In a new study, researchers have found that the prevalence of chronic pain is increasing for all demographics of U.S. adults.
The research, which appears in the journal Demography, highlights that the prevalence of chronic pain has increased the most for people from lower socioeconomic backgrounds.
The researchers also found associations between people’s mental and physical health and a higher prevalence of chronic pain.
A public health issue
Researchers have noted that chronic pain can have a significant negative effect on a person’s well-being, as well as “the economic balance sheet of populations.”
According to the Centers for Disease Control and Prevention (CDC), chronic pain is one of the leading reasons why a person may seek medical care.
However, despite this, it has received relatively little recognition as a public health issue. While there has been an increase in research looking at chronic pain, little research has looked at its effects at the population level.
Without information on the prevalence of chronic pain in the population, policymakers may not respond appropriately to the severity of the issue.
To respond to this lack of information at the population level, the researchers behind the present study set out to build their understanding of the changing rates of chronic pain for U.S. adults.
They also wanted to see whether the prevalence of chronic pain changed faster for specific demographics and what factors may be accounting for these changes.
The researchers drew on data from the National Health Interview Survey, which covered the years 2002–2018. Each year, the survey received responses from 19,040–32,149 people, with a total of 441,707 individuals taking part.
The survey covered various aspects of people’s health, including their experiences of chronic pain.
The survey was particularly valuable because it asked people about five common sites of pain: the lower back, the neck, the face and jaw, the joints, and the head. The researchers gained a more granular understanding of which sites of pain were most prevalent.
The survey also provided extensive demographic data on the participants, as well as information on their health and well-being.
The researchers found that the prevalence of chronic pain had increased for all demographics, though it had increased more for older adults and Black, male respondents with less education and a lower income than it had done for white, female participants with higher incomes and levels of education.
“We looked at the data from every available perspective, including age, gender, race, ethnicity, education, and income, but the results were always the same: There was an increase in pain no matter how we classified the population,” says Dr. Hanna Grol-Prokopczyk, associate professor of sociology in the University at Buffalo College of Arts and Sciences, and co-author of the paper.
“You might think that with medical advances, we’d be getting healthier and experiencing less pain, but the data strongly suggest the exact opposite,” Dr. Grol-Prokopczyk says.
Reports of chronic pain in at least one of the five sites increased by 10% during the study period, which represents 10.5 million more people.
Joint pain and lower back pain were the most prevalent sites of pain both in 2002 and by the end of the study period in 2018.
The researchers found an increasing disparity in who experiences pain. People whose household income was four times the poverty level saw a 14% increase in the risk of experiencing chronic pain. However, those whose income was only twice the poverty level saw a 42% increase.
The researchers were also able to get a sense of the important factors that could account for the increase in the prevalence of chronic pain.
For people between the ages of 65 and 84 years, physical health issues were associated with chronic pain prevalence. These included high body mass index, diabetes, kidney issues, and hypertension.
For younger and middle-aged people, mental health issues such as distress and alcohol were more prominent.
According to Dr. Grol-Prokopczyk: “What we’re seeing in the younger age groups demonstrates how pain in some ways functions as much as a mental health problem as it does a physical health problem. Pain can be exacerbated by stress, and stress can bring about alcohol use.”
Public health issue
For Dr. Grol-Prokopczyk, the findings add further weight to the need to respond to pain as a public health issue.
“Pain is a leading cause of disability, and there is evidence that pain has an impact on life expectancy,” Dr. Grol-Prokopczyk says. “So the problem is one not only affecting quality of life but potentially even quantity of life.”
According to corresponding author Dr. Anna Zajacova, of the department of sociology at the University of Western Ontario in London, Canada, when supporting patients with chronic pain, clinicians need to recognize the complex underlying factors that may be contributing to it.
“The U.S. healthcare system focuses on procedures and medications,” she told Medical News Today. “For pain, however, the focus needs to shift to prevention and management, including support of self-management and interdisciplinary conservative treatment approaches.”
“Chronic pain is a major public health problem, and as such, it needs to be addressed by policy directives such as increasing funding for pain treatment, especially interdisciplinary approaches to managing pain.
Absent those, clinicians do have the ability to provide support to their pain patients. While medicine recognizes the ‘biopsychosocial roots’ of chronic pain, clinicians are often compelled to look for an underlying, hopefully treatable, physical condition.” – Dr. Zajacova
“Yet chronic pain is an extremely complex phenomenon, and physicians must consider the psychosocial drivers of their patient’s pain from work, family, or financial stress, social support, and overall, the social world they live in.”