizing (Pain Catastrophizing Scale - PCS)
Time Frame: Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
The PCS is a 13-item questionnaire assessing rumination, magnification, and helplessness related to pain. Each item is rated 0-4, with total scores ranging from 0-52. Higher scores indicate greater catastrophizing.
Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Correlation Between Weekly Team Performance and Symptom Changes
Time Frame: Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).

Team performance will be operationalized as:

Win, Loss, or Did Not Play,

Rival team win/loss,

Margin of victory/defeat. These variables will be analyzed against weekly NPRS and PHQ-2 scores to determine associations between sports-related emotional events and chronic pain symptoms.
Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Weekly Response Rate / Completion Rate
Time Frame: Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).
Proportion of participants completing each weekly survey.
Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Evidence In Motion

Collaborators

St. Ambrose University

Investigators

  • Principal Investigator: Adriaan Louw, PT, PhD, Evidence in Motion

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 18, 2025

Primary Completion (Actual)

January 9, 2026

Study Completion (Actual)

January 9, 2026

Study Registration Dates

First Submitted

March 11, 2026

First Submitted That Met QC Criteria

May 6, 2026

First Posted (Actual)

May 13, 2026

Study Record Updates

Last Update Posted (Actual)

May 13, 2026

Last Update Submitted That Met QC Criteria

May 6, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NFLStudy2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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