Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries.
Pain is the leading cause of disability worldwide, yet no harmonized self-reported reference framework exists to characterize how its burden is distributed across the lifespan and world regions. In this study, we harmonized individual-level self-reported pain data from 6,125,459 participants across 902 population-based data sources in 118 countries to establish global reference trajectories of pain. We implemented these trajectories in an open-access benchmarking platform for positioning external datasets against global pain norms. Pain prevalence ranged from roughly 2% for facial pain to 40% for back pain, was consistently higher in women across all 11 anatomical sites (risk ratio range: 1.08-1.83) and increased most steeply before age 55 years. Contrary to existing estimates that generally project higher prevalence of pain conditions in higher Human Development Index (HDI) regions, we found that individuals in the lowest HDI countries experienced a substantially higher late-life prevalence of any bodily pain than those in the highest (risk difference: 30.6 percentage points (95% confidence interval: 26.9-34.3)), with low back pain approaching twice the prevalence at the oldest ages. Globally, 18.3% of pain burden across anatomical sites was attributable to three modifiable risk factors (smoking, obesity and low income), but this varied from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe, indicating that the factors underlying pain in lower-HDI settings remain poorly characterized. Together, these reference trajectories provide a common framework for defining and comparing pain burden and informing more equitable global surveillance and prevention.
Authors
Fillingim Fillingim, Tanguay-Sabourin Tanguay-Sabourin, Neuert Neuert, Zare Zare, Norman Norman, Guglietti Guglietti, Hobeika Hobeika, Ayorinde Ayorinde, Salimzadeh Salimzadeh, Jamshidi Jamshidi, Alenazi Alenazi, Tehrani-Banihashemi Tehrani-Banihashemi, Alqahtani Alqahtani, Olaya Olaya, Mbenza Mbenza, Oladeji Oladeji, Penninx Penninx, Paudyal Paudyal, de Melo de Melo, Berna Berna, Humberg Humberg, Claudepierre Claudepierre, Smith Smith, VanDenKerkhof VanDenKerkhof, Giltay Giltay, Garcia-Esquinas Garcia-Esquinas, Parlindungan Parlindungan, Abbasi Abbasi, Artalejo Artalejo, Jones Jones, Slade Slade, Bouziri Bouziri, Flor Flor, Iso Iso, Gilron Gilron, Uthman Uthman, Peláez-Ballestas Peláez-Ballestas, Nzambi Nzambi, Ayuso-Mateos Ayuso-Mateos, Haro Haro, Wager Wager, de Souza de Souza, Nakamura Nakamura, Yamada Yamada, Rau Rau, Talih Talih, Beasley Beasley, Dueñas Dueñas, Zins Zins, Miret Miret, Wake Wake, Pratama Pratama, Almalki Almalki, Chaaya Chaaya, Anshory Anshory, Kondo Kondo, Moghadam Moghadam, Mansor Mansor, Alsaed Alsaed, Keeratisiroj Keeratisiroj, Gureje Gureje, Kurniari Kurniari, Noormohammadpour Noormohammadpour, Lebughe Lebughe, Elzahaf Elzahaf, Kordi Kordi, Lucas Lucas, Bhandari Bhandari, Telles Telles, Hidayat Hidayat, Samreen Samreen, Al-Emadi Al-Emadi, Barreto Barreto, RoknSharifi RoknSharifi, Inoue Inoue, Adhikari Adhikari, Wibowo Wibowo, Sharma Sharma, Villeneuve Villeneuve, Tabuchi Tabuchi, Khursheed Khursheed, Yamato Yamato, Jackson Jackson, Santos Santos, Siritaratiwat Siritaratiwat, Liu Liu, Liu Liu, , Sawyer Sawyer, Khalatbari-Soltani Khalatbari-Soltani, SteingrĂmsdĂłttir SteingrĂmsdĂłttir, Macfarlane Macfarlane, Blyth Blyth, Vachon-Presseau Vachon-Presseau
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