Pain management spans medication, exercise, rehabilitation, complementary therapies and behavioral approaches. The statistics below distinguish broad musculoskeletal burden from U.S. chronic pain, define the populations measured, and show how treatment use and costs were recorded.
Key Pain Management Statistics
The following figures summarize the most broadly useful findings:
- In GBD 2019, 1.71 billion people worldwide lived with a musculoskeletal condition.
- In GBD 2019, low back pain affected an estimated 570 million people worldwide.
- In GBD 2019, musculoskeletal conditions produced about 149 million years lived with disability worldwide.
- In 2023, 24.3% of U.S. adults had chronic pain during the prior 3 months.
- In 2023, 8.5% of U.S. adults had high-impact chronic pain.
- U.S. adult chronic-pain prevalence increased from 20.4% in 2019 to 24.3% in 2023.
- In 2021, 51.6 million U.S. adults experienced chronic pain.
- In 2023, chronic pain affected 36.0% of U.S. adults age 65 and older.
- In 2023, chronic pain affected 31.4% of U.S. adults in nonmetropolitan areas.
- Among U.S. adults with chronic pain in 2020, 75.5% used over-the-counter pain relievers in the prior 3 months.
- Among U.S. adults with chronic pain in 2020, 55.0% used exercise.
- In 2020, 60.2% of U.S. adults with chronic pain used both pharmacologic and nonpharmacologic therapies.
- In 2021, mean annual medical spending was $16,437 for U.S. adults with chronic pain.
- In 2021, chronic pain was associated with $8,068 in additional annual medical spending per U.S. adult after adjustment.
- The modeled U.S. chronic-pain economic cost was $722.8 billion in 2021.
- In 2021, employed U.S. adults with chronic pain missed 6.9 workdays on average.
Contents
- Global pain management burden and musculoskeletal data
- U.S. chronic pain prevalence and trends
- Pain disparities by population and place
- Medication use in pain management
- Nonpharmacologic and multimodal pain management
- Pain management costs, work and outcomes
Global Pain Management Burden and Musculoskeletal Data
The World Health Organization reports that musculoskeletal conditions affected about 1.71 billion people worldwide in GBD 2019. This is a broad category rather than a single pain diagnosis, so it should not be read as the number of people seeking pain treatment.
The same WHO summary estimated about 149 million years lived with disability (YLDs) from musculoskeletal conditions, equal to 17% of all global YLDs in 2019. YLDs describe years lived with health-related disability and are not a count of patients.
| Condition, GBD 2019 | Estimated people worldwide | Disability measure |
|---|---|---|
| Low back pain | 570 million | 7.4% of global YLDs |
| Osteoarthritis | 528 million | 19 million YLDs |
| Fractures | 440 million | 26 million YLDs |
| Neck pain | 222 million | 22 million YLDs |
| Rheumatoid arthritis | 18 million | 2.4 million YLDs |
| Gout | 54 million | 1.7 million YLDs |
Source: World Health Organization, “Musculoskeletal health”. These are GBD 2019 estimates, and the conditions overlap conceptually with pain but are not interchangeable with chronic-pain prevalence.
U.S. Chronic Pain Prevalence and Pain Management Trends
CDC/NCHS defines chronic pain as pain on most days or every day during the prior 3 months. High-impact chronic pain adds a frequent limitation in life or work, making it a narrower measure of functional burden.
In the U.S. civilian noninstitutionalized adult population, chronic pain affected 24.3% in 2023, while high-impact chronic pain affected 8.5%. The comparable 2019 estimates were 20.4% and 7.4%, respectively.
| U.S. adult measure | 2019 | 2023 |
|---|---|---|
| Chronic pain | 20.4% | 24.3% |
| High-impact chronic pain | 7.4% | 8.5% |
Source: CDC/NCHS, “Chronic Pain and High-impact Chronic Pain in U.S. Adults, 2023”. The comparison uses separate NCHS survey years.
A separate CDC analysis of annual NHIS data found chronic-pain prevalence ranging from 20.5% to 21.8% during 2019–2021, while high-impact prevalence ranged from 6.9% to 7.8%. The 2020 high-impact question was asked only in quarters 3 and 4 and weighted to annualize; these are cross-sectional series rather than a longitudinal follow-up.
In 2021, an estimated 51.6 million U.S. adults experienced chronic pain, including 17.1 million with high-impact chronic pain. The estimates cover civilian noninstitutionalized adults.
Pain Management Statistics by Population and Place
Pain burden varied across demographic and geographic groups in the 2023 NCHS estimates. Women had chronic-pain prevalence of 25.4%, compared with 23.2% for men; high-impact pain was 9.6% among women and 7.3% among men.
Age differences were also substantial: chronic pain rose from 12.3% among adults ages 18–29 to 36.0% among adults age 65 and older. High-impact pain increased from 3.0% to 13.5% across the same age groups.
Selected 2023 comparisons were:
- Chronic pain was 30.7% among non-Hispanic American Indian/Alaska Native adults and 11.8% among non-Hispanic Asian adults.
- High-impact chronic pain was 12.7% in the non-Hispanic American Indian/Alaska Native group and 2.6% in the non-Hispanic Asian group.
