{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T20:22:48Z","timestamp":1794601368879,"version":"4.9.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Gouvernement du Canada | Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["453096"],"award-info":[{"award-number":["453096"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Louise and Alan Edwards Foundation\u2019s Edwards Foundation","id":[{"id":"https:\/\/ror.org\/021435c82","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pain is the leading cause of disability worldwide, yet no harmonized self-reported reference framework exists to characterize how its burden is distributed across the lifespan and world regions. In this study, we harmonized individual-level self-reported pain data from 6,125,459 participants across 902 population-based data sources in 118 countries to establish global reference trajectories of pain. We implemented these trajectories in an open-access benchmarking platform for positioning external datasets against global pain norms. Pain prevalence ranged from roughly 2% for facial pain to 40% for back pain, was consistently higher in women across all 11 anatomical sites (risk ratio range: 1.08\u22121.83) and increased most steeply before age 55\u2009years. 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 a substantially higher late-life prevalence of any bodily pain than those in the highest (risk difference: 30.6 percentage points (95% confidence interval: 26.9\u221234.3)), with low back pain approaching twice the prevalence at the oldest ages. Globally, 18.3% of pain burden across anatomical sites 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 factors underlying pain in lower-HDI settings remain poorly characterized. Together, these reference trajectories provide a common framework for defining and comparing pain burden and informing more equitable global surveillance and prevention.<\/jats:p>","DOI":"10.1038\/s41591-026-04696-w","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:03:23Z","timestamp":1791212603000},"page":"4298-4306","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Global and regional reference curves for pain across the lifespan in 6.1 million individuals in 118 countries"],"prefix":"10.1038","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4774-1565","authenticated-orcid":false,"given":"Matt","family":"Fillingim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0426-8322","authenticated-orcid":false,"given":"Christophe","family":"Tanguay-Sabourin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Neuert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azin","family":"Zare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jax","family":"Norman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca V.","family":"Guglietti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-7187","authenticated-orcid":false,"given":"Lise","family":"Hobeika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abimbola","family":"Ayorinde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Salimzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad-reza","family":"Jamshidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aqeel M.","family":"Alenazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Tehrani-Banihashemi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8275-6906","authenticated-orcid":false,"given":"Bader A.","family":"Alqahtani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Olaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin Longo","family":"Mbenza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bibilola","family":"Oladeji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-9672","authenticated-orcid":false,"given":"Brenda","family":"Penninx","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Buddhi","family":"Paudyal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caique","family":"de Melo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Berna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarissa","family":"Humberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Claudepierre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"VanDenKerkhof","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik J.","family":"Giltay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Garcia-Esquinas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-0408","authenticated-orcid":false,"given":"Faisal","family":"Parlindungan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima Qayyum","family":"Abbasi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Rodr\u00edguez","family":"Artalejo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0016-7591","authenticated-orcid":false,"given":"Gareth T.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Slade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-3700","authenticated-orcid":false,"given":"Hanifa","family":"Bouziri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-5398","authenticated-orcid":false,"given":"Herta","family":"Flor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9241-7289","authenticated-orcid":false,"given":"Hiroyasu","family":"Iso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5293-8792","authenticated-orcid":false,"given":"Ian","family":"Gilron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-6483","authenticated-orcid":false,"given":"Imad","family":"Uthman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingris","family":"Pel\u00e1ez-Ballestas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Paul Divengi","family":"Nzambi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luis","family":"Ayuso-Mateos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Maria","family":"Haro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Wager","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-052X","authenticated-orcid":false,"given":"Juliana