Pain Prevalence Across the Lifespan Mapped in 6.1 Million People Worldwide

Self-reported pain prevalence rises most steeply before age 55 years and is substantially higher in late life among people in low Human Development Index (HDI) countries, according to an analysis of harmonized data from 6.1 million individuals in 118 countries published in Nature Medicine.

The investigators harmonized individual-level data from 6,125,459 participants aged 5 to more than 100 years across 902 population-based data sources, drawn from studies and surveys conducted between 1990 and 2025. Using generalized linear mixed-effects models, they constructed lifespan reference trajectories for pain at 11 anatomical sites and made them available in an open-access benchmarking tool.

Prevalence ranged from roughly 2% for facial pain to 40% for back pain and was higher in women at all 11 sites (risk ratio range, 1.08-1.83). Seven of 11 sites showed an inverted-U trajectory, peaking in mid-to-late adulthood, whereas back, hip, and knee pain continued to increase across the lifespan. In contrast to existing estimates that generally project higher prevalence of pain conditions in higher-HDI regions, prevalence of any bodily pain at age 80 years or older was 30.6 percentage points higher in low- than high-HDI settings (95% CI, 26.9-34.3), and low back pain approached twice the prevalence at the oldest ages.

Globally, 18.3% of pain burden across anatomical sites was attributable to smoking, obesity, and low income, ranging from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. According to the authors, this indicates that the factors underlying pain in lower-HDI settings remain poorly characterized.

The authors noted that most datasets were cross-sectional, so the trajectories describe population age patterns rather than within-person change. Pain measures differed across studies, coverage was uneven across regions and at the youngest and oldest ages, and the database may be affected by selection bias.

Source: Fillingim M, Tanguay-Sabourin C, Neuert L, et al. Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries. Nat Med. Published online October 5, 2026. doi:10.1038/s41591-026-04696-w