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Chronic Pain Among Adults — United States, 2019–2021
Open accessAbstract
Chronic pain (i.e., pain lasting ≥3 months) is a debilitating condition that affects daily work and life activities for many adults in the United States and has been linked with depression (1), Alzheimer disease and related dementias (2), higher suicide risk (3), and substance use and misuse (4).During 2016, an estimated 50 million adults in the United States experienced chronic pain, resulting in substantial health care costs and lost productivity (5,6).Addressing chronic pain and improving the lives of persons living with pain is a public health imperative.Population research objectives in the National Pain Strategy, which was released in 2016 by the Interagency Pain Research Coordinating Committee, call for more precise estimates of the prevalence of chronic pain and high-impact chronic pain (i.e., chronic pain that results in substantial restriction to daily activities) in the general population and within various population groups to guide efforts to reduce the impact of chronic pain (3).Further, a 2022 review of U.S. chronic pain surveillance systems identified the National Health Interview Survey (NHIS) as the best source for pain surveillance data (7).CDC analyzed data from the 2019-2021 NHIS to provide updated estimates of the prevalence of chronic pain and highimpact chronic pain among adults in the United States and within population groups defined by demographic, geographic, socioeconomic, and health status characteristics.During 2021, an estimated 20.9% of U.S. adults (51.6 million persons) experienced chronic pain, and 6.9% (17.1 million persons) experienced high-impact chronic pain.New findings from this analysis include that non-Hispanic American Indian or Alaska Native (AI/AN) adults, adults identifying as bisexual, and adults who are divorced or separated are among the populations experiencing a higher prevalence of chronic pain and highimpact chronic pain.Clinicians, practices, health systems, and payers should vigilantly attend to health inequities and ensure access to appropriate, affordable, diversified, coordinated, and effective pain management care for all persons (8).NHIS is a cross-sectional, household survey of the civilian, noninstitutionalized population conducted annually by the National Center for Health Statistics (NCHS).*Data were analyzed using the 2019-2021 Sample Adult Interviews.† Survey questions used to estimate the prevalence of pain included, "In the past three months, how often did you have pain?Would you say never, some days, most days, or every day?" and "Over the past three months, how often did your pain limit your life or work activities?Would you say never, some days, most days, INSIDE 386 Secondary Cases of Invasive Disease Caused by Encapsulated and Nontypeable Haemophilus influenzae -10 U.S. Jurisdictions, 2011-2018 391 Update on Wild Poliovirus Type 1 Outbreak -Southeastern Africa, 2021-2022 398 Racial and Ethnic Disparities in Mpox Cases and Vaccination Among Adult Males -United States, May-December 2022 404 Epidemiologic and Clinical Features of Mpox-Associated Deaths -United States, May 10, 2022-March 7, 2023 411 Notes From the Field: Campylobacteriosis Outbreak Associated with Consumption of Raw Water -Montana, 2022 414 QuickStats
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“In the US, 30.1% of those with HICP are employed 2”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [2]
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“The mean age of the PATH participants (49.8 years) is also typical of the HICP population in the US (low 50s). 2”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [2]
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“Chronic pain is one of the most common chronic conditions in the United States based on multiple prevalence studies 1 with the most recent national estimate at 20.9% of US adults. 2”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [2]
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“The employment status, however, is not typical. In the US, 30.1% of those with HICP are employed 2 while 50% of the PATH participants are employed full-time, and 17% are employed part-time.”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [2]
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“67% of the participants were employed at least part-time vs only 30.1% of those with HICP in the US are employed. 2”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [2]
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Citations
Cites
Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016
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“6 Understanding barriers and facilitators of implementation of a pilot mind-body program for older adults with chronic pain in underserved clinics is important to make such programs more accessible and to minimize pain-related health disparities.”
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The effects of socioeconomic position on endogenous pain modulation: A quasi-experimental approach
Raghuraman, N., Akintola, T., Rassu, F. S., O’Connor, T. D., Chen, S., Gruber‐Baldini, A. L., & Colloca, L. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.104778 · Cited by 4
Bunnell, A. A., Marshall, E. M., Estes, S. K., Deadmond, M. C., Loesgen, S., & Strother, J. A. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115526 · Cited by 4
“Chronic pain affects more than 20 % of U.S. adults and current therapeutic approaches often have limited effectiveness or severe side effects [1].”
Therapeutic Uses and Efficacy of Low-Dose Naltrexone: A Scoping Review
Leiber, K. K., & Parker, R. W. (2025) · Cureus · doi:10.7759/cureus.81086 · Cited by 4
“Despite over 50 million Americans experiencing chronic pain each year, there are still minimal efficacious, inexpensive, and non-addictive treatment options [2].”
