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Chronic pain continued to affect more than one in five U.S. adults, new CDC survey data showed.

During 2021, an estimated 51.6 million adults (20.9%) had chronic pain lasting 3 months or longer, and 17.1 million (6.9%) had high-impact chronic pain -- pain severe enough to restrict daily activities -- reported S. Michaela Rikard, PhD, of the CDC's National Center for Injury Prevention and Control, and co-authors.

Pain prevalence was higher in adults who were American Indian or Alaska Native, who identified as bisexual, or who were divorced or separated, the researchers said in .

"Clinicians, practices, health systems, and payers should vigilantly attend to health inequities and ensure access to appropriate, affordable, diversified, coordinated, and effective pain management care for all persons," Rikard and colleagues wrote.

The 2022 provides recommendations about multimodal approaches to pain management and strategies to reduce pain care disparities, the researchers stated. "In addition, that address primary injury prevention, improved access to affordable, culturally responsive health care, and more effective pain management therapies can mitigate the burden of chronic pain," they pointed out.

The prevalence of chronic pain in 2021 was similar to the prepandemic estimate of 20.4% in 2016, Rikard and co-authors noted.

The new findings come from the 2019-2021 (NHIS), a cross-sectional poll conducted annually by the National Center for Health Statistics. Sample sizes and response rates for the NHIS were 31,997 adults in 2019 with a response rate of 61.1%; 31,568 in 2020 with a response rate of 48.9%; and 29,482 in 2021 with a response rate of 50.9%.

Consistent with previous surveys, chronic pain was defined as pain most days or every day in the previous 3 months. High-impact chronic pain was defined as chronic pain that limited daily life or work activities most days or every day in the previous 3 months. Pain prevalence was adjusted for age.

Chronic pain prevalence ranged from 28.0% in American Indian or Alaska Native populations to 7.7% in Asian populations. High-impact pain was 12.8% in American Indian or Alaska Native respondents, but considerably less in white (6.5%) and Asian (2.1%) adults.

Among people identifying as bisexual, chronic pain prevalence was 32.9%, and was lower in people who identified as straight (19.3%) and gay or lesbian (20.7%).

Divorced or separated people had a higher prevalence of both chronic pain and high-impact chronic pain (29.6% and 10.1%, respectively) than married people (18.2% and 5.2%, respectively).

Among all chronic medical conditions reported in the survey, the prevalence of chronic pain and high-impact chronic pain was highest among people with a history of myalgic encephalomyelitis/chronic fatigue syndrome (70.0% and 43.8%, respectively) or dementia (54.9% and 34.2%, respectively).

The findings have several limitations, Rikard and co-authors acknowledged. Military personnel and people in nursing homes and other institutions were excluded from the study, they noted. Survey responses were self-reported and subject to recall bias. In addition, the COVID-19 pandemic affected data collection and changed health care access and utilization, which may have influenced results.

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