Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies

Abstract

ObjectivesThere is little consensus regarding the burden of pain in the UK. The purpose of this review was to synthesise existing data on the prevalence of various chronic pain phenotypes in order to produce accurate and contemporary national estimates.DesignMajor electronic databases were searched for articles published after 1990, reporting population-based prevalence estimates of chronic pain (pain lasting >3 months), chronic widespread pain, fibromyalgia and chronic neuropathic pain. Pooled prevalence estimates were calculated for chronic pain and chronic widespread pain.ResultsOf the 1737 articles generated through our searches, 19 studies matched our inclusion criteria, presenting data from 139 933 adult residents of the UK. The prevalence of chronic pain, derived from 7 studies, ranged from 35.0% to 51.3% (pooled estimate 43.5%, 95% CIs 38.4% to 48.6%). The prevalence of moderate-severely disabling chronic pain (Von Korff grades III/IV), based on 4 studies, ranged from 10.4% to 14.3%. 12 studies stratified chronic pain prevalence by age group, demonstrating a trend towards increasing prevalence with increasing age from 14.3% in 18–25 years old, to 62% in the over 75 age group, although the prevalence of chronic pain in young people (18–39 years old) may be as high as 30%. Reported prevalence estimates were summarised for chronic widespread pain (pooled estimate 14.2%, 95% CI 12.3% to 16.1%; 5 studies), chronic neuropathic pain (8.2% to 8.9%; 2 studies) and fibromyalgia (5.4%; 1 study). Chronic pain was more common in female than male participants, across all measured phenotypes.ConclusionsChronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults, based on data from the best available published studies. This figure is likely to increase further in line with an ageing population.

Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations

“…Karen D. Davis 1,2,3 , Herta Flor 4 , Henry T. Greely 5 , Gian Domenico Iannetti 6 , Sean Mackey 7 , Markus Ploner 8 , Amanda Pustilnik 9,10 , Irene Tracey 11 , Rolf-Detlef Treede 12 and Tor D. Wager 13,14 Abstract | Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain.…”

“…Chronic pain is associated with enormous personal and societal costs; individuals with chronic pain often have a reduced quality of life and unmet therapeutic needs, and society is struggling to cope with the large numbers of people with this condition. Chronic pain affects up to 35% of the population, and costs of medical care and loss of wages and productivity are escalating [5][6][7] . Efforts to improve prevention, treatment and rehabilitation for patients with chronic pain are ongoing.…”

Opioid-induced constipation: Pathophysiology, treatment and management

“…Around one third to one half of the UK population report chronic pain (Fayaz et al, 2016) for which many are prescribed opioid analgesia (Moore et al, 2013). Around half of people admitted into palliative care are reported to experience constipation, with approximately 80% requiring laxatives, especially those taking opioid medications (Fallon andO'Neill, 1998 andSykes, 2013).…”

Gabapentin and Pregabalin: Do the Benefits Outweigh the Harms?

“…Chronic pain affects between a third and a half of the UK population and the moral imperative to treat pain has likely provoked the rise in opioid use. 6,7 UK guidelines for the management of chronic lower back pain recommend a step-wise approach to pharmacological management, and weak opioids are only considered if a NSAID is contraindicated or has been ineffective. 8 Unfortunately, however, many non-opioid analgesics have limited utility in clinical practice (for example, NSAIDs are a common cause of adverse drug reactions resulting in hospitalisation).…”