Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries

Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries Publisher

Summary: Who bears the greatest pain burden? A global analysis found late-life bodily pain markedly higher in low-development regions, challenging earlier estimates. #GlobalHealth #PainResearch

Fillingim M ; Tanguay Sabourin C ; Neuert L ; Zare A ; Norman J ; Guglietti G V ; Hobeika L ; Ayorinde A ; Salimzadeh A ; Jamshidi A R ; Alenazi A M ; Tehrani Banihashemi A ; Alqahtani B A ; Olaya B Show All Authors

Fillingim M
Tanguay Sabourin C
Neuert L
Zare A
Norman J
Guglietti G V
Hobeika L
Ayorinde A
Salimzadeh A
Jamshidi A R
Alenazi A M
Tehrani Banihashemi A
Alqahtani B A
Olaya B
Mbenza B L
Oladeji B
Penninx B
Paudyal B
De Melo C
Berna C
Humberg C
Claudepierre P
Smith E
Vandenkerkhof E
Giltay E J
Garcia Esquinas E
Parlindungan F
Abbasi F Q
Artalejo F R
Jones G T
Slade G
Bouziri H
Flor H
Iso H
Gilron I
Uthman I
Pelaez Ballestas I
Nzambi J P D
Ayuso Mateos J L
Haro J M
Wager J
De Souza J B
Nakamura K
Yamada K
Rau L M
Talih M
Beasley M J
Duenas M
Zins M
Miret M
Wake M
Pratama M Z
Almalki M
Chaaya M
Anshory M
Kondo N
Moghadam N
Mansor N
Alsaed O
Keeratisiroj O
Gureje O
Kurniari P K
Noormohammadpour P
Lebughe P
Elzahaf R A
Kordi R
Lucas R
Bhandari R P
Telles R W
Hidayat R
Samreen S
Al Emadi S
Barreto S M
Roknsharifi S
Inoue S
Adhikari S
Wibowo S A K
Sharma S
Villeneuve S
Tabuchi T
Khursheed T
Yamato T
Jackson T
Santos V S
Siritaratiwat W
Liu X
Liu Z Z
Schumann G
Wirsching P
Whelan R
Walter H
Vaidya N
Hohmann S
Smolka M N
Poustka L
Paus T
Orfanos D P
Nees F
Artiges E
Martinot M L P
Martinot J L
Lemaitre H
Heinz A
Grigis A
Gowland P
Desrivieres S
Bruhl R
Bokde A L W
Barker G J
Banaschewski T
Sawyer S M
Khalatbari Soltani S
Steingrimsdottir O A
Macfarlane G J
Blyth F
Vachon Presseau E

Source: Nature Medicine Published:2026

Abstract

Pain is the leading cause of disability worldwide, yet no harmonized self-reported reference framework exists to characterize how its burden is distributed across the lifespan and world regions. In this study, we harmonized individual-level self-reported pain data from 6,125,459 participants across 902 population-based data sources in 118 countries to establish global reference trajectories of pain. We implemented these trajectories in an open-access benchmarking platform for positioning external datasets against global pain norms. Pain prevalence ranged from roughly 2% for facial pain to 40% for back pain, was consistently higher in women across all 11 anatomical sites (risk ratio range: 1.08−1.83) and increased most steeply before age 55 years. Contrary to existing estimates that generally project higher prevalence of pain conditions in higher Human Development Index (HDI) regions, we found that individuals in the lowest HDI countries experienced a substantially higher late-life prevalence of any bodily pain than those in the highest (risk difference: 30.6 percentage points (95% confidence interval: 26.9−34.3)), with low back pain approaching twice the prevalence at the oldest ages. Globally, 18.3% of pain burden across anatomical sites was attributable to three modifiable risk factors (smoking, obesity and low income), but this varied from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe, indicating that the factors underlying pain in lower-HDI settings remain poorly characterized. Together, these reference trajectories provide a common framework for defining and comparing pain burden and informing more equitable global surveillance and prevention. © The Author(s) 2026.

