Nature medicine · 2026

Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries.

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Fillingim Matt, Tanguay-Sabourin Christophe, Neuert Lindsay, Zare Azin, Norman Jax, Guglietti Gianluca V, Hobeika Lise, Ayorinde Abimbola, Salimzadeh Ahmad, Jamshidi Ahmad-Reza, Alenazi Aqeel M, Tehrani-Banihashemi Arash, Alqahtani Bader A, Olaya Beatriz, Mbenza Benjamin Longo, Oladeji Bibilola, Penninx Brenda, Paudyal Buddhi, de Melo Caique, Berna Chantal, Humberg Clarissa, Claudepierre Pascal, Smith Elisa, VanDenKerkhof Elizabeth, Giltay Erik J, Garcia-Esquinas Esther, Parlindungan Faisal, Abbasi Fatima Qayyum, Artalejo Fernando Rodríguez, Jones Gareth T, Slade Gary, Bouziri Hanifa, Flor Herta, Iso Hiroyasu, Gilron Ian, Uthman Imad, Peláez-Ballestas Ingris, Nzambi Jean-Paul Divengi, Ayuso-Mateos Jose Luis, Haro Josep Maria, Wager Julia, de Souza Juliana Barcellos, Nakamura Kazutoshi, Yamada Keiko, Rau Lisa-Marie, Talih Makram, Beasley Marcus J, Dueñas María, Zins Marie, Miret Marta, Wake Melissa, Pratama Mirza Zaka, Almalki Mohammed, Chaaya Monique, Anshory Muhammad, Kondo Naoki, Moghadam Navid, Mansor Norma, Alsaed Omar, Keeratisiroj Orawan, Gureje Oye, Kurniari Pande Ketut, Noormohammadpour Pardis, Lebughe Pierrot, Elzahaf Raga A, Kordi Ramin, Lucas Raquel, Bhandari Rashmi Parekh, Telles Rosa Weiss, Hidayat Rudy, Samreen Saba, Al-Emadi Samar, Barreto Sandhi Maria, RoknSharifi Shima, Inoue Shinsuke, Adhikari Sudeep, Wibowo Suryo Anggoro Kusumo, Sharma Sweekriti, Villeneuve Sylvia, Tabuchi Takahiro, Khursheed Tayyeba, Yamato Tie, Jackson Todd, Santos Veronica Souza, Siritaratiwat Wantana, Liu Xianchen, Liu Zhen-Zhen, IMAGEN Consortium, Sawyer Susan M, Khalatbari-Soltani Saman, Steingrímsdóttir Ólöf Anna, Macfarlane Gary J, Blyth Fiona, Vachon-Presseau Etienne

Аннотация

Pain is the leading cause of disability worldwide, yet no harmonized self-reported reference framework exists to characterize how its burden is distributed across the lifespan and world regions. In this study, we harmonized individual-level self-reported pain data from 6,125,459 participants across 902 population-based data sources in 118 countries to establish global reference trajectories of pain. We implemented these trajectories in an open-access benchmarking platform for positioning external datasets against global pain norms. Pain prevalence ranged from roughly 2% for facial pain to 40% for back pain, was consistently higher in women across all 11 anatomical sites (risk ratio range: 1.08-1.83) and increased most steeply before age 55 years. Contrary to existing estimates that generally project higher prevalence of pain conditions in higher Human Development Index (HDI) regions, we found that individuals in the lowest HDI countries experienced a substantially higher late-life prevalence of any bodily pain than those in the highest (risk difference: 30.6 percentage points (95% confidence interval: 26.9-34.3)), with low back pain approaching twice the prevalence at the oldest ages. Globally, 18.3% of pain burden across anatomical sites was attributable to three modifiable risk factors (smoking, obesity and low income), but this varied from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe, indicating that the factors underlying pain in lower-HDI settings remain poorly characterized. Together, these reference trajectories provide a common framework for defining and comparing pain burden and informing more equitable global surveillance and prevention.

Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries.

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