By Louise M. Klebanoff, MD

Assistant Professor of Clinical Neurology, Weill Cornell Medical College

Dr. Klebanoff reports no financial relationships relevant to this field of study.

SYNOPSIS: Chronic and disabling pain is a common and serious cause of morbidity among U.S. adults.

SOURCE: Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact pain among adults – United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001-1006.

Chronic pain is one of the most common reasons adults seek medical care. Chronic pain is associated with multiple physical and psychological conditions that contribute to restricted mobility and daily activities, dependence on opioids, anxiety and depression, and poor perceived health or reduced quality of life. In turn, this leads to high healthcare costs and lost productivity. One of the nation’s science-based health objectives is to decrease the prevalence of adults experiencing high-impact chronic pain.

To estimate the prevalence of chronic pain in the United States, the CDC analyzed data from the 2016 National Health Interview Survey. Chronic pain was defined as pain on most days or every day in the past six months. High-impact chronic pain was defined as chronic pain that limited life or work activities on most days or every day during the last six months. Based on this survey, about 50 million U.S. adults reported chronic pain, with 19.6 million experiencing high-impact chronic pain. Higher prevalence of chronic pain and chronic high-impact pain was seen in women, older adults, adults who previously but not currently were employed, adults living in poverty, those with public health insurance, and those in rural regions. The age-adjusted prevalence of chronic pain was significantly lower among adults with a college degree. There were no significant racial or ethnic differences in those with chronic high-impact pain, although non-Hispanic white adults reported more chronic pain than other ethnic/racial subgroups.

Annually, chronic pain accounts for an estimated $560 billion in direct medical costs, lost productivity, and disability programs. Identifying populations at risk is the first step for developing targeted interventions for pain management.

COMMENTARY

Chronic pain is a common, multidimensional medical condition that contributes to high healthcare costs, lost productivity, and poor quality of life, and fuels the current opioid epidemic. High-impact chronic pain refers to pain that is frequent and disabling. The results of this study help quantify the prevalence of high-impact chronic pain and, by identifying specific patient populations at risk, will help inform targeted interventions.