By Pat Anson, PNN Editor

A startling new study has concluded that the prevalence of chronic pain has grown substantially in the United States since 2002, affecting virtually every age group, sex, ethnicity and demographic. By 2018, over half of American adults (54%) reported having pain, with each birth group in greater pain than the one that came before it.

“You might think that with medical advances we’d be getting healthier and experiencing less pain, but the data strongly suggest the exact opposite,” said co-author Hanna Grol-Prokopczyk, PhD, an associate professor of sociology in the University at Buffalo College of Arts and Sciences.

“We looked at the data from every available perspective including age, gender, race, ethnicity, education, and income, but the results were always the same: There was an increase in pain no matter how we classified the population.”

Grol-Prokopczyk and her colleagues analyzed responses from over 441,000 people who participated in the National Health Interview Survey (NHIS) from 2002 to 2018. While research on pain trends usually focuses on people over age 50, they look at adults aged 25-84. The data was analyzed for reports of joint, low back, neck, face or jaw pain, along with headaches and migraines.

The research findings, published in the journal Demography, show that pain increased for each body site during the study period, especially for joint, low back and neck pain. Reports of pain in at least one site increased by 10%, representing an additional 10.5 million adults experiencing pain.

Not surprisingly, pain was most common in the oldest age group (65-84), with health problems such as high body mass index (BMI), hypertension, diabetes and kidney conditions correlating with increases in pain. Obesity was also associated with more pain in young and middle-aged adults, along with more stress and alcohol consumption.

“What we’re seeing in the younger age groups demonstrates how pain in some ways functions as much as a mental health problem as it does a physical health problem,” said Grol-Prokopczyk. “Pain can be exacerbated by stress, and stress can bring about alcohol use.”

Socioeconomic disparities are also involved. While pain increased for people in every income and education level, it rose faster for low-income Americans and those who never attended college.

“This study has documented steep, sustained, and pervasive increases in chronic pain among Americans across the adult life span. This is a concerning finding that should stimulate new research in demography and other social sciences. We found that key correlates of the rise in pain prevalence include not only specific diagnoses, such as arthritis, but also psychological distress, increased body weight, and heavier alcohol use -- factors that highlight the psychosocial roots of pain in populations,” researchers concluded.

Are Americans experiencing more pain or just reporting it more often? And what role, if any, did the opioid crisis play? The researchers found no definitive answers to either question, but they speculated that increased opioid use and awareness about pain may have led Americans to report pain more readily in the hope of getting it treated.

“Our findings in this study are not an argument for increased opioid use; in contrast, we posit that opioids may have contributed to the rise of pain prevalence in the United States,” they said.

That statement is puzzling, because opioid prescribing peaked in 2011 and has steadily declined ever since. The researchers apparently did not consider that more pain is being reported because it is often poorly treated or untreated.

A recent PNN survey of nearly 3,700 patients found that over 92% believe their pain levels and quality of life have grown worse. Over a third said they were unable to find a doctor to treat their pain and 58% said they were taken off opioids or tapered to a lower dose against their wishes.