Pain is among the leading causes of disability worldwide, yet until now researchers have lacked a consistent way to compare how often people report it across different ages, sexes and regions. A new global analysis published in Nature Medicine takes a substantial step toward filling that gap, drawing on self-reported pain data from more than 6 million people living in 118 countries and territories.
The work, led by Matt Fillingim and Etienne Vachon-Presseau with colleagues, offers what may be the broadest picture yet of who reports pain, in which parts of the body, and at what stage of life. Two findings stand out: women reported pain more often than men in every body area studied, and pain did not rise steadily with age the way many people assume — the steepest increases happened before age 55.
A Global Snapshot Built From Millions of Reports
The research team analyzed self-reported pain data gathered between 1990 and 2025 from 6,125,459 individuals, spanning ages 5 to over 100. Rather than relying on diagnosed conditions recorded in clinical settings, the analysis centered on what people said about their own pain. That distinction matters, the authors note, because estimates built only from diagnoses can miss pain among people with limited access to health care — precisely the populations where the burden may be heaviest.
The prevalence of pain varied enormously depending on the body area in question, ranging from roughly 2% for facial pain to about 40% for back pain. The analysis covered 11 distinct body areas, allowing the researchers to compare patterns across regions and age groups rather than treating pain as a single, undifferentiated category.
Women Report Pain More Often in Every Body Area
Across all 11 body areas examined, pain was more frequently reported by women than by men. The gender gap was not uniform, however. The largest differences appeared for facial pain, headaches, and stomach or abdominal pain — three categories that have long been noted in clinical settings but had not been documented at this scale across so many countries simultaneously.
The consistency of the pattern is notable. Because the difference held across every body area rather than clustering in a few, it suggests the disparity is not confined to particular conditions or specific health systems, but reflects something broader in how pain is experienced or reported.
The Sharpest Increase Comes Before 55
Perhaps the most counterintuitive result concerns age. Many people expect pain to accumulate gradually and then accelerate in later life, but the data tell a different story. Across all body areas combined, pain prevalence climbed most sharply before age 55, flattening somewhat afterward.
The underlying patterns also diverged by body region. Headaches and abdominal pain tended to peak earlier in life before declining, while back, hip and knee pain continued to rise with advancing age. This suggests that "pain" as a single measure conceals very different life-course trajectories depending on where in the body it occurs — a nuance the authors argue should shape how prevention and monitoring programs are designed.
Where You Live Changes the Picture
The analysis also uncovered a striking link between pain and national development levels. Starting around age 40, pain anywhere in the body, joint pain and back pain all increased more rapidly in countries with lower Human Development Index (HDI) values.
The divergence became especially pronounced at older ages. Among people aged 80 or older, the prevalence of any bodily pain was roughly 31 percentage points higher in lower-HDI countries than in higher-HDI countries. Low back pain was nearly twice as common in those lower-development settings.
Risk Factors Explain Less Than Expected
One of the more puzzling findings involves known risk factors. Smoking, obesity and low income are widely understood to contribute to pain burden, and they do — but the analysis found they explained a smaller share of the pain reported in lower-development settings than expected. In other words, the standard explanatory toolkit does not fully account for why pain is so much more prevalent in those countries.
The authors are candid that the reasons remain unclear. The gap points toward factors beyond individual behaviors and economics — possibly differences in physical labor, environmental conditions, healthcare access, injury exposure, or the ways pain is perceived and reported across cultures — but the study does not resolve which of these is at work.
A Benchmarking Tool for Future Research
Beyond its descriptive findings, the study introduces an analytical resource: the Global Lifespan Pain Benchmarking Tool. The researchers demonstrated its use by applying it to a hypothetical external cohort, producing representative output that illustrates how the model could be deployed to compare pain patterns in new populations.
The value of such a tool lies in standardization. Without a common reference framework, studies conducted in different countries or time periods are difficult to compare directly. A shared benchmark could allow researchers and public health agencies to situate their own local data against global patterns and identify where pain prevalence diverges from what might be expected.
What Prevention Might Look Like
The findings carry practical implications for how pain is addressed at the population level. Because the sharpest increases occur before age 55, the authors suggest that prevention efforts may need to begin earlier in life than current strategies typically assume — well before the chronic conditions commonly associated with later-life pain take hold.
They also emphasize that prevention should be tailored to different regions. A uniform global approach would overlook the fact that pain trajectories diverge markedly depending on HDI and geography. Regions with lower development indicators face a heavier and earlier-rising burden, which argues for resource allocation and intervention design that reflect local realities rather than a one-size-fits-all model.
Caveats and Open Questions
The authors are careful to flag a significant limitation. Most of the data were collected at a single point in time, meaning the analysis shows differences between age groups rather than tracking how pain changes within the same individuals as they grow older. Cross-sectional patterns can hint at life-course trends, but they cannot confirm them.
That leaves several questions open. Do people in lower-HDI countries genuinely experience more pain, or are reporting differences shaped by cultural expectations and healthcare access? Why does the gender gap persist so consistently across body areas? And what interventions would most effectively flatten the pre-55 rise in pain prevalence?
What the study does establish is a foundation: a large, multi-country, multi-decade dataset and a benchmarking framework for making sense of it. For a symptom that ranks among the world's leading causes of disability, that kind of shared measurement infrastructure is a prerequisite for anything resembling coordinated global action.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
