Most people picture pain as something that arrives late, with old joints and old age. A study published on October 5 in Nature Medicine suggests the build-up starts much earlier. Drawing on 6,125,459 people in 118 countries, the researchers found that self-reported pain climbs fastest before the age of 55, and that women report more of it than men at every one of the 11 body sites they examined.

What the researchers measured

The team pooled self-reported pain data from 902 population-based sources collected between 1990 and 2025, according to the paper as summarized by Healthline. Participants ranged from age 5 to over 100, and 55 percent were female. The 11 sites were the head, face, neck or shoulder, foot or ankle, hand or wrist, elbow, chest, back, stomach or abdomen, hip and knee.

They also looked at three broader measures: any bodily pain, high-intensity pain (an average of 7 or more on a 0 to 10 scale) and generalized pain, defined with the 2016 fibromyalgia criteria as pain in four of five body regions. The goal, the authors said, was a standard way to compare pain across ages and regions, something the field has lacked.

Back pain was the most commonly reported, affecting 40 percent of participants. Facial pain was the least common, at 2 percent.

Midlife is where the damage accumulates

The age pattern is the finding with the most practical weight. Any bodily pain rose steadily across the lifespan, from around 30 percent at age 5 to 70 percent among people aged 100 and older, Healthline reported. But the steepest increases came earlier. At musculoskeletal sites such as the hips, back and knees, prevalence rose fastest between ages 20 and 55, and kept climbing to peak at or beyond 75.

The more severe measures peaked in the middle of life instead. High-intensity pain peaked around age 50, and generalized pain around age 70, before both declined. Headache, abdominal and facial pain rose earlier and then fell, per the authors' account quoted by The Guardian.

That shape matters because prevention advice often waits until people are old. The data suggest most of the burden accumulates before midlife ends, which is when exercise, weight and smoking are still easier to change.

The gender gap, and what it does not explain

Women reported higher pain prevalence than men at all 11 sites. The gaps were biggest for facial pain, headache and abdominal pain, and all three broader measures were also higher in women.

Researchers outside the study urged caution on interpretation. Dr. Garg of the University of Cincinnati told that university's news service that the estimates reflect point or period prevalence rather than chronic pain, and that the reasons for the gap are complicated and include biological, hormonal and psychosocial factors. Most of the data are also cross-sectional, so they show age patterns across populations rather than changes in individual people over time.

A real gap is not the same as an explained gap. Self-reported pain depends on how people are asked, what they feel permitted to say and what they have been told to expect. This study documents that women report more pain, consistently and across the world. It does not settle why.

Smoking, weight and money

Smoking, obesity and lower household income together accounted for 18.3 percent of the global pain burden across all body sites, according to the study. Obesity was increasingly associated with pain from early adulthood, particularly in weight-bearing joints such as the knees, hips, feet and ankles. That is one reason the question of how early obesity is treated matters; our report on WHO's first child obesity guidelines covers where that debate stands for younger patients.

The income gradient is sharp in one place. People in the lowest income groups were more than twice as likely to report chest pain as those in the highest, with the gap widest in midlife and narrower in older age. Smokers reported modestly but consistently more pain from adolescence through age 65.

The map has holes

The authors chose self-reported pain rather than diagnoses deliberately, because estimates built on diagnoses can leave out people with limited access to healthcare, The Guardian reported. That is a strength. It is also why the limits deserve attention. The paper acknowledges different ways of measuring pain, uneven coverage across regions and thin data for the oldest and youngest age groups.

Dr. Roger Fillingim, a pain researcher, said one of the clearest goals of the work is to motivate more investment in collecting and maintaining high-quality pain data where it is currently weak. Without that data, it is harder to understand why the burden is so high at certain ages and which prevention or treatment strategies fit.

The number worth keeping from this study is not a percentage. It is 118 countries, a count that sounds comprehensive until you ask how many are represented by one old survey. A global pain map is only as good as the places someone bothered to ask.

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