Barcellos","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutoshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5144-7166","authenticated-orcid":false,"given":"Lisa-Marie","family":"Rau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8834-5016","authenticated-orcid":false,"given":"Makram","family":"Talih","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6045-386X","authenticated-orcid":false,"given":"Marcus J.","family":"Beasley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4822-7258","authenticated-orcid":false,"given":"Mar\u00eda","family":"Due\u00f1as","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-4282","authenticated-orcid":false,"given":"Marie","family":"Zins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3252-854X","authenticated-orcid":false,"given":"Marta","family":"Miret","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Wake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirza Zaka","family":"Pratama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Almalki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Chaaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2214-5238","authenticated-orcid":false,"given":"Muhammad","family":"Anshory","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-8195","authenticated-orcid":false,"given":"Navid","family":"Moghadam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norma","family":"Mansor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Alsaed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orawan","family":"Keeratisiroj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oye","family":"Gureje","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pande Ketut","family":"Kurniari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pardis","family":"Noormohammadpour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4984-0452","authenticated-orcid":false,"given":"Pierrot","family":"Lebughe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raga A.","family":"Elzahaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Kordi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi Parekh","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa Weiss","family":"Telles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudy","family":"Hidayat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Samreen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samar","family":"Al-Emadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7383-7811","authenticated-orcid":false,"given":"Sandhi Maria","family":"Barreto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shima","family":"RoknSharifi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-3425","authenticated-orcid":false,"given":"Sudeep","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suryo Anggoro Kusumo","family":"Wibowo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sweekriti","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2338-0467","authenticated-orcid":false,"given":"Sylvia","family":"Villeneuve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-3125","authenticated-orcid":false,"given":"Takahiro","family":"Tabuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3083-4458","authenticated-orcid":false,"given":"Tayyeba","family":"Khursheed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tie","family":"Yamato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica Souza","family":"Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wantana","family":"Siritaratiwat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianchen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen-Zhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"IMAGEN Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4595-1144","authenticated-orcid":false,"given":"Tobias","family":"Banaschewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5214-7421","authenticated-orcid":false,"given":"Gareth J.","family":"Barker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0114-4914","authenticated-orcid":false,"given":"Arun L. W.","family":"Bokde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0111-5996","authenticated-orcid":false,"given":"R\u00fcdiger","family":"Br\u00fchl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-7060","authenticated-orcid":false,"given":"Sylvane","family":"Desrivi\u00e8res","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-4817","authenticated-orcid":false,"given":"Penny","family":"Gowland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Grigis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Heinz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5952-076X","authenticated-orcid":false,"given":"Herve","family":"Lemaitre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0136-0388","authenticated-orcid":false,"given":"Jean-Luc","family":"Martinot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0452-2450","authenticated-orcid":false,"given":"Marie-Laure Paillere","family":"Martinot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4461-7646","authenticated-orcid":false,"given":"Eric","family":"Artiges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-8234","authenticated-orcid":false,"given":"Frauke","family":"Nees","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1242-8990","authenticated-orcid":false,"given":"Dimitri Papadopoulos","family":"Orfanos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1495-9338","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Paus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luise","family":"Poustka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5398-5569","authenticated-orcid":false,"given":"Michael N.","family":"Smolka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hohmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilakshi","family":"Vaidya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-6121","authenticated-orcid":false,"given":"Henrik","family":"Walter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2790-7281","authenticated-orcid":false,"given":"Robert","family":"Whelan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-6846","authenticated-orcid":false,"given":"Paul","family":"Wirsching","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7740-6469","authenticated-orcid":false,"given":"Gunter","family":"Schumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Sawyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8437-1906","authenticated-orcid":false,"given":"Saman","family":"Khalatbari-Soltani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d3l\u00f6f Anna","family":"Steingr\u00edmsd\u00f3ttir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary J.","family":"Macfarlane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1128-6756","authenticated-orcid":false,"given":"Fiona","family":"Blyth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-3154","authenticated-orcid":false,"given":"Etienne","family":"Vachon-Presseau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"4696_CR1","doi-asserted-by":"publisher","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","volume":"5","author":"ML Ferreira","year":"2023","unstructured":"Ferreira, M. L. et al. Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 5, e316\u2013e329 (2023).","journal-title":"Lancet Rheumatol."},{"key":"4696_CR2","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","volume":"161","author":"SN Raja","year":"2020","unstructured":"Raja, S. N. et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain 161, 1976\u20131982 (2020).","journal-title":"Pain"},{"key":"4696_CR3","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1097\/j.pain.0000000000002557","volume":"163","author":"Z Zimmer","year":"2022","unstructured":"Zimmer, Z., Fraser, K., Grol-Prokopczyk, H. & Zajacova, A. A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain 163, 1740\u20131750 (2022).","journal-title":"Pain"},{"key":"4696_CR4","doi-asserted-by":"publisher","first-page":"e779","DOI":"10.1097\/PR9.0000000000000779","volume":"4","author":"KN S\u00e1","year":"2019","unstructured":"S\u00e1, K. N. et al. Prevalence of chronic pain in developing countries: systematic review and meta-analysis. Pain Rep. 4, e779 (2019).","journal-title":"Pain Rep."},{"key":"4696_CR5","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1097\/j.pain.0000000000001009","volume":"158","author":"\u00d3A Steingr\u00edmsd\u00f3ttir","year":"2017","unstructured":"Steingr\u00edmsd\u00f3ttir, \u00d3. A., Landmark, T., Macfarlane, G. J. & Nielsen, C. S. Defining chronic pain in epidemiological studies: a systematic review and meta-analysis. Pain 158, 2092\u20132107 (2017).","journal-title":"Pain"},{"key":"4696_CR6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.pain.2004.09.012","volume":"113","author":"RH Dworkin","year":"2005","unstructured":"Dworkin, R. H. et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 113, 9\u201319 (2005).","journal-title":"Pain"},{"key":"4696_CR7","doi-asserted-by":"publisher","first-page":"T10","DOI":"10.1016\/j.jpain.2015.08.010","volume":"17","author":"RB Fillingim","year":"2016","unstructured":"Fillingim, R. B., Loeser, J. D., Baron, R. & Edwards, R. R. Assessment of chronic pain: domains, methods, and mechanisms. J. Pain 17, T10\u2013T20 (2016).","journal-title":"J. Pain"},{"key":"4696_CR8","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","volume":"46","author":"F Wolfe","year":"2016","unstructured":"Wolfe, F. et al. 2016 Revisions to the 2010\/2011 fibromyalgia diagnostic criteria. Semin. Arthritis Rheum. 46, 319\u2013329 (2016).","journal-title":"Semin. Arthritis Rheum."},{"key":"4696_CR9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.pain.2007.11.002","volume":"138","author":"Y Kamaleri","year":"2008","unstructured":"Kamaleri, Y., Natvig, B., Ihlebaek, C. M. & Bruusgaard, D. Localized or widespread musculoskeletal pain: does it matter? Pain 138, 41\u201346 (2008).","journal-title":"Pain"},{"key":"4696_CR10","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/S2665-9913(23)00163-7","volume":"5","author":"JD Steinmetz","year":"2023","unstructured":"Steinmetz, J. D. et al. Global, regional, and national burden of osteoarthritis, 1990\u20132020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 5, e508\u2013e522 (2023).","journal-title":"Lancet Rheumatol."},{"key":"4696_CR11","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1016\/S1474-4422(18)30322-3","volume":"17","author":"LJ Stovner","year":"2018","unstructured":"Stovner, L. J. et al. Global, regional, and national burden of migraine and tension-type headache, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 17, 954\u2013976 (2018).","journal-title":"Lancet Neurol."},{"key":"4696_CR12","doi-asserted-by":"publisher","first-page":"e142","DOI":"10.1016\/S2665-9913(23)00321-1","volume":"6","author":"A-M Wu","year":"2024","unstructured":"Wu, A.-M. et al. Global, regional, and national burden of neck pain, 1990\u20132020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 6, e142\u2013e155 (2024).","journal-title":"Lancet Rheumatol."},{"key":"4696_CR13","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1136\/annrheumdis-2021-221173","volume":"81","author":"C Maher","year":"2022","unstructured":"Maher, C. & Ferreira, G. Time to reconsider what Global Burden of Disease studies really tell us about low back pain. Ann. Rheum. Dis. 81, 306\u2013308 (2022).","journal-title":"Ann. Rheum. Dis."},{"key":"4696_CR14","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2023.1605763","volume":"68","author":"J Mu\u00f1oz Laguna","year":"2023","unstructured":"Mu\u00f1oz Laguna, J. et al. Certainty of the Global Burden of Disease 2019 modelled prevalence estimates for musculoskeletal conditions: a meta-epidemiological study. Int. J. Public Health 68, 1605763 (2023).","journal-title":"Int. J. Public Health"},{"key":"4696_CR15","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s00296-023-05500-5","volume":"44","author":"M Shivakumar","year":"2024","unstructured":"Shivakumar, M. et al. Musculoskeletal disorders and pain in agricultural workers in low- and middle-income countries: a systematic review and meta-analysis. Rheumatol. Int. 44, 235\u2013247 (2024).","journal-title":"Rheumatol. Int."},{"key":"4696_CR16","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.bjae.2018.05.006","volume":"18","author":"WW Morriss","year":"2018","unstructured":"Morriss, W. W. & Roques, C. J. Pain management in low- and middle-income countries. BJA Educ. 18, 265\u2013270 (2018).","journal-title":"BJA Educ."},{"key":"4696_CR17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2021-000108","volume":"1","author":"SP Cohen","year":"2022","unstructured":"Cohen, S. P. et al. Chronic pain and infection: mechanisms, causes, conditions, treatments, and controversies. BMJ Med. 1, e000108 (2022).","journal-title":"BMJ Med."},{"key":"4696_CR18","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1038\/nrendo.2010.146","volume":"6","author":"A Arabi","year":"2010","unstructured":"Arabi, A., El Rassi, R. & El-Hajj Fuleihan, G. Hypovitaminosis D in developing countries\u2014prevalence, risk factors and outcomes. Nat. Rev. Endocrinol. 6, 550\u2013561 (2010).","journal-title":"Nat. Rev. Endocrinol."},{"key":"4696_CR19","unstructured":"The Sustainable Development Goals Report 2022 https:\/\/unstats.un.org\/sdgs\/report\/2022\/ (United Nations, 2022)."},{"key":"4696_CR20","unstructured":"Human Development Report 2021\u201322 https:\/\/hdr.undp.org\/content\/human-development-report-2021-22 (United Nations Development Programme, 2022)."},{"key":"4696_CR21","doi-asserted-by":"publisher","unstructured":"Okifuji, A. & Hare, B. The association between chronic pain and obesity. J. Pain Res. 8, 399\u2212408 https:\/\/doi.org\/10.2147\/JPR.S55598 (2015).","DOI":"10.2147\/JPR.S55598"},{"key":"4696_CR22","doi-asserted-by":"publisher","first-page":"87.e7","DOI":"10.1016\/j.amjmed.2009.05.028","volume":"123","author":"R Shiri","year":"2010","unstructured":"Shiri, R., Karppinen, J., Leino-Arjas, P., Solovieva, S. & Viikari-Juntura, E. The association between smoking and low back pain: a meta-analysis. Am. J. Med. 123, 87.e7\u201387.e35 (2010).","journal-title":"Am. J. Med."},{"key":"4696_CR23","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1093\/rheumatology\/keaa758","volume":"60","author":"J Prego-Dom\u00ednguez","year":"2021","unstructured":"Prego-Dom\u00ednguez, J., Khazaeipour, Z., Mallah, N. & Takkouche, B. Socioeconomic status and occurrence of chronic pain: a meta-analysis. Rheumatology 60, 1091\u20131105 (2021).","journal-title":"Rheumatology"},{"key":"4696_CR24","doi-asserted-by":"publisher","first-page":"660","DOI":"10.2471\/BLT.07.043497","volume":"85","author":"M de Onis","year":"2007","unstructured":"de Onis, M. et al. Development of a WHO growth reference for school-aged children and adolescents. Bull. World Health Organ. 85, 660\u2013667 (2007).","journal-title":"Bull. World Health Organ."},{"key":"4696_CR25","unstructured":"National Health Inequality Monitoring: A Step-by-Step Manual https:\/\/www.who.int\/publications\/b\/31149 (World Health Organization, 2017)."},{"key":"4696_CR26","unstructured":"Handbook on Health Inequality Monitoring with a Special Focus on Low- and Middle-Income Countries https:\/\/www.who.int\/publications\/i\/item\/9789241548632 (World Health Organization, 2013)."},{"key":"4696_CR27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-912","volume":"12","author":"AR Hosseinpoor","year":"2012","unstructured":"Hosseinpoor, A. R. et al. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey. BMC Public Health 12, 912 (2012).","journal-title":"BMC Public Health"},{"key":"4696_CR28","doi-asserted-by":"publisher","first-page":"e816","DOI":"10.1097\/PR9.0000000000000816","volume":"5","author":"DE Schoth","year":"2020","unstructured":"Schoth, D. E., Radhakrishnan, K. & Liossi, C. A systematic review with subset meta-analysis of studies exploring memory recall biases for pain-related information in adults with chronic pain. Pain Rep. 5, e816 (2020).","journal-title":"Pain Rep."},{"key":"4696_CR29","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-016-0946-6","volume":"17","author":"TK Gill","year":"2016","unstructured":"Gill, T. K. et al. The use of self-report questions to examine the prevalence of musculoskeletal problems: a test-retest study. BMC Musculoskelet. Disord. 17, 100 (2016).","journal-title":"BMC Musculoskelet. Disord."},{"key":"4696_CR30","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1007\/s11136-010-9681-x","volume":"19","author":"JE Broderick","year":"2010","unstructured":"Broderick, J. E., Schneider, S., Schwartz, J. E. & Stone, A. A. Interference with activities due to pain and fatigue: accuracy of ratings across different reporting periods. Qual. Life Res. 19, 1163\u20131170 (2010).","journal-title":"Qual. Life Res."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04696-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04696-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04696-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T19:49:16Z","timestamp":1794599356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04696-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["4696"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04696-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-9510059\/v1","asserted-by":"object"}]},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"23 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"T.T. 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\u2009months. T.B. 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. G.J.B. reports honoraria from GE Healthcare for teaching on scanner programming courses. L.P. reports advisory or consultancy roles for Roche and Vifor Pharma, speaker fees from Shire and royalties from Hogrefe, Kohlhammer and Schattauer. The other authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}