Chronic pain is among the most common chronic conditions in the United States, but estimates of its prevalence and impact vary widely. In 2019, the National Center for Health Statistics of the Centers for Disease Control and Prevention added a new set of questions relating to pain to its National Health Interview Survey (NHIS), a large household-based annual survey that offers valuable insights into the health statuses of U.S. adults nationwide. In an article published in Pain, researchers from Brigham and Women's Hospital and Mass Eye and Ear report that 50.2 million (20.5%) U.S. adults experience chronic pain based on analysis of the new NHIS data. They estimated the total value of lost productivity due to chronic pain to be nearly $300 billion annually.

"Chronic pain is a serious condition that affects millions of Americans," said corresponding author R. Jason Yong, MD, MBA, medical director of the Pain Management Center at the Brigham and associate chief of pain in the Department of Anesthesiology, Perioperative, and Pain Medicine. "Other studies have touched on this fact, but data from pain clinics, hospitals and other providers tends to only provide information on people seeking out medical attention. Having the NHIS data to validate previous studies is incredibly impactful."

The authors found that respondents with chronic pain reported missing significantly more workdays compared to those without chronic pain (10.3 days versus 2.8). They used these figures to quantify the total economic impact of chronic pain on Americans, which they estimated to be $79.9 billion in lost wages. Those with chronic pain also reported more limitations to their engagement in social activities and activities of daily living. Back, hip, knee and foot pain were the most common sources of pain reported, and physical therapy and massage therapy were most commonly sought as treatments.

"The impetus for our study arose from the day-to-day clinical finding that many of our chronic sinusitis patients also reported headache, migraine and other forms of chronic pain," said senior author Neil Bhattacharyya, MD, MA, FACS, professor of Otolaryngology — Head and Neck Surgery at Mass Eye and Ear. "We decided to look at the bigger picture of chronic pain, and we were somewhat surprised at the large-scale presence of chronic pain in the US."

The 2019 NHIS included data from 31,997 adults across the nation. When the data was first published in May, investigators decided to focus their initial analysis on ascertaining national estimates of prevalence and impact, but plan to conduct further analysis of other questions included in the survey. This may reveal more specific trends related to pain and its treatment across the U.S., especially regarding opioid use.

"Given the overall scale and impact of pain on Americans, we see that a multimodal, multidisciplinary approach to treating pain is even more important than what we have been emphasizing over the past few decades," Yong said. "Pain medicine is relatively young as a field, and it encompasses specialties including emergency medicine, anesthesia, psychiatry, neurology, physiatry and radiology. We need all of the tools in our armamentarium to treat patients suffering from chronic pain."