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Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries

Style	Citing Format
MLA	Fillingim M, et al.. "Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries." Nature Medicine, vol. , no. , 2026, pp. -.
APA	Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, Hobeika L, Ayorinde A, Salimzadeh A, Jamshidi A R, Alenazi A M, Tehrani Banihashemi A, Alqahtani B A, Olaya B, Mbenza B L, Oladeji B, Penninx B, Paudyal B, De Melo C, ... Vachon Presseau E (2026). Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries. Nature Medicine, (), -.
Chicago	Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, Hobeika L, et al.. "Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries." Nature Medicine , no. (2026): -.
Harvard	Fillingim M et al. (2026) 'Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries', Nature Medicine, (), pp. -.
Vancouver	Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, et al.. Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries. Nature Medicine. 2026;():-.
BibTex	@article{ author = {Fillingim M and Tanguay Sabourin C and Neuert L and Zare A and Norman J and Guglietti G V and Hobeika L and Ayorinde A and Salimzadeh A and Jamshidi A R and Alenazi A M and Tehrani Banihashemi A and Alqahtani B A and Olaya B and Mbenza B L and Oladeji B and Penninx B and Paudyal B and De Melo C and Berna C and Humberg C and Claudepierre P and Smith E and Vandenkerkhof E and Giltay E J and Garcia Esquinas E and Parlindungan F and Abbasi F Q and Artalejo F R and Jones G T and Slade G and Bouziri H and Flor H and Iso H and Gilron I and Uthman I and Pelaez Ballestas I and Nzambi J P D and Ayuso Mateos J L and Haro J M and Wager J and De Souza J B and Nakamura K and Yamada K and Rau L M and Talih M and Beasley M J and Duenas M and Zins M and Miret M and Wake M and Pratama M Z and Almalki M and Chaaya M and Anshory M and Kondo N and Moghadam N and Mansor N and Alsaed O and Keeratisiroj O and Gureje O and Kurniari P K and Noormohammadpour P and Lebughe P and Elzahaf R A and Kordi R and Lucas R and Bhandari R P and Telles R W and Hidayat R and Samreen S and Al Emadi S and Barreto S M and Roknsharifi S and Inoue S and Adhikari S and Wibowo S A K and Sharma S and Villeneuve S and Tabuchi T and Khursheed T and Yamato T and Jackson T and Santos V S and Siritaratiwat W and Liu X and Liu Z Z and Schumann G and Wirsching P and Whelan R and Walter H and Vaidya N and Hohmann S and Smolka M N and Poustka L and Paus T and Orfanos D P and Nees F and Artiges E and Martinot M L P and Martinot J L and Lemaitre H and Heinz A and Grigis A and Gowland P and Desrivieres S and Bruhl R and Bokde A L W and Barker G J and Banaschewski T and Sawyer S M and Khalatbari Soltani S and Steingrimsdottir O A and Macfarlane G J and Blyth F and Vachon Presseau E}, title = {Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries}, journal = {Nature Medicine}, volume = {}, number = {}, pages = {-}, year = {2026} }
RIS	TY - JOUR AU - Fillingim M AU - Tanguay Sabourin C AU - Neuert L AU - Zare A AU - Norman J AU - Guglietti G V AU - Hobeika L AU - Ayorinde A AU - Salimzadeh A AU - Jamshidi A R AU - Alenazi A M AU - Tehrani Banihashemi A AU - Alqahtani B A AU - Olaya B AU - Mbenza B L AU - Oladeji B AU - Penninx B AU - Paudyal B AU - De Melo C AU - Berna C AU - Humberg C AU - Claudepierre P AU - Smith E AU - Vandenkerkhof E AU - Giltay E J AU - Garcia Esquinas E AU - Parlindungan F AU - Abbasi F Q AU - Artalejo F R AU - Jones G T AU - Slade G AU - Bouziri H AU - Flor H AU - Iso H AU - Gilron I AU - Uthman I AU - Pelaez Ballestas I AU - Nzambi J P D AU - Ayuso Mateos J L AU - Haro J M AU - Wager J AU - De Souza J B AU - Nakamura K AU - Yamada K AU - Rau L M AU - Talih M AU - Beasley M J AU - Duenas M AU - Zins M AU - Miret M AU - Wake M AU - Pratama M Z AU - Almalki M AU - Chaaya M AU - Anshory M AU - Kondo N AU - Moghadam N AU - Mansor N AU - Alsaed O AU - Keeratisiroj O AU - Gureje O AU - Kurniari P K AU - Noormohammadpour P AU - Lebughe P AU - Elzahaf R A AU - Kordi R AU - Lucas R AU - Bhandari R P AU - Telles R W AU - Hidayat R AU - Samreen S AU - Al Emadi S AU - Barreto S M AU - Roknsharifi S AU - Inoue S AU - Adhikari S AU - Wibowo S A K AU - Sharma S AU - Villeneuve S AU - Tabuchi T AU - Khursheed T AU - Yamato T AU - Jackson T AU - Santos V S AU - Siritaratiwat W AU - Liu X AU - Liu Z Z AU - Schumann G AU - Wirsching P AU - Whelan R AU - Walter H AU - Vaidya N AU - Hohmann S AU - Smolka M N AU - Poustka L AU - Paus T AU - Orfanos D P AU - Nees F AU - Artiges E AU - Martinot M L P AU - Martinot J L AU - Lemaitre H AU - Heinz A AU - Grigis A AU - Gowland P AU - Desrivieres S AU - Bruhl R AU - Bokde A L W AU - Barker G J AU - Banaschewski T AU - Sawyer S M AU - Khalatbari Soltani S AU - Steingrimsdottir O A AU - Macfarlane G J AU - Blyth F AU - Vachon Presseau E TI - Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries JO - Nature Medicine VL - IS - SP - EP - PY - 2026 ER -

