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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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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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Zebrowski, A., Fernandez, J., Pinkelton, C., Kitzmiller, R. R., Kiefer, A., Stanley, L., Mody, G. N., Moore, C., & Mazur, L. M. (2025) · doi:10.2196/preprints.90626
Narrative Review of Pain Management Among U.S. College Students
Schuller, K. A. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2025.12.013
Lashley, H., Holmes, S., Klinedinst, N. J., & Resnick, B. M. (2026) · Journal of Nursing Measurement · doi:10.1891/jnm-2025-0032
Ibemere, S. O., Knisely, M. R., Akpotu, I. C., Darby, J. E., de Martelly, V. A., Doorenbos, A. Z., Ezenwa, M. O., Matthie, N., Molokie, R. E., Schlaeger, J. M., et al. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2025.12.015
Sürmeli, M., özdemir, Ö. Ç., & Topcuoğlu, C. (2026) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-026-09535-0
“Pain is a complex and multidimensional experience and represents a significant public health challenge [1].”
Santos, C., & Tumin, D. (2026) · Southern Medical Journal · doi:10.14423/smj.0000000000001935
Cognitive decline in U.S. military veterans: risk factors and clinical implications
MacLennan, R. J., Chapin, B. A., Solberg, L. M., & Clark, D. J. (2026) · Frontiers in Dementia · doi:10.3389/frdem.2026.1704367
Shimada, S., Ledesma, S., Flynn, D. M., Tintle, N., Ransom, J. C., McQuinn, H. M., Snow, T. J., Ieronimakis, N. M., Wi, D., Burke, L., et al. (2026) · Biological Research For Nursing · doi:10.1177/10998004261423210
“While chronic pain is experienced by one in four adults across the US population overall, approximately one in three ADSMs are diagnosed with chronic pain (Reif et al., 2018; Rikard et al., 2023).”
Sex Differences in Pain Sensitivity Among Cognitively Healthy Older Adults
McDaniel, A. L., Boon, J. T., Monroe, T. B., Siva, A., Fletcher, A., Moss, K., Bruehl, S. P., Dietrich, M. S., Cowan, R. L., Crum, M., et al. (2026) · Biological Research For Nursing · doi:10.1177/10998004261422188
“Approximately 30% of older adults experience chronic pain annually, de fi ned as pain reported most days of the week for at least 3months (Rikard et al., 2023).”
Unique Issues When People Try to Beat the Compliance Drug Test (Adherence Testing)
Boyd, J. M., & McMillin, G. A. (2026) · Springer eBooks · doi:10.1007/978-3-032-15015-8_9
A qualitative analysis of healthcare professionals’ perspectives on goal adjustment in chronic pain
Roux, L., Gustin, S. M., & Newton-John, T. R. O. (2026) · British Journal of Pain · doi:10.1177/20494637261418200 · Cited by 1
Louie, P. (2026) · Society and Mental Health · doi:10.1177/21568693261419145
FDA 510(k) clearances for chronic pain devices: regulatory trends and safety outcomes from 1976–2025
Almarie, B., & Fregni, F. (2026) · Expert Review of Medical Devices · doi:10.1080/17434440.2026.2633305
Salikka, T., Kylmä, J., & Fröjd, S. A. (2026) · European Journal of Pain · doi:10.1002/ejp.70235
“Epidemiological data underscores the magnitude of chronic pain's impact, affecting an estimated 19% of adults in Europe (Breivik et al. 2006) and 20.9% of adults in the United States (Rikard et al. 2023).”
InfluentialMedicaid Coverage Restrictions and On-Label Buprenorphine Prescribing for Chronic Pain
Tiako, M. J. N., Abrams, M. P., & Taylor, E. P. (2026) · Journal of General Internal Medicine · doi:10.1007/s11606-026-10243-7
Understanding Psychotherapy Services: Crash Course for Physicians
Pilipenko, N. (2026) · Springer eBooks · doi:10.1007/978-3-032-12819-5_10
Liu, W., Peng, J., Zhao, L., Cheng, X., Leng, Y., Yang, J., Yu, Q., & Wang, C. (2026) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-026-09674-4
Occurrence of Musculoskeletal Pain in Pole Vaulters
Ježíková, K., & Sekereš, M. (2026) · Slovak Journal of Sport Science · doi:10.24040/sjss.2025.10.2.34-41
Bates, N., Huerta, P. L., Carraway, M., Zimmerman, J., Tumin, D., & Ryan, D. P. (2026) · Drugs & Aging · doi:10.1007/s40266-026-01289-7
To Join or Not to Join: A Nurse’s Story of “Why”
Oliver, J. E. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2026.02.009
DETECT: Data-Driven Evaluation of Treatments Enabled by Classification Transformers
Mao, Y., Yang, L., Yang, S., Shao, E., & Li, Z. (2025) · IEEE ... International Conference on Data Mining workshops · doi:10.1109/icdmw69685.2025.00431
Liu, Y., Liu, Q., Fu, Q., Gao, B., Xie, J., Ji, C., Ma, Y., 张宝平, & Liu, Y. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.108897
Jackson, G., Bejte, B., Penate, A., Reedy, M., Hanney, W. J., & Anderson, A. W. (2026) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2026.2642719
“Chronic pain is a highly prevalent condition impacting approximately 20% of individuals, with shoulder pain being the third most common anatomical location [1,2].”
Voss, S., Penna, S. L., Yum, A., Gothe, N. P., & Gagnon, C. M. (2026) · PM&R · doi:10.1002/pmrj.70110
Behavioral Interventions for Health Behaviors in Primary Care
Jackson, K., Montgomery, M., Daniel, R. M., Botello, R., Mixco, G., Mosley, T., Porter, D., Sekula, M. K. K., Swanson, J., Roberman, S., et al. (2026) · Springer eBooks · doi:10.1007/978-3-032-09558-9_9 · Cited by 1
Navigating sleep and pain challenges: Practical insights for nurse practitioners
Jackson, H., & Schmitt, T. L. (2026) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000001277
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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