Cited by 588Musculoskeletal pain and rehabilitationOpioid Use Disorder TreatmentPain Management and Opioid Use

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Chronic Pain Among Adults — United States, 2019–2021

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Rikard, S. Michaela, Strahan, Andrea E., Schmit, Kristine M., Guy, Gery P.·2023·MMWR. Morbidity and Mortality Weekly Report

DOI 10.15585/mmwr.mm7215a1PMC PMC10121254

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Abstract

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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FIGURE Prevalence of chronic pain* and high-impact chronic pain† among adults — United States, 2019–2021§,¶ * Pain reported on most days or every day during the previous 3 months. † Chronic pain that limited life or work activities on most days or every day during the previous 3 months. § Sample sizes for chronic pain and high-impact chronic pain were as follows: 2019 (n = 31,304; n = 31,281), 2020 (n = 31,126; n = 17,409), 2021 (n = 28,759; n = 28,740). Survey responses coded as “refused,” “don’t know,” “not ascertained,” or missing responses were excluded from the analysis. In 2020, the survey question used to define high-impact chronic pain was only included in quarters 3 and 4. Therefore, the sample size was smaller, and survey weights were doubled to produce annual estimates for high-impact chronic pain for 2020. ¶ With 95% CIs indicated with error bars.CC0 · PubMed Central

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Background
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“21 The efficient discovery and development of novel analgesics are urgently needed to address this crisis; however, progress has been challenging, with a probability of approval by the U.S. Food and Drug Administration (FDA) of only 0.7% for novel analgesics that have completed phase 1 studies…”
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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
ORCID: Rikard, S. Michaela
Strahan, Andrea E.
Schmit, Kristine M.
Guy, Gery P.
Venue: MMWR. Morbidity and Mortality Weekly Report
Publisher: Centers for Disease Control MMWR Office
Published: 2023-04-14
Volume: 72
Issue: 15
Pages: 379-385
ISSN: 0149-2195 (ISSN-L)
1545-861X
DOI: 10.15585/mmwr.mm7215a1
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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