Featured research · Published in The Journal of Pain

Prevalence, Burden, and Factors Associated with Chronic Pain and High-Impact Chronic Pain in U.S. Adults, 2019–2023

Author: Michael Ray · The Journal of Pain (Elsevier), 2026 · Read the full published article

Featured on PainBeacon with the author's permission. The abstract below is reproduced from the published article; the plain-English summary that follows is written by PainBeacon and reflects our editorial interpretation, not the author's words.

Abstract

Given chronic pain remains a major public health concern and focus of national prevention and management objectives, this study examined temporal trends, a complementary prevalence-burden framework, and multilevel correlates of chronic pain and high-impact chronic pain across demographic, sociodemographic, health-related, mental health, and health care access, utilization, and affordability domains. Pooled data from 2019, 2021, and 2023 National Health Interview Survey (N=91,001 adults) were analyzed using survey-weighted logistic regression models sequentially adjusted by domain and fully adjusted for all covariates. Chronic pain prevalence increased from 20.5% in 2019 to 24.3% in 2023, while high-impact chronic pain rose from 7.5% to 8.5%. In fully adjusted models, higher odds of chronic pain were observed among adults aged ≥25 years, those experiencing socioeconomic disadvantage (unemployment, and poverty), individuals reporting poor self-rated health, rheumatic conditions, and frequent anxiety or depressive symptoms, and those reporting greater health care utilization and cost-related barriers to care and prescriptions. Sensitivity analyses using high-impact chronic pain as the outcome demonstrated similar or stronger associations across age groups and for socioeconomic disadvantage, depressive symptoms, health care utilization, and affordability barriers. These findings suggest that rising chronic pain and high-impact chronic pain are closely linked not only to socioeconomic and mental health factors, but also to health care access, utilization, and affordability context, supporting more equitable screening, care planning, and pain management strategies.

The PainBeacon plain-English summary

This summary is ours, not the author's. For the study itself, see the abstract above and the published article.

What the study looked at. Researchers pooled three waves of the National Health Interview Survey — 2019, 2021, and 2023 — covering 91,001 U.S. adults, one of the largest nationally representative samples used to track chronic pain. The analysis examined not just how many people have chronic pain, but how severely it burdens their daily lives, and which demographic, health, and healthcare-access factors are associated with it.

What it found.

Chronic pain rose from 20.5% of U.S. adults in 2019 to 24.3% in 2023 — more than 1 in 5 adults.
High-impact chronic pain — pain that limits life or work activities on most days or every day — rose from 7.5% to 8.5% over the same period, roughly 1 in 13 adults.
The study distinguishes prevalence (how many people have pain) from burden (how much it limits their lives) — a framing that matters for anyone deciding when pain warrants specialist care.
After adjusting for everything at once, chronic pain was more likely among adults 25 and older, people facing unemployment or poverty, those in poor self-rated health or with rheumatic conditions, those with frequent anxiety or depression symptoms — and, notably, people who use more healthcare and people who skip care or prescriptions because of cost.
The cost finding cuts both ways: pain drives people into the healthcare system, yet affordability barriers are tied to more chronic pain, not less. Access and affordability aren't side issues — the study suggests they're part of the picture itself.

Why it matters for patients. If you're living with chronic pain, you are far from alone — and the numbers are moving in the wrong direction, despite national goals (Healthy People 2030) to reduce high-impact chronic pain. For the millions of adults whose pain limits daily activities, timely access to qualified pain management care matters. That's the gap PainBeacon exists to help close: our own analysis found 61% of U.S. counties have no pain management clinic (see our pain care deserts study).

How to cite

Ray, B.M. (2026). Prevalence, burden, and factors associated with chronic pain and high-impact chronic pain in U.S. adults, 2019–2023. The Journal of Pain. https://www.jpain.org/article/S1526-5900(26)00129-X/abstract