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A Nature Medicine study analyzed self-reported pain data from more than 6.1 million people across 118 countries and territories. It found that pain does not rise uniformly with age: several types peak before 55, while back, hip and knee pain tend to increase into older age. Reported pain was higher among women across all 11 anatomical sites studied, and some pain measures rose more steeply in countries with lower Human Development Index values.
A global analysis of 6.1 million people in 118 countries and territories found that pain follows different patterns across the lifespan: headaches and several other pain types tend to peak before age 55, while back, hip and knee pain generally rise into older age. Published in Nature Medicine, the study also found that women reported more pain than men across all 11 anatomical sites examined, and that pain prevalence in older age differed by countries’ Human Development Index (HDI) levels.
The researchers analyzed self-reported pain data from 6,125,459 participants in 902 population-based data sources. Participants were aged 5 to over 100, 55% were female, and the underlying studies had been conducted between 1990 and 2025. The analysis covered 11 anatomical sites and produced estimates by age and global region.
Reported prevalence varied substantially by site, ranging from 2% for facial pain to 40% for back pain. Women’s reported prevalence was higher across all 11 sites. The largest relative differences were for facial pain, headache and stomach or abdominal pain: women reported prevalence levels 83%, 74% and 60% higher than men, respectively, according to the study.
The age patterns were not uniform. Prevalence of back, hip and knee pain rose most rapidly between ages 20 and 55 and continued increasing, reaching its highest levels at or beyond age 75. By contrast, seven of the 11 pain types peaked in mid-to-late adulthood and declined later; the pattern was most apparent for headache, abdominal pain, neck or shoulder pain, elbow pain and facial pain. Any bodily pain increased from about 30% at age five to 70% among people aged 100 or older, while high-intensity pain peaked around 50 and generalized pain around 70 before declining.
Pain Patterns Differ by Age and Place
The results challenge the idea that pain simply rises steadily with age. They suggest that the timing of pain burden depends on the body site: some complaints are more prevalent earlier, while lower-body musculoskeletal pain tends to continue rising among older adults. That distinction could help researchers compare populations and identify when prevention or services may be most relevant, although the study does not establish that any specific intervention will reduce pain.
Differences by national development level also point to unequal experiences in later life. From age 40, estimates for any bodily pain, joint pain and back pain rose more steeply in countries with lower HDI values. At the oldest ages, low back pain prevalence in low-HDI countries was nearly twice that in high-HDI countries. These comparisons describe population patterns; they do not show that HDI itself causes pain or explain the mechanisms behind the gap.
The authors also examined smoking, obesity and low household income. Their analysis estimated that these three factors collectively accounted for about 18% of site-specific pain burden globally. The estimate varied by region, from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. Because these are modeled associations, they should not be read as proof that the factors caused that share of pain in each individual.
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Why Researchers Built Global Curves
Pain is a major contributor to disability, but there is no objective biomarker that measures it. Researchers therefore often rely on people’s reports of their symptoms. Existing global estimates, including those from the Global Burden of Disease study, draw largely on clinically defined conditions and modeled data from different sources. Such estimates support disease surveillance but may miss people with limited access to health care.
Population surveys collect pain reports more directly, but comparisons are difficult: surveys may ask different questions, refer to different time periods, or define body locations differently. The study’s authors combined data from hundreds of sources to estimate patterns across age and geography. The resulting curves are intended as reference points for comparisons among countries, cohorts and clinical populations—not as individual forecasts or diagnoses.
The findings also refine the distinction between pain sites. The study reported that upper-body pain, including neck, shoulder and elbow pain, tended to peak earlier and decline later, whereas lower-body musculoskeletal pain more often continued to rise. The authors suggested that prevention may need to begin earlier in life and be tailored to the type of pain, but the analysis itself did not test prevention programs.
“Pain does not increase linearly with age.”
— The study authors, as summarized by News-Medical
Limits of the Pain Estimates
The estimates rely on self-reported data drawn from surveys that differed in their questions, timeframes and anatomical definitions. The researchers sought to harmonize those sources, but the underlying variation may affect comparisons. The study describes reported prevalence and does not provide an objective measure of pain or establish why the patterns occur.
It is also unclear from the reported findings how much of the differences between countries reflects access to diagnosis and care, work and living conditions, survey methods, or other unmeasured factors. The analysis links smoking, obesity and low income with greater pain prevalence, but does not prove those factors caused the reported pain. The study’s population-level curves also cannot predict an individual’s experience.
How Researchers May Use the Curves
The reference estimates can be used to compare pain patterns across populations and to assess whether a particular cohort or clinical group differs from the broader age-specific patterns. Further research will be needed to explain why pain prevalence diverges in older age across HDI groups and to examine factors that were not fully captured in the analysis.
The authors’ findings point toward studying prevention at different stages of life and by pain site. No specific follow-up study, intervention trial or policy change is identified in the source report. Until such work is available, the curves should be treated as a description of reported population patterns rather than evidence that a particular approach will prevent or treat pain.
Key Questions
How many people and countries did the study cover?
The analysis included 6,125,459 people from 902 population-based data sources in 118 countries and territories. Participants ranged from age 5 to over 100.
Does pain generally increase with age?
Not in the same way for every type. Back, hip and knee pain tended to rise into older age, while several types—including headache and abdominal pain—peaked earlier and declined later. Any bodily pain increased across the lifespan in the study’s estimates.
What differences did the study report between women and men?
Women reported higher prevalence across all 11 anatomical sites studied. The largest reported differences were for facial pain, headache and stomach or abdominal pain. These are population-level comparisons, not explanations of why the differences occur.
What does the study say about countries with lower HDI?
From age 40, estimates for any bodily pain, joint pain and back pain rose more steeply in low-HDI countries. At the oldest ages, low back pain prevalence was nearly twice the estimate for high-HDI countries. The study does not establish the causes of that gap.
Can the findings explain what causes a person’s pain?
No. The study describes reported patterns across populations and identifies associations with factors such as smoking, obesity and low household income. It does not determine the cause of an individual’s pain or test a treatment.
Source: rss