- Chronic pain was 20.5% in large central metropolitan areas and 31.4% in nonmetropolitan areas.
- High-impact chronic pain was 7.3% in large central metropolitan areas and 11.5% in nonmetropolitan areas.
Source: CDC/NCHS, “Chronic Pain and High-impact Chronic Pain in U.S. Adults, 2023”. These are cross-sectional associations, not evidence that sex, age, race, or urbanization causes pain.
The 2021 CDC analysis adds further population detail. Age-adjusted high-impact pain was 12.8% among non-Hispanic American Indian/Alaska Native adults, compared with 2.1% among non-Hispanic Asian adults.
Age-adjusted chronic pain was 32.9% among bisexual adults, 19.3% among straight adults, and 20.7% among gay or lesbian adults.
Other 2021 estimates included 29.6% chronic pain among divorced or separated adults versus 18.2% among married adults, and high-impact pain of 10.1% versus 5.2%. Chronic pain was 21.6% among U.S.-born adults and 11.9% among adults born outside the United States.
Among adults reporting poor general health, chronic pain prevalence was 67.6% and high-impact prevalence 48.7% in 2021. Among adults reporting a disability, the corresponding figures were 52.4% and 32.0%; these measures are self-reported and observational.
Source: CDC, “Chronic Pain Among Adults — United States, 2019–2021”.
Medication Use in Pain Management
Among U.S. adults with chronic pain in 2020, 75.5% used over-the-counter pain relievers during the prior 3 months. Prescription nonopioids were reported by 31.3%, and prescription opioids by 13.5%.
Prescription opioid use declined from 15.2% in 2019 to 13.5% in 2020 in this population. The comparison comes from separate cross-sectional years, and access to care in 2020 was affected by the pandemic.
| Pharmacologic measure among U.S. adults with chronic pain | 2020 |
|---|---|
| Over-the-counter pain relievers | 75.5% |
| Prescription nonopioids | 31.3% |
| Prescription opioids | 13.5% |
| Pharmacologic therapy only | 26.6% |
| Nonopioid-only therapy | 22.4% |
| Opioid-only therapy | 1.0% |
Source: CDC, “Prevalence of Pharmacologic and Nonpharmacologic Pain Management Therapies Among Adults With Chronic Pain—United States, 2020”. Categories can overlap, and self-reported use does not establish misuse, adequacy, effectiveness, or treatment history.
Unadjusted prescription opioid use varied by age: 16.3% among adults age 65 and older versus 5.9% among adults ages 18–44 with chronic pain in 2020.
Nonpharmacologic and Multimodal Pain Management Participation
Nonpharmacologic approaches were common in the same 2020 survey. Exercise was reported by 55.0% of U.S. adults with chronic pain, while 36.7% used at least one complementary therapy.
Reported participation included:
- 17.2% used physical, rehabilitative, or occupational therapy.
- 17.8% used massage for pain, a measure of massage use rather than effectiveness or massage-chair products.
- 16.4% used meditation, guided imagery, or another relaxation technique.
- 11.4% used spinal manipulation or chiropractic care.
- 8.5% used yoga, tai chi, or qigong.
- 2.6% used talk therapy such as cognitive behavioral therapy.
The survey also captured combinations. 60.2% used both pharmacologic and nonpharmacologic therapies, while 50.9% used both nonopioid and nonpharmacologic therapy.
Another 8.4% used nonpharmacologic therapy only.
These figures represent any reported use over the relevant 3-month period, not coordinated multidisciplinary care, dosage, frequency, clinical response, or treatment success. Individual therapies alone were not reportable in some categories because of small samples.
Pain Management Costs, Work Disruption and Outcomes
A 2021 MEPS cost-of-illness analysis estimated mean annual medical spending at $16,437 for U.S. adults with chronic pain, compared with $5,382 for adults without chronic pain. The figures cover all medical spending, not pain-treatment bills alone.
| Annual measure, United States, 2021 dollars | With chronic pain | Without chronic pain |
|---|---|---|
| Mean medical spending | $16,437 | $5,382 |
| Out-of-pocket spending | $1,902 | $786 |
| Ambulatory-care spending | $7,352 | $2,046 |
| Prescription-medication spending | $4,007 | $1,278 |
Source: “Economic Costs of Chronic Pain—United States, 2021”. Prescription spending does not identify which medicines were used for pain, and ambulatory care includes office-based and outpatient visits.
After adjustment, chronic pain was associated with $8,068 in additional annual medical spending per U.S. adult and $2,923 in additional annual lost productivity. The modeled aggregate U.S. economic cost was $722.8 billion in 2021, comprising $530.6 billion in medical care and $192.2 billion in lost productivity; medical care represented 73.4% of those two modeled components.
Work disruption was also measurable. In 2021, 12.5% of adults with chronic pain were unable to work because of illness or injury, compared with 3.0% without chronic pain, and employed adults with chronic pain missed 6.9 workdays on average, compared with 3.5 days among employed adults without chronic pain.
The cost study is cross-sectional, and its associations do not prove that pain caused every measured expense or absence. Its modeled totals omit institutionalized populations, over-the-counter medicines, caregiver productivity, presenteeism, transportation, and intangible costs.