Chronic pain, the leading cause of disability worldwide, is now better understood thanks to a study published in Nature Medicine. The research, which involved collaborators Makram Talih and Raquel Lucas from the Institute of Public Health of the University of Porto (ISPUP), analyzed data from over 6 million individuals across 118 countries, covering all age groups and eleven body regions.
Led by McGill University in Canada, the study utilized data from 902 sources, including ISPUP's Geração XXI cohort, to build global reference curves for self-reported pain. Data collected between 1990 and 2025 focused on pain in the head, face, neck or shoulder, elbow, hand or wrist, chest, back, stomach or abdominal area, hip, knee, and foot or ankle.
The investigation found that pain prevalence increases throughout life, from about 30% at age 5 to approximately 70% at age 100. However, the progression varies by region: in seven of the eleven analyzed zones, pain follows an "inverted U" curve, increasing, peaking, and then decreasing. Headaches, for instance, peak around age 34, while back, hip, and knee pain continue to rise with age, reaching their maximum around 75 years or older.
The findings challenge the notion that pain continuously accumulates with aging, suggesting that the "window of opportunity for effective prevention may arise earlier." The most rapid increase in pain prevalence occurs before age 55 across all body regions.
After age 65, disparities in pain prevalence become significantly more pronounced. In countries with lower Human Development Index (HDI), pain is 30.6 percentage points higher than in countries with higher HDI, particularly in lower back pain. Eastern Europe shows the highest prevalence of pain in old age. These results differ from previous estimates as they rely on direct self-reports, better capturing pain in populations with less access to healthcare.
Modifiable factors such as smoking, obesity, and low income account for 18.3% of the global pain burden. Obesity is linked to pain in weight-bearing joints, while lower incomes correlate with more pain across all body areas. The impact of these factors varies regionally, being lower in Sub-Saharan Africa.
Women report more pain than men across all eleven analyzed regions. The likelihood of reporting pain is significantly higher for women in facial pain (83% more), headaches (74% more), and abdominal pain (60% more), as well as for high-intensity and generalized pain (around 50% more).
