TL;DR
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A Nature Medicine study analyzing self-reported data from more than 6.1 million people in 118 countries found that pain patterns differ by body site, age, sex and country development. Many types of pain rise most sharply before age 55, while back, hip and knee pain tend to continue increasing into older age; the study also found higher pain prevalence among women and steeper late-life increases in lower-HDI countries.
A global analysis of 6.1 million people in 118 countries and territories found that pain does not rise uniformly with age: several types peak before age 55, while back, hip and knee pain often increase into old age. Published in Nature Medicine, the study also found that women reported more pain than men across all 11 anatomical sites examined, and that late-life pain patterns differed by countries’ level of human development.
The researchers combined self-reported pain information from 902 population-based data sources, covering participants aged 5 to over 100. The source studies were conducted between 1990 and 2025; 55% of participants were female. The analysis estimated prevalence across 11 anatomical sites and produced reference curves to compare pain patterns by age and region.
Across the sites studied, estimated prevalence ranged from 2% for facial pain to 40% for back pain. Prevalence was higher among women at every site. The largest reported differences were for facial pain, headache and stomach or abdominal pain: women’s prevalence was 83%, 74% and 60% higher than men’s, respectively, according to the study.
Patterns differed substantially by pain location. Headache, abdominal, facial, neck or shoulder, and elbow pain were among the types that peaked in mid-to-late adulthood and then declined. By contrast, back, hip and knee pain generally rose most sharply between ages 20 and 55 and reached their highest prevalence at age 75 or older. The researchers also estimated that any bodily pain increased from about 30% at age five to 70% at age 100 or older, while high-intensity pain peaked around age 50 and generalized pain around age 70 before declining.
Pain Burden Changes With Age and Place
The findings challenge the broad assumption that pain simply becomes more common with every year of aging. Instead, the age pattern depends on the body site: some pain types are more prevalent earlier, while lower-body musculoskeletal pain tends to rise later in life. That distinction may matter for how researchers compare populations and how health services plan for different needs across adulthood.
The results also point to a geographic divide in older age. From around age 40, prevalence of any bodily pain, joint pain and back pain rose more steeply in countries with lower Human Development Index (HDI) values. At age 80 or older, low-back-pain prevalence in those countries was nearly twice that in high-HDI countries. These are population-level differences and do not establish why individuals experience pain or prove that a country’s HDI itself causes it.
The study’s risk-factor analysis associated smoking, obesity and low household income with higher pain prevalence. The researchers estimated that these factors together accounted for about 18% of site-specific pain burden globally. That estimate varied by region, from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. The remaining burden, especially in lower-HDI settings, is not explained by those factors in the analysis.
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Why Global Pain Estimates Differ
Pain is a major source of disability, but there is no objective biomarker that measures it. Researchers therefore often depend on people’s reports of their own pain. Those reports can be difficult to compare across countries because surveys may ask about different time periods, use different questionnaires or define body areas differently.
Other global estimates, including those associated with the Global Burden of Disease study, often rely on clinically defined conditions and modeled data from multiple sources. Such approaches support disease surveillance, but may miss people with limited access to health care. The new analysis draws on population-based surveys to describe reported pain more directly, while its authors’ harmonization and modeling do not remove all differences among the underlying surveys.
The study’s broad geographic coverage offers reference trajectories across the lifespan that can be used to compare cohorts, clinical populations and countries. Its results also suggest that prevention and services may need to account for when particular pain types tend to rise, rather than treating pain as a single condition that increases steadily with age.
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Limits of the Pain Comparisons
The estimates are based on self-reported pain, not a clinical test that independently confirms or measures pain. Differences in survey wording, recall periods and anatomical definitions complicate comparisons across the 902 sources, even though the study aimed to harmonize the data. The source report does not provide enough detail here to determine how consistently each country or age group was represented across all pain sites.
The regional patterns also do not identify the causes of the late-life gaps. The researchers found associations with smoking, obesity and household income, but those factors account for only part of the estimated burden and do not establish causation. The source report says the factors underlying pain in lower-HDI countries remain poorly characterized. It is also not clear from the reported findings how the estimates would change if measured using a common survey in every country.
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Using the Curves in Future Research
The researchers present the curves as reference estimates for comparison, not as a substitute for country-specific surveys or individual clinical assessment. Future work could test the patterns with more consistently designed surveys and investigate why pain prevalence diverges in older age across countries with different HDI levels.
The reported analysis does not name a specific follow-up study or policy change. For now, its principal contribution is a broad set of estimates showing where pain prevalence rises, peaks or falls across the lifespan. Further research will be needed to clarify the roles of social conditions, health access and other factors that were not captured by the three risk factors highlighted in the report.
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Key Questions
Does pain always increase with age?
No. The analysis found that pain patterns vary by body site. Several types, including headache and abdominal pain, peaked before or during mid-to-late adulthood and declined afterward, while back, hip and knee pain tended to rise into older age.
Which pain types were most prevalent in the study?
Among the 11 anatomical sites examined, estimated prevalence ranged from 2% for facial pain to 40% for back pain. These are study-wide estimates, not figures for every country or age group.
What differences did researchers report between women and men?
Women had higher reported prevalence than men across all 11 sites. The largest differences were for facial pain, headache and abdominal pain; the study does not show that sex alone explains those differences.
Why did pain patterns differ by country development level?
The study found steeper increases in several types of pain after about age 40 in countries with lower HDI values, but it did not establish a cause. Smoking, obesity and low household income were associated with pain, while the report says other factors in lower-HDI countries remain poorly characterized.
Can the study explain an individual person’s pain?
No. These are population-level estimates based on self-reports, not a tool for diagnosis. Anyone seeking help for pain should discuss their situation with a qualified health professional.
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