Researchers conducted a comprehensive international analysis examining pain distribution across populations and the human lifespan, analyzing data from more than 6 million individuals aged five and older across 118 countries between 1990 and 2025. The study, published in Nature Medicine, represents one of the largest harmonization efforts in pain epidemiology and evaluated pain at 11 bodily sites including the head, neck, shoulders, back, abdomen, and joints.
Female participants consistently reported higher pain levels than male participants across all measured bodily regions, with particularly pronounced differences in headache, facial pain, and abdominal pain. The research identified distinct patterns across the lifespan, with pain increasing most steeply before age 55 during working-age adulthood, then peaking at or beyond age 75. Back pain was reported by approximately 40% of participants, while facial pain was the least common at 2%. Different pain types showed varying trajectories, with headache, abdominal, and facial pain peaking earlier in life before declining, while musculoskeletal pain generally increased progressively with age.
The study found that individuals in lower Human Development Index regions experienced substantially higher pain prevalence in later life, with nearly twice the rates of low back pain in older age compared to other regions. High-intensity pain peaked at approximately age 50, while generalized pain peaked around age 70. The analysis revealed that 18.3% of global pain burden was attributable to smoking, obesity, and low household incomes, with regional variation ranging from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe.
Researchers emphasized that their approach measured self-reported pain rather than relying solely on diagnoses, potentially providing more equitable monitoring across populations with varying healthcare access. The authors noted important study limitations, including different measurement methods across regions and uneven geographic coverage, though these did not alter overall identified patterns. Expert commentary highlighted the research as landmark evidence of a consistent global gender pain gap, while noting the paradox that women experience more pain yet often receive delayed diagnosis and undertreatment.
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