Style

Citing Format

MLA

Fillingim M, et al.. "Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries." Nature Medicine, vol. , no. , 2026, pp. -.

APA

Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, Hobeika L, Ayorinde A, Salimzadeh A, Jamshidi A R, Alenazi A M, Tehrani Banihashemi A, Alqahtani B A, Olaya B, Mbenza B L, Oladeji B, Penninx B, Paudyal B, De Melo C, ... Vachon Presseau E (2026). Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries. Nature Medicine, (), -.

Chicago

Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, Hobeika L, et al.. "Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries." Nature Medicine , no. (2026): -.

Harvard

Fillingim M et al. (2026) 'Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries', Nature Medicine, (), pp. -.

Vancouver

Fillingim M, Tanguay Sabourin C, Neuert L, Zare A, Norman J, Guglietti G V, et al.. Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries. Nature Medicine. 2026;():-.

BibTex

@article{ author = {Fillingim M and Tanguay Sabourin C and Neuert L and Zare A and Norman J and Guglietti G V and Hobeika L and Ayorinde A and Salimzadeh A and Jamshidi A R and Alenazi A M and Tehrani Banihashemi A and Alqahtani B A and Olaya B and Mbenza B L and Oladeji B and Penninx B and Paudyal B and De Melo C and Berna C and Humberg C and Claudepierre P and Smith E and Vandenkerkhof E and Giltay E J and Garcia Esquinas E and Parlindungan F and Abbasi F Q and Artalejo F R and Jones G T and Slade G and Bouziri H and Flor H and Iso H and Gilron I and Uthman I and Pelaez Ballestas I and Nzambi J P D and Ayuso Mateos J L and Haro J M and Wager J and De Souza J B and Nakamura K and Yamada K and Rau L M and Talih M and Beasley M J and Duenas M and Zins M and Miret M and Wake M and Pratama M Z and Almalki M and Chaaya M and Anshory M and Kondo N and Moghadam N and Mansor N and Alsaed O and Keeratisiroj O and Gureje O and Kurniari P K and Noormohammadpour P and Lebughe P and Elzahaf R A and Kordi R and Lucas R and Bhandari R P and Telles R W and Hidayat R and Samreen S and Al Emadi S and Barreto S M and Roknsharifi S and Inoue S and Adhikari S and Wibowo S A K and Sharma S and Villeneuve S and Tabuchi T and Khursheed T and Yamato T and Jackson T and Santos V S and Siritaratiwat W and Liu X and Liu Z Z and Schumann G and Wirsching P and Whelan R and Walter H and Vaidya N and Hohmann S and Smolka M N and Poustka L and Paus T and Orfanos D P and Nees F and Artiges E and Martinot M L P and Martinot J L and Lemaitre H and Heinz A and Grigis A and Gowland P and Desrivieres S and Bruhl R and Bokde A L W and Barker G J and Banaschewski T and Sawyer S M and Khalatbari Soltani S and Steingrimsdottir O A and Macfarlane G J and Blyth F and Vachon Presseau E}, title = {Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries}, journal = {Nature Medicine}, volume = {}, number = {}, pages = {-}, year = {2026} }

