Pain is often associated with advancing age, but a sweeping global analysis suggests that the steepest rise in bodily pain may occur much earlier in life — before the age of 55. The findings challenge the common perception that aches and discomfort steadily accumulate only in old age, highlighting how pain affects people across different stages of life and varies significantly between populations.
The study, published in the journal Nature Medicine, analysed self-reported pain data from more than 6.1 million people aged five to over 100 across 118 countries and territories. It found that pain prevalence increased most sharply before the age of 55 across the body areas examined, although the pattern differed depending on the type of pain.
The findings also revealed substantial differences in the prevalence of pain across anatomical regions, with back pain emerging as the most common complaint and facial pain among the least prevalent. While approximately 40 per cent of people reported back pain, the prevalence of facial pain was around two per cent.
Researchers, including those from Canada’s McGill University, examined pain affecting 11 body areas, including the face, head, neck and shoulder, chest, abdomen, back, hip, knee, foot and ankle. Across all these areas, women consistently reported more pain than men, with the widest differences observed in facial pain, headaches, and stomach or abdominal pain.
The analysis drew on data collected between 1990 and 2025, offering a broad picture of how pain is distributed across age groups, geographical regions and populations with different levels of socioeconomic development.
Pain remains a leading cause of disability worldwide, affecting mobility, everyday activities and quality of life. Yet comparing its prevalence across countries and age groups has long posed a challenge, partly because people experience and report pain differently and there is no universally standardised method for measuring self-reported pain.
The researchers noted that estimates based on diagnosed medical conditions may fail to capture the full extent of the problem, particularly among people who have limited access to healthcare. Many people live with persistent discomfort without receiving a formal diagnosis, leaving an important part of the global pain burden underrepresented in conventional assessments. The study’s findings suggest that the relationship between pain and age is more complex than a simple, gradual increase over a lifetime. Although the overall prevalence of pain rose most steeply before 55, individual pain conditions followed different trajectories.
Headaches and abdominal pain, for instance, tended to peak earlier in life. In contrast, pain affecting the back, hip and knee continued to increase with age, reflecting the differing patterns associated with these complaints.
The findings underline the importance of looking beyond age alone when assessing pain. The stage of life at which pain becomes more prevalent may depend on the affected body area, while differences in living conditions and access to resources may further shape how frequently people experience discomfort.
DEVELOPMENT GAP IN PAIN
One of the study’s most striking findings concerned the relationship between pain and a country’s level of human development. From the age of 40, overall pain, joint pain and back pain increased more rapidly in countries with lower Human Development Index (HDI) values than in those with higher scores.
The gap became particularly pronounced among older people. By the age of 80 or above, the prevalence of any bodily pain was around 31 percentage points higher in countries with lower HDI values than in countries with higher HDI values. Low back pain was also nearly twice as common in the lower-development settings.
The Human Development Index takes into account indicators relating to health, education and income. The differences identified in the study point to the need to examine how broader social and economic circumstances may influence people’s experience of pain, alongside individual health and age.
Interestingly, established risk factors such as smoking, obesity and low income explained a smaller share of the pain burden in countries with lower levels of development. The researchers said the reasons behind the higher prevalence of pain in these settings remain unclear.
The findings therefore raise important questions about whether differences in working conditions, healthcare access, living environments and other unmeasured factors contribute to the pattern. However, the analysis did not establish which factors were responsible, and further research would be needed to determine the causes of the observed differences.
A CASE FOR EARLIER PREVENTION
The researchers said the findings could help improve comparisons of pain across populations and strengthen global efforts to monitor and prevent it. They also suggested that prevention strategies may need to begin earlier in life rather than focusing predominantly on older age groups.
The sharp rise in pain prevalence before 55 points to the importance of understanding pain during adulthood, when people may be balancing employment, family responsibilities and other demands of daily life. Identifying risk factors and addressing preventable causes earlier could help inform public health strategies, although the study did not directly test the effectiveness of any particular intervention.
At the same time, the differences between countries indicate that a single approach may not adequately address the global burden.
Prevention and pain-management policies may need to account for regional circumstances, population needs and inequalities in access to healthcare.
The researchers cautioned, however, that the findings have an important limitation. Most of the data analysed were collected at a single point in time, meaning the study compared people from different age groups rather than tracking the same individuals as they grew older.
Consequently, the results show how pain prevalence differs across ages but cannot establish precisely how an individual’s experience of pain changes over a lifetime. Further longitudinal research would be needed to follow people over time and better understand the factors driving these patterns.
Even with this limitation, the analysis provides a wide-ranging assessment of the global distribution of pain and challenges the assumption that its burden is concentrated mainly in old age. Its central message is that pain can become increasingly common well before later life, with the timing and extent of that rise shaped by the type of pain and the circumstances in which people live.
For researchers and policymakers, the findings offer a broader basis for understanding pain as a public health concern — one that warrants attention across the lifespan and requires approaches sensitive to differences between populations. (Agencies)