Graded chronic pain status—An epidemiologic evaluation

Von Korff, Michael; Dworkin, Samuel F.; Le Resche, Linda

doi:10.1016/0304-3959(90)91125-3

Cited by 488Musculoskeletal pain and rehabilitationPediatric Pain Management TechniquesPain Management and Opioid Use

Graded chronic pain status—An epidemiologic evaluation

Von Korff, Michael, Dworkin, Samuel F., Le Resche, Linda·1990·Pain

DOI 10.1016/0304-3959(90)91125-3

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Abstract

In epidemiologic research on chronic pain, differentiation of recurrent, persistent and disabling pain states is critical in the investigation of burden, natural history, effective intervention and causal processes. We report population-based data concerning the development and evaluation of a graded classification of pain status. In a probability sample of 1016 health maintenance organization enrollees, recurrent or persistent pain was observed in 45%; severe and persistent pain in 8%; severe and persistent pain with 7 or more days of pain-related activity limitation in 2.7%; and severe, persistent pain with activity limitation and 3 or more indicators of pain dysfunction in 1.0% of the population sample. Graded chronic pain status was associated with psychological impairment, unfavorable appraisal of health status, and frequency of use of pain medications and health care. The presence of severe and persistent pain increased the likelihood of multiple indicators of pain dysfunction, but there was considerable heterogeneity in pain dysfunction among persons with comparable pain experience. Our data suggest grading chronic pain in terms of 3 axes: time (persistence); severity; and impact (disability and dysfunctional illness behaviors).

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Definitions based solely on pain duration do not consider the multidimensional nature of chronic pain, namely activity limitations and participation restrictions.
“Although conceptually appealing, this hotly debated7 approach does not consider the multidimensional nature of chronic pain, namely, the presence of activity limitations and participation restrictions,5,17,30–36 classifications recognized by the World Health Organization.37”
From Prevalence and Profile of High-Impact Chronic Pain in the United States (2019) · cites this paper as [32]

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Authors: Von Korff, M., Dworkin, S. F., & Le Resche, L.
Affiliations: University of Washington (US)
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1990-03
Volume: 40
Issue: 3
Pages: 279-291
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/0304-3959(90)91125-3
OpenAlex: W2073924607
Cited by: 488
References: 23
Citations by year: 2026: 2 · 2025: 10 · 2024: 7 · 2023: 9 · 2022: 12 · 2021: 23 · 2020: 12 · 2019: 10 · 2018: 15 · 2017: 7 · 2016: 17 · 2015: 18 · 2014: 18 · 2013: 25 · 2012: 23
FWCI: 9.23
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01de007197-03)
National Institute of Dental and Craniofacial Research (DE07197)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: chronic pain, pain intensity, pain persistence, pain-related disability, activity limitation, psychological impairment, analgesic use, health care utilization, natural history of pain
MeSH terms: Chronic Disease, Disability Evaluation, Female, Health Maintenance Organizations, Humans, Male, Pain, Pain Measurement, Surveys and Questionnaires, Sick Role, Socioeconomic Factors, Time Factors, Confounding Factors, Epidemiologic, Prevalence

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Graded chronic pain status—An epidemiologic evaluation

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