Effects of aging on experimentally induced pain perception during a distraction task
Fernández-Palacios, F. G., Tejera-Alonso, Á., Pacho-Hernández, J. C., Naeimi, A., De-la-Llave-Rincón, A. I., Ambite‐Quesada, S., Ortega‐Santiago, R., Fernández‐de‐las‐Peñas, C., Valera‐Calero, J. A., & Cigarán‐Méndez, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-94849-7 · Cited by 4
Centeno, M. V., Alam†, M. S., Haldar, K., & Apkarian, A. V. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105396 · Cited by 8
Investigation of the Relationship Between Perceived Mental Workload and Chronic Pain
Colpitts, K. N., Dias, J. L., Faulkenberry, T. J., & Bozer, A. L. H. (2023) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn28.4.247 · Cited by 3
Outcomes of Psychotherapy for Co-Morbid Pain and Substance Use Disorders: A Review of the Literature
Araque, S. J. M., Nguyen, L. T., & Nadal, C. N. (2024) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/15360288.2024.2393842 · Cited by 4
Lagunas, M.-A., Jin, J., Rivera, P. M., & Widman, C. (2025) · Journal of Health Psychology · doi:10.1177/13591053241312493 · Cited by 4
“About 15.4% of Hispanic and Latine adults in the U.S. experience chronic pain and 5.3% endorse high-impact pain that significantly disrupts daily activities (Rikard et al., 2023).”
InfluentialHolzer, K. J., Bernstein, H. W., Veasley, C., Haroutounian, S., Amtmann, D., Pederson, A. B., Reeve, B. B., Turk, D. C., Dworkin, R. H., & Langford, D. J. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105358 · Cited by 3
Johnson, H., Carper, R., English, R. A., Xia, Y., & Uhl, T. L. (2025) · JOSPT open. · doi:10.2519/josptopen.2025.0111 · Cited by 3
Impact of Pain Self-Efficacy on Health Outcomes in High-Impact Chronic Pain
You, D. S., Lannon, E. W., Kim, S., Dildine, T. C., Weber, K. A., II, Raney, E., & Mackey, S. (2025) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001295 · Cited by 3
Ke, Y., Wu, C., Cheng, Z., & Liang, M. (2025) · Journal of Pain Research · doi:10.2147/jpr.s521606 · Cited by 3
Li, B., Huang, Y., Liu, Q., Xiao, P., Li, L., & Zeng, K. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-101039 · Cited by 3
Babiloni, A. H., Alonso, B. F., Martel, M. O., Boggero, I. A., Lavigne, G. J., Goode, A. P., & Kapos, F. P. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105541 · Cited by 3
Personalised Transdermal Therapy for Chronic Pain with Digital Twin Technology
Porwal, S., Malviya, R., Sridhar, S. B., Shareef, J., Warsi, M. H., & Wadhwa, T. (1970) · Current Drug Targets · doi:10.2174/0113894501395522250903070018 · Cited by 3
Taccardi, D., Zacharias, A. M., Gowdy, H. G. M., Knezic, M., Parisien, M., Bisson, E. J., Fang, Z. Y., Stickley, S. A., Brown, E., Camiré, D., et al. (2025) · Journal of Clinical Investigation · doi:10.1172/jci188620 · Cited by 3
“This disease substantially impairs quality of life, resulting in a higher risk of anxiety and depression as well as reduced work and wages, creating a dependence on prescribed opioids used to treat the pain (3, 4).”
Majid, U., Hoppe, T., Priest, P., Lacroix, L., Held, N. J., Pedlar, D., & Kuluski, K. (2025) · Healthcare · doi:10.3390/healthcare13202655 · Cited by 3
Yu, C., Barr, A. B., Yang, Y., & Grol-Prokopczyk, H. (2025) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbaf220 · Cited by 3
“In 2021, approximately 20.9% of U.S. adults (i.e., 51.6 million) experienced chronic pain, and 6.9% (about 17.1 million) experienced high-impact (i.e., highly disabling) chronic pain (Rikard et al., 2023).”
InfluentialLawley, S., Green, A., Johnson, C., & Burton, M. D. (2025) · Neural Regeneration Research · doi:10.4103/nrr.nrr-d-25-00806 · Cited by 3
“The massive disease burden associated with chronic pain is an international health crisis estimated to affect 20.9% of U.S. adults and 27.5% of adults worldwide (Zimmer et al., 2022; Rikard, 2023).”