RIS

TY - JOUR
AU - Fillingim M
AU - Tanguay Sabourin C
AU - Neuert L
AU - Zare A
AU - Norman J
AU - Guglietti G V
AU - Hobeika L
AU - Ayorinde A
AU - Salimzadeh A
AU - Jamshidi A R
AU - Alenazi A M
AU - Tehrani Banihashemi A
AU - Alqahtani B A
AU - Olaya B
AU - Mbenza B L
AU - Oladeji B
AU - Penninx B
AU - Paudyal B
AU - De Melo C
AU - Berna C
AU - Humberg C
AU - Claudepierre P
AU - Smith E
AU - Vandenkerkhof E
AU - Giltay E J
AU - Garcia Esquinas E
AU - Parlindungan F
AU - Abbasi F Q
AU - Artalejo F R
AU - Jones G T
AU - Slade G
AU - Bouziri H
AU - Flor H
AU - Iso H
AU - Gilron I
AU - Uthman I
AU - Pelaez Ballestas I
AU - Nzambi J P D
AU - Ayuso Mateos J L
AU - Haro J M
AU - Wager J
AU - De Souza J B
AU - Nakamura K
AU - Yamada K
AU - Rau L M
AU - Talih M
AU - Beasley M J
AU - Duenas M
AU - Zins M
AU - Miret M
AU - Wake M
AU - Pratama M Z
AU - Almalki M
AU - Chaaya M
AU - Anshory M
AU - Kondo N
AU - Moghadam N
AU - Mansor N
AU - Alsaed O
AU - Keeratisiroj O
AU - Gureje O
AU - Kurniari P K
AU - Noormohammadpour P
AU - Lebughe P
AU - Elzahaf R A
AU - Kordi R
AU - Lucas R
AU - Bhandari R P
AU - Telles R W
AU - Hidayat R
AU - Samreen S
AU - Al Emadi S
AU - Barreto S M
AU - Roknsharifi S
AU - Inoue S
AU - Adhikari S
AU - Wibowo S A K
AU - Sharma S
AU - Villeneuve S
AU - Tabuchi T
AU - Khursheed T
AU - Yamato T
AU - Jackson T
AU - Santos V S
AU - Siritaratiwat W
AU - Liu X
AU - Liu Z Z
AU - Schumann G
AU - Wirsching P
AU - Whelan R
AU - Walter H
AU - Vaidya N
AU - Hohmann S
AU - Smolka M N
AU - Poustka L
AU - Paus T
AU - Orfanos D P
AU - Nees F
AU - Artiges E
AU - Martinot M L P
AU - Martinot J L
AU - Lemaitre H
AU - Heinz A
AU - Grigis A
AU - Gowland P
AU - Desrivieres S
AU - Bruhl R
AU - Bokde A L W
AU - Barker G J
AU - Banaschewski T
AU - Sawyer S M
AU - Khalatbari Soltani S
AU - Steingrimsdottir O A
AU - Macfarlane G J
AU - Blyth F
AU - Vachon Presseau E
TI - Global and Regional Reference Curves for Pain Across the Lifespan in 6.1 Million Individuals in 118 Countries
JO - Nature Medicine
VL -
IS -
SP -
EP -
PY - 2026
ER -

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