1 in 5 adults in US has chronic pain

Key takeaways:

• In 2021, approximately 20.9%, or 51.6 million, of adults in the U.S. experienced chronic pain.
• Some underrepresented populations faced higher rates of chronic pain.

An estimated one in five adults in the United States had chronic pain in 2021, with 6.9% experiencing intense pain that limited their daily activities, according to the CDC.

The data also revealed disparities among certain population groups.

Chronic pain, or pain that lasts for at least 3 months, can be a debilitating condition that affects various aspects of life for many people in the U.S., S. Michaela Rikard, PhD, a public health analytics and modeling fellow at the CDC’s division of overdose prevention, and colleagues wrote. It has also been linked to substance use, depression, higher suicide risk and Alzheimer’s disease.

Previous data from 2016 showed that about 50 million adults in the U.S. experienced chronic pain and 19.6 million faced “high-impact chronic pain” — pain intense enough to also limit daily life or work activities.

“Addressing chronic pain and improving the lives of persons living with pain is a public health imperative,” Rikard and colleagues wrote.

According to the researchers, the National Health Interview Survey (NHIS) — a cross-sectional, household survey of the civilian, noninstitutionalized population conducted annually by the National Center for Health Statistics — was identified in a 2022 review of U.S. chronic pain surveillance systems as the “best source for pain surveillance data.”

So, Rikard and colleagues used data from the 2019 to 2021 NHIS to estimate the prevalence of chronic pain and high impact chronic pain among all adults in the U.S. and within population groups defined by socioeconomic, geographic, demographic and health status characteristics.

Rikard and colleagues found that, between 2019 and 2021, chronic pain prevalence in U.S. adults ranged from 20.5% to 21.8%. When it came to high-impact chronic pain, the prevalence ranged from 6.9% to 7.8%.

In 2021, approximately 20.9% (or 51.6 million) of adults in the U.S. experienced chronic pain, and 6.9% (17.1 million) faced high-impact chronic pain. The researchers noted that the estimated prevalence of high-impact chronic pain was lower than that in 2016: 6.9% vs 8%.

Rikard and colleagues noted some disparities. Adults who were bisexual, American Indian or Alaska Native (AI/AN) and divorced or separated all faced a higher prevalence of both chronic pain and high-impact chronic pain.

The age-adjusted prevalence of chronic pain was:

• 32.9% among bisexual adults, compared with 20.7% among gay or lesbian adults and 19.3% among straight adults;
• 29.6% for those who were divorced or separated compared with 18.2% for those who were married; and
• 21.6% for those born in the U.S. vs. 11.9% for those born outside of the U.S.

Finally, high-impact chronic pain among AI/AN adults was twice as high as white adults and six times higher than Asian adults: 12.8% vs. 6.5% and 2.1%, respectively.

“Clinicians, practices, health systems, and payers should vigilantly attend to health inequities and ensure access to appropriate, affordable, diversified, coordinated, and effective pain management care for all persons,” Rikard and colleagues wrote.

The researchers additionally noted that of all the chronic medical conditions that were reported, the age-adjusted prevalence of chronic pain and high-impact chronic pain was highest among adults with a history of myalgic encephalomyelitis/chronic fatigue syndrome, at 70% and 43.8%, respectively, and dementia, at 54.9% and 34.2%, respectively.

“These findings can guide policymakers, clinicians, and researchers in future research examining the underlying reasons for disparities and in the development of tailored interventions and strategies addressing chronic pain in the United States,” Rikard and colleagues concluded.