InfluentialInteroception-Based Yoga for Chronic Pain: A Pilot Feasibility Study
Voss, S., Patel, I., Skowron, C., Petruzzello, S. J., & Gothe, N. P. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251400362 · Cited by 3
“…train interoceptive attention (eg, via intentional breath regulation and mindful movement), it is also possible that in the absence of speci fi c cues 1 can move through yoga postures with little awareness of the breath or without consideration for using discomfort to inform the use of variations.”
A real-world database analysis of the prevalence of pain medication use in the United States
Lopez, A., Menzie, A. M., Kenderes, M., & Rubin, J. L. (2026) · PAIN Reports · doi:10.1097/pr9.0000000000001396 · Cited by 3
Decoding chronic pain: integrating genetics, neuroimaging, and AI for precision management
Uckac, B., Ogonowski, N. S., García‐Marín, L. M., Díaz‐Torres, S., Farrell, S. F., Nyholt, D. R., & Rentería, M. E. (2026) · Frontiers in Pain Research · doi:10.3389/fpain.2026.1747942 · Cited by 3
“In the United States, 20.9% of adults report chronic pain, and 6.9% experience high-impact pain associated with substantial disability (8).”
InfluentialOliva, F., Merola, M., Olivero, A., & Leombruni, P. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23030316 · Cited by 3
“This burden aligns with epidemiological evidence on chronic pain, including high-impact chronic pain, which contributes markedly to disability and healthcare demand [4,5].”
Schwandt, M. L., Ramchandani, V. A., Upadhyay, J., Ramsden, C. E., Diazgranados, N., & Goldman, D. A. (2024) · Alcohol · doi:10.1016/j.alcohol.2024.03.013 · Cited by 3
Li, P., Zhang, Q., Zheng, H., Qiao, Y., Snyder, G. L., Martin, T., Yao, W., Zhang, L., & Davis, R. E. (2024) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.4c00480 · Cited by 3
Meert, L., Picavet, H. S. J., Vervullens, S., Meeus, M., van Kuijk, S. M. J., Verschuren, W. M. M., & Smeets, R. (2024) · Clinical Rheumatology · doi:10.1007/s10067-024-07251-5 · Cited by 3
Sundlof, M., Switalla, K. M., Jones, E., Bahr, M., Doering, M., Martin, D., McCormick-Deaton, J., Melton, G. B., & Tignanelli, C. J. (2025) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000004529 · Cited by 4
Real-world healthcare utilization and costs of peripheral nerve stimulation with a micro-IPG system
Kalia, H., Thapa, B. B., Staats, P. S., Martin, P., Stetter, K., Feldman, B., & Marci, C. D. (2025) · Pain Management · doi:10.1080/17581869.2025.2449810 · Cited by 3
Justice, C., Haddow, S., Shafto, K., Reeves, T. J., Knox, J. E., & Prasad, A. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251322501 · Cited by 3
Follistatin, A Novel Therapeutic Target for Chronic Pain
Nie, H., & Liu, B. (2025) · Neuroscience Bulletin · doi:10.1007/s12264-025-01369-5 · Cited by 3
“According to a recent survey, the prevalence of chronic pain is estimated to be > 20% among the population [2].”
Najib, U., Cheng, E. M., Singh, R. B. H., Ayub, N., Nelson, S. E., Bushard, P. J., Jordan, J. T., Sico, J. J., Turbes, M., & Anderson, W. E. (2025) · Neurology · doi:10.1212/wnl.0000000000213544 · Cited by 3
Madden, E. F., Daulys, G., Tingey, B., Frabis, F., Lagisetty, P., Kroth, P. J., & Qeadan, F. (2025) · PAIN Reports · doi:10.1097/pr9.0000000000001261 · Cited by 3
Metadata
- Authors
- Rikard, S. M., Strahan, A. E., Schmit, K. M., & Guy, G. P.
- Affiliations
- National Center for Injury Prevention and Control (US)
- Corresponding author
- Rikard, S. Michaela
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2023-04-14
- Volume
- 72
- Issue
- 15
- Pages
- 379-385
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC10121254
- OpenAlex
- W4365442769
- Cited by
- 588
- References
- 8
- Citations by year
- 2026: 144 · 2025: 265 · 2024: 143 · 2023: 35
- FWCI
- 91.10
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- chronic pain, high-impact chronic pain, prevalence, adults, health disparities, American Indian and Alaska Native adults, bisexuals, marital status, socioeconomic status, pain management, National Health Interview Survey, health equity
- MeSH terms
- Adult, Health Status, Humans, Population Surveillance, United States, Prevalence, American Indian or Alaska Native, Chronic Pain, Pain Management
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