Estimates of Pain Prevalence and Severity in Adults: United States, 2012

  • Richard L. Nahin
    Address reprint requests to Richard L. Nahin, PhD, MPH, National Center for Complementary and Integrative Health, National Institutes of Health, 6707 Democracy Blvd., Suite 401, Bethesda, MD 20892-5475.
    National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
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      • 2012 estimates of pain prevalence and severity are presented for U.S. adults.
      • A simple, 2-item measure for categorizing pain severity is introduced.
      • Pain persistence and bothersomeness designate 5 discrete categories of pain severity.
      • The study describes the concurrent validation of the measure.
      • Pain severity is associated with race, ethnicity, preferred language, sex, and age.


      Using a simple approach for coding pain severity, the present study describes self-reported pain in U.S. adults. Data are included for 8,781 adults who completed the Functioning and Disability Supplement of the 2012 National Health Interview Survey. An internationally piloted pain severity coding system was used to group participants into 5 discrete ordered pain categories based on their pain persistence (days with pain in the last 3 months) and bothersomeness (little, a lot, somewhere in between): pain free and categories 1 (low) to 4 (high). It is estimated that 126.1 million adults reported some pain in the previous 3 months, with 25.3 million adults (11.2%) suffering from daily (chronic) pain and 23.4 million (10.3%) reporting a lot of pain. Based on the persistence and bothersomeness of their pain, 14.4 million adults (6.4%) were classified as having the highest level of pain, category 4, with an additional 25.4 million adults (11.3%) experiencing category 3 pain. Individuals with category 3 or 4 pain were likely to have worse health status, to use more health care, and to suffer from more disability than those with less severe pain. Associations were seen between pain severity and selected demographic variables including race, ethnicity, preferred language, sex, and age.


      U.S. estimates of pain prevalence are presented using a simple approach for assigning pain severity developed by the Washington Group on Disability Statistics. Concurrent validity is assessed. Although this approach is promising, additional work is required to determine the usefulness of the Washington Group pain categories for pain research or clinical practice.

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