Edited by Anushree Chaphalkar
Medscape Pain
TOPLINE:
The prevalence of chronic and high-impact chronic pain increased significantly in US adults from 2019 to 2023, with long COVID accounting for approximately 13% of both increases, new research showed.
METHODOLOGY:
- Researchers analyzed data for more than 90,000 adults from three cross-sectional waves of the National Health Interview Survey (2019, 2021, and 2023).
- The primary outcomes were chronic pain (pain on most or every day over the previous 3 months) and high-impact chronic pain (pain that limits activities on most or every day).
- Also assessed were six site-specific types of pain: back pain; arm, shoulder, or hand pain; hip, knee, or leg pain; headache or migraine; abdominal, pelvic, or genital pain; and tooth or jaw pain.
- Covariates included demographics, socioeconomic status, health behaviors, physical health conditions, mental health, health insurance type, and long COVID.
TAKEAWAY:
- The prevalence of chronic pain increased significantly from 21% in 2019 to 24% in 2023, representing an 18% overall increase; prevalence of high-impact chronic pain increased from 8% to 9%, representing a 13% overall increase (both, P < .001). Each condition affected 60 and 21 million US adults, respectively, in 2023.
- From 2019 to 2023, pain prevalence increased across all examined body sites except for teeth/jaw, with a significant increase in back/neck pain (P < .001), arm/shoulder pain (P = .03), hip/knee/leg pain (P = .006), headache/migraine (P < .001), and abdominal/pelvic pain (P < .001).
- Long COVID accounted for about 13% of the increase in prevalence of both chronic and high-impact chronic pain during the study period, and for up to 40% of the increase in some of the site-specific pain types, especially arm/shoulder pain.
- Conventional demographic, health, and socioeconomic covariates, along with long COVID, did not fully explain the observed increase in pain prevalence post-pandemic, indicating the potential role of broader systemic factors.
IN PRACTICE:
“We found that chronic pain, already a widespread health problem, reached an all-time high prevalence in the post-pandemic era, necessitating urgent attention and interventions to address and alleviate this growing health crisis,” the investigators wrote.
“Our findings should be replicated with other nationally representative data sources, and a broader set of potential explanatory factors should be used to explain the post-pandemic trends,” they added.
LIMITATIONS:
The study’s cross-sectional design prevented the establishment of causality. Survey method changes, declining response rates, increased telephone interviews, and a major questionnaire redesign may have influenced pain prevalence estimates over time. All covariates were self-reported and increased the chance of recall error — particularly concerning long COVID reports, where both over- and underreporting were possible because of the condition’s complexity and recent emergence. Additionally, the study included only noninstitutionalized adults and derived sex from Social Security records, limiting the generalizability of the findings.