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. 2025 Apr;19(2):125-137.
doi: 10.1177/20494637241310697. Epub 2024 Dec 24.

Global and regional trends and projections of chronic pain from 1990 to 2035: Analyses based on global burden of diseases study 2019

Mengyi Zhu  1 , Jiarui Zhang  2 , Diefei Liang  3 , Junxiong Qiu  2 , Yuan Fu  2 , Zhaopei Zeng  2 , Jingjun Han  4 , Junmeng Zheng  2 , Liling Lin  5
Affiliations

Global and regional trends and projections of chronic pain from 1990 to 2035: Analyses based on global burden of diseases study 2019

Mengyi Zhu et al. Br J Pain. 2025 Apr.

Abstract

Background: Chronic pain poses a significant public health challenge. We present the global and regional data on Prevalence, Incidence and Years Lived with Disability (YLDs) for Chronic pain from the Global burden of disease (GBD) study 2019 data and analyze their associations with Socio-demographic index (SDI), age, and gender, and the future trends from 2020 to 2035.

Methods: Regional trends in the burden of chronic pain and its association with age, gender, and SDI were assessed from 1990 to 2019. Joinpoint analysis was employed to describe trends in chronic pain burden across different SDI regions. Additionally, the Bayesian Age-Period-Cohort model (BAPC) was used for predicting future trends. Age-standardized rates (ASRs) of prevalence, incidence, and YLDs were employed to quantify the burden of chronic pain.

Results: Between 1990 and 2019, a significant increase was observed in global prevalence and YLDs rates of chronic pain. Higher rates were found among females, whereas a faster rise was noted among males. Notably, Low Back Pain (LBP) and Migraine accounted for predominant YLDs globally, particularly among those aged 75 and above. A notable prevalence of Tension-type Headache (TTH) was observed among younger populations. Furthermore, ASRs for chronic pain were highest in high-SDI regions. Projections suggest an increase in headache ASRs globally for both genders from 2020 to 2035.

Conclusion: From 1990 to 2019, the global burden of chronic pain increased significantly, with projections indicating a continued rise in headache burden over the next 15 years, underscoring the need for heightened attention to these issues.

Keywords: Bayesian age-period-cohort model; chronic pain; global burden of diseases study; headache; incidence; musculoskeletal disorders; prevalence; socio-demographic index; years lived with disability.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The percentages in ASIRs of seven conditions in different age groups, regions for males and females in 1990 and 2019, the trends in ASIRs of chronic pain and SDI in 21 regions for both sexes in 2019, and the trends in ASIRs of chronic pain in five different SDI regions in 2019. (a): The percentage in ASIRs of seven conditions in 20 age groups for males and females in 2019; (b): the percentage in ASIRs of seven conditions in 21 regions for both sexes in 1990 and 2019; (c): trends in ASIRs of Chronic pain and SDI in 21 regions for both sexes in 2019; (d): trends in ASIRs of Chronic pain in five SDI group regions for both sexes in 2019 and its APC. Abbreviation: ASIR: age-standardized incidence rate; APC: annual percent change; SDI: socio-demographic index.
Figure 2.
Figure 2.
National distribution of chronic pain ASIRs and AAPC for both genders in 2019 in 204 countries. (a): Distribution of ASIR of chronic pain; (b): distribution of AAPC of ASIR of chronic pain. Abbreviation: ASIR: age-standardized incidence rate; AAPC: average annual percent change.
Figure 3.
Figure 3.
The percentages in ASYRs of seven conditions in different age groups, regions for males and females in 1990 and 2019, the trends in ASYRs of Chronic pain and SDI in 21 regions for both sexes in 2019, and the trends in ASYRs of chronic pain in five different SDI regions in 2019. (a): The percentage in ASYRs of seven conditions in 20 age groups for males and females in 2019; (b): the percentage in ASYRs of seven conditions in 21 regions for both sexes in 1990 and 2019; (c): trends in ASYRs of chronic pain and SDI in 21 regions for both sexes in 2019; (d): trends in ASYRs of chronic pain in five SDI group regions for both sexes in 2019 and its APC. Abbreviation: ASYR: age-standardized YLDs rate; APC: annual percent change; SDI: socio-demographic index.
Figure 4.
Figure 4.
National distribution of chronic pain ASYRs and AAPC for both genders in 2019 in 204 countries. (a): Distribution of ASYR of chronic pain; (b): distribution of AAPC of ASYR of chronic pain. Abbreviation: ASYR: age-standardized YLDs rate; AAPC: average annual percent change.
Figure 5.
Figure 5.
Trends of ASPR and ASIR of chronic pain with headache and musculoskeletal disorders for males and females from 2020 to 2035. (a): Trends of ASPR of chronic pain with headache and musculoskeletal disorders for males and females from 2020 to 2035; (b): trends of ASIR of chronic pain with headache and musculoskeletal disorders for males and females from 2020 to 2035. Abbreviation: ASPR: age-standardized prevalence rate; ASIR: age-standardized incidence rate.
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