Global Pain Study of 6 Million People Finds Sharpest Rise Comes Before Age 55

Pain does not simply accumulate with age the way wrinkles or gray hair do. A new global analysis, pooling self-reported pain data from more than six million people across 118 countries, finds that prevalence rises most steeply in the decades before 55, that women report more pain than men at every one of 11 body sites studied, and that older adults in poorer countries carry a far heavier pain burden than their counterparts in wealthier ones. The study, led by researchers at McGill University, was published Monday in Nature Medicine and is described by its authors as the largest effort yet to map how pain unfolds across the human lifespan.

The paper, titled "Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries," was written by Matt Fillingim, Etienne Vachon-Presseau and colleagues at McGill University's Faculty of Dentistry and Oral Health Sciences, with collaborators spanning institutions from the University of Aberdeen to Tehran University of Medical Sciences and the University of Sydney. The team harmonized data from 902 population-based studies collected between 1990 and 2025, covering participants from age 5 to over 100, 55 percent of them female.

The Numbers Behind the Curves

Across the 11 anatomical sites the researchers tracked — including the back, head, abdomen, face, hips and knees — self-reported pain prevalence ranged from about 2 percent for facial pain to roughly 40 percent for back pain, the most common complaint in the dataset. Overall, the share of people reporting pain anywhere in the body climbed from about 30 percent at age 5 to roughly 70 percent among those 100 or older, but the climb was far from linear. The researchers found that seven of the 11 pain sites followed an inverted U-shaped pattern, rising, peaking in mid-to-late adulthood, and then declining, rather than increasing indefinitely into old age.

The timing of those peaks varied widely by type. Headache prevalence peaked around age 34, abdominal pain around 23, while pain in the back, hips and knees kept climbing well into later life. High-intensity pain peaked around age 50, the authors found, while more generalized, multi-site pain peaked later, around age 70. The published paper notes that the researchers used generalized linear mixed-effects models with natural cubic splines to generate the age curves, accounting for clustering by study cohort and world region, and built what they call an open-access benchmarking platform so other researchers can compare their own cohort data against the new global norms.

A Consistent Sex Gap, Widest for the Face and Head

Women reported more pain than men at all 11 body sites, with risk ratios ranging from 1.08 to 1.83 depending on location. The largest gaps were for facial pain, where women's reported risk ratio was 1.83 times that of men, followed by headache at 1.74 and stomach or abdominal pain at 1.60. That pattern echoes a body of smaller, regional studies that have long found women report more chronic pain conditions such as migraine, fibromyalgia and temporomandibular disorders, but the new analysis is among the first to confirm the gap holds consistently across a near-global sample rather than within a handful of high-income countries where most prior pain epidemiology has been concentrated.

A Widening Gap by National Development

Perhaps the study's most striking finding runs counter to what researchers expected going in. From around age 40 onward, pain anywhere in the body, as well as joint pain and back pain specifically, increased more rapidly in countries with lower scores on the United Nations' Human Development Index than in wealthier nations. By age 80 and older, the gap in any bodily pain between the lowest- and highest-HDI countries reached 30.6 percentage points, with a 95 percent confidence interval of 26.9 to 34.3. Low back pain in the oldest age groups was nearly twice as common in low-HDI settings as in high-HDI ones.

That disparity was not explained away by the usual suspects. Smoking, obesity and low household income, taken together, accounted for only about 18.3 percent of the global pain burden the researchers measured, ranging from 12.6 percent in sub-Saharan Africa up to 27.1 percent in eastern Europe. In other words, the modifiable risk factors doctors typically counsel patients about left most of the disparity unexplained, a gap the authors say likely reflects differences in access to pain treatment, physically demanding labor, and health-system capacity that the available data could not fully capture.

Outside Experts Urge a Measured Reading

Independent pain specialists who reviewed the paper for Spain's Science Media Centre said the findings are valuable but should not be read as describing a single, unified condition called "pain."

"Pain should not be considered a single disease," said Javier Rivera, head of the rheumatology and fibromyalgia unit at Spain's National Pain Institute, who was not involved in the research. He noted that pain confined to one site can occur alongside chronic, generalized pain conditions such as fibromyalgia, which could make site-specific and whole-body pain appear more similar in the data than they actually are in patients.

Rivera also pointed to the study's biggest structural limitation: it is cross-sectional, meaning each data point reflects a different group of people measured once, rather than the same individuals tracked over time. That design means the age curves show how pain prevalence differs between age groups in the population at a given moment, not how any one person's pain necessarily changes as they grow older. The authors acknowledge the same limitation in the paper, noting that measurement methods also varied across the hundreds of studies pooled together, and that the reference curves capture age patterns rather than long-term trends within individuals.

Implications for Prevention and Research

The authors frame the findings as an argument for rethinking when pain prevention efforts begin. Because prevalence rises fastest before 55 rather than in retirement-age populations, where much chronic pain research and clinical attention has historically focused, the researchers argue that screening and prevention may need to start earlier in adulthood — and that strategies calibrated to high-income countries may not translate well to lower-resource settings, where the late-life pain burden is proportionally larger despite lower rates of smoking-, obesity- and income-related risk factors.

The open-access benchmarking tool the team built alongside the paper is meant to let hospitals, public-health agencies and other researchers plug in their own regional or clinical data and see how it compares with the global reference curves, potentially flagging populations whose pain burden is higher than the global norm would predict for their age and sex. Whether health systems act on that signal, particularly in lower-income regions where the gap was widest, is likely to shape how much practical difference the research makes beyond its academic contribution to pain epidemiology.