Pain burden builds earlier in life than expected

Clinical takeaway: Don’t wait until older age to focus on pain prevention. Across most pain types, prevalence increased most rapidly before age 55, suggesting that working-age adulthood may be an important window for addressing modifiable risk factors and preventing later pain burden.

Pain is a leading cause of disability worldwide, but estimates typically rely on clinically defined conditions and have been heavily informed by data from high-income countries. Self-reported pain may offer a different picture, particularly where access to diagnosis and care is limited.

Researchers harmonized self-reported pain data from 6,125,459 people ages 5 to 100-plus across 902 population-based data sources in 118 countries. Across 11 anatomical sites, prevalence ranged from about 2% for facial pain to 40% for back pain and was consistently higher in women than men.

Pain did not simply rise steadily with age. Seven of 11 pain sites followed an inverted-U pattern, with prevalence increasing and then declining later in life. Headache peaked around age 34 and abdominal pain around 23, while back, hip and knee pain generally continued increasing into older age. High-intensity pain peaked at about age 50 and generalized pain at about 70.

Geography also mattered. By age 80 and older, prevalence of any bodily pain was 30.6 percentage points higher in countries with the lowest Human Development Index (HDI) than in those with the highest HDI, while low back pain approached twice the prevalence at the oldest ages.

Smoking, obesity and low income together accounted for an estimated 18.3% of pain burden globally, although that proportion ranged from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. The authors caution that most underlying datasets were cross-sectional, so the curves reflect population age patterns rather than changes within individuals over time.

The findings suggest “the window for effective prevention may occur earlier than current clinical and policy frameworks typically assume,” the authors wrote.

Source: Fillingim M, et al. (2026 Oct 5) Nat Med. Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries