Pain is the leading cause of disability worldwide, yet no population-based reference exists against which individual cohorts, clinical populations, or countries can be benchmarked. Here, we harmonised individual-level self-reported pain data from 6,075,021 participants across 894 population-based data sources in 118 countries to establish global reference trajectories of pain across the lifespan, implemented in an open-access benchmarking platform. Pain prevalence ranged from 2.5% for facial pain to 45.0% for back pain, was consistently higher in women across all eleven anatomical sites (risk ratio range 1.09 to 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 nearly twice the late-life prevalence of any bodily pain compared with those in the highest (risk difference 31.8 percentage points [95% CI 30.1–33.6]). Globally, 18.3% of site-specific pain burden 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 drivers of pain in lower-HDI settings remain poorly characterised.

TT reports research funding, consulting fees, or lecture fees from Daiichi Sankyo Healthcare Co., Ltd., Johnson & Johnson K.K., Data Seed Inc., Workout-Plus LLC, EMMA Co., Ltd., Addness Inc., and CotoIT Inc. within the past 36 months. TB reports advisory or consultancy roles for AGB Pharma, Eyelevel, Infectopharm, Medice, Neurim Pharmaceuticals, Oberberg GmbH, and Takeda; conference support or speaker fees from Janssen-Cilag, Medice, and Takeda; and royalties from Hogrefe, Kohlhammer, CIP Medien, and Oxford University Press. GJB reports honoraria from GE Healthcare for teaching on scanner programming courses. LP reports advisory or consultancy roles for Roche and Vifor Pharma, speaker fees from Shire, and royalties from Hogrefe, Kohlhammer, and Schattauer. All other authors declare no competing interests.

This work was supported by the Canadian Institutes of Health Research (RN441786-453096), the Fonds de recherche du Quebec en Sante (283687), the Reseau quebecois de recherche sur la douleur, and the Louise and Alan Edwards Grants in Pain Research (to E.V.P.); by the Louise and Alan Edwards Foundation (to M.F.).

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This study was granted ethical approval under McGill Faculty of Medicine and Health Sciences IRB Study Number A12-M69-23B (23-10-068).

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