Researchers conducting what they describe as one of the largest harmonization efforts in pain epidemiology gathered data from more than 6 million individuals spanning 118 countries between 1990 and 2025, encompassing ages from five years to over 100. The findings, published in Nature Medicine, examined pain distribution both geographically and across the human lifespan, focusing on pain as the leading global cause of disability.
The study measured self-reported pain across 11 bodily sites including the head, face, neck, shoulder, foot, ankle, hand, wrist, elbow, chest, back, stomach, abdomen, hip, and knee. Results showed that women consistently reported higher pain levels than men across all measured locations, with particularly pronounced differences in headache, facial, and abdominal pain. Approximately 40% of participants reported back pain, while facial pain was the least common at 2%.
Pain patterns varied significantly by type and age group. For both sexes, the steepest increase in pain occurred before age 55, with peaks occurring at or beyond 75 years old, particularly for back, hip, and knee pain. High-intensity pain peaked around age 50, while generalized pain peaked around age 70. Different pain types followed distinct trajectories: headache, abdominal, and facial pain peaked earlier in life before declining, whereas musculoskeletal pain, especially in weight-bearing areas, increased progressively with age.
Researchers identified modifiable risk factors contributing to global pain burden. The analysis found that 18.3% of global pain burden was attributable to smoking, obesity, and low household incomes, with regional variations ranging from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. Smoking, obesity, and income disparities showed distinct regional patterns across different global areas.
Expertise commentary highlighted the significance of the findings within the context of existing healthcare inequalities. The research underscored that despite women experiencing greater pain burden globally and consistently across body sites, their pain continues to face dismissal, delayed diagnosis, and undertreatment in clinical settings, pointing to the need for improved sex-specific analysis in healthcare delivery and research funding.
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