577: Mapping the Spatiotemporal Trajectories of Pain Across the Lifespan.

Topic: Education, Societal Impact, and Others
Subtopic: Epidemiology

Background and Aims: Pain is a leading cause of disability worldwide, yet global, age resolved reference estimates for common bodily pain sites are lacking. Existing prevalence estimates are fragmented, regionally biased, and often limited to single pain phenotypes. We aimed to construct global lifespan trajectories of self reported pain across multiple anatomical sites using harmonized individual participant data. Our objective was to characterize how pain prevalence and intensity vary by age, sex, anatomical site, and world region, and to provide population level benchmarks for clinical, epidemiological, and policy applications.

Methods: We harmonized individual participant data from 124 population based study programs spanning 113 countries (n >5.6 million; ages 5 to 90+). Pain presence was mapped across eleven anatomical sites and overall pain intensity where available. Hierarchical logistic mixed effects models with spline functions of age were used to estimate age specific prevalence, accounting for study level clustering and methodological heterogeneity. Models were stratified by sex and adjusted for recall window. Rate of change analyses identified periods of accelerated risk across the lifespan.

Results: Pain prevalence followed distinct, site specific lifespan patterns. Musculoskeletal pain (back, hip, knee, neck or shoulder) increased steadily from early adulthood, peaking in mid to late life. Non musculoskeletal pain (headache, abdominal, facial) rose sharply in adolescence, peaking in early adulthood before declining. Females exhibited higher prevalence across nearly all sites. Regional variation was modest for musculoskeletal pain but pronounced for headache. Rate of change analyses highlighted adolescence and midlife as key periods of risk acceleration, varying by pain site.

Conclusions: This study provides the first global, age resolved reference trajectories for self reported pain across multiple anatomical sites. Pain is not a uniform phenomenon but follows site, sex, and age specific patterns that differ across regions. These normative trajectories offer a benchmark for identifying atypical pain burden, informing prevention strategies, and forecasting population level demand for pain care across the lifespan.

References: 1. Woolf, C. J. (2010). Overcoming obstacles to developing new analgesics. Nature Medicine, 16(11), 1241–1247.
2. Rahim-Williams, B., Riley III, J. L., Williams, A. K., & Fillingim, R. B. (2012). A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter?. Pain Medicine, 13(4), 522-540.

Presenting Author: Matt Fillingim
Submitting Author: Matt Fillingim

Senior Author: Etienne Vachon-Presseau

IASP 2026 Global Year theme of Neuropathic Pain: No

• Etienne Vachon-Presseau: PhD - McGill University