New chronic pain — defined as pain on most days or every day for more than 3 months — occurred more frequently than other common chronic conditions, according to a US survey.
The incidence of chronic pain was 52.4 cases per 1,000 person-years, report Richard Nahin, MPH, PhD, of the NIH in Bethesda, Maryland, and coauthors.
This is higher for diabetes (7.1 cases/1,000 person-years), depression (15.9 cases) and hypertension (45.3 cases), the researchers said. JAMA Network Open.
Moreover, chronic pain was persistent: nearly two-thirds (61.4%) of adults with chronic pain in 2019 had it in 2020.
The findings are from the National Health Interview Survey (NHIS) data and the first estimates of the incidence of chronic pain at the national level.
Recent NHIS data shows that chronic pain accounts for about 21% of the US population, affecting approximately 51.6 million adults. High-impact chronic pain – a severe illness that limits daily activities – affects 17.1 million people.
“Understanding the phenomenon beyond the overall prevalence is critical to understanding how chronic pain manifests and changes over time,” Nahin said in a statement. “These data on the development of pain emphasize the need for the use of multidisciplinary, multidisciplinary interventions to change pain perception and improve people’s outcomes.”
The NHIS is an annual survey conducted by the National Center for Health Statistics. Nahin and colleagues evaluated 10,415 adults who participated in the 2019 and 2020 surveys. Participants with chronic pain at both time points were considered to have persistent chronic pain.
The sample consisted of 51.7% women. More than half of the study population — 54% — aged 18 to 49. The majority of participants (72.6%) were white; 16.5% were Hispanic and 12.2% were black. Most (70.5%) were not college graduates.
At baseline (2019), 40.3% of participants reported no pain, 38.9% reported persistent pain, and 20.8% reported chronic pain.
In the year For those without pain in 2019, the incidence rate of chronic pain was 52.4/1,000 cases (95% CI 44.9–59.9). The hazard ratio for high impact chronic pain was 12.0 (95% CI 8.2-15.8). Regardless of pain status in 2019, lower education and older age were associated with higher long-term pain in 2020.
In the year In 2020, rates of persistent chronic pain and persistent high-impact chronic pain were 462.0 and 361.2 cases per 1,000 person-years, respectively.
In the year Of those reporting non-chronic pain in 2019, 14.9% progressed to chronic pain at follow-up. In the year Among those reporting chronic pain in 2019, 10.4% were fully recovered (pain free) by 2020.
Although chronic pain is sometimes thought to last indefinitely, our finding that 10.4% of adults with chronic pain improved over time is consistent with previous evidence from studies in Denmark, Norway, Sweden and the United Kingdom, where rates ranged from 5.4%. up to 8.7%,” the researchers pointed out.
The study did not include information on the causes of pain and survey data was collected only twice during the 2-year follow-up, Nahin and co-authors admitted. People with new or persistent chronic pain or high-impact chronic pain may have been less likely to participate in the 2020 follow-up survey, leading to underestimated rates.
Researchers stated that there is no conflict of interest.
JAMA Network Open
Source reference: Nahin RL, et al. “Estimated Risk Rates and Persistent Chronic Pain Among US Adults, 2019-2020” JAMA Netw Open 2023; DOI:10.1001/jamanetworkopen.2023.13563.