{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:38:42Z","timestamp":1793637522640,"version":"4.5.1"},"reference-count":75,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T00:00:00Z","timestamp":1757116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Chronic pain (CP) is a global healthcare concern requiring careful monitoring. In Italy, the most recent CP prevalence estimates date back to 2003. In this work, we analyzed data from the 2019 European Health Interview Survey, based on a representative sample of the Italian population (n = 44,492), to update national CP prevalence estimates and evaluate its psychosocial burden. CP was detected using a validated questionnaire. Our results show that approximately 10.5 million adults (24.1%) suffer from CP; prevalence and intensity are higher among females and increase with age. In 54.3% of cases, CP was triggered by a diagnosed disease, while 13.6% remain undiagnosed and 14.8% do not seek treatment for CP. Severe CP accounts for 29.4% of cases. Individuals with severe CP are significantly more likely to experience difficulties in social participation (OR 4.82; CI 4.41\u20135.27), increased work absences (OR 4.18; CI 3.53\u20134.94), depression (OR 7.10; CI 6.22\u20138.11), and greater use of primary (OR 2.90; CI 2.64\u20133.18) and specialist healthcare (OR 2.63; CI 2.40\u20132.89) as well as diagnostic procedures (OR 2.27; CI 2.07\u20132.49). Among subjects diagnosed with depression or severe chronic anxiety, CP seems to reduce access to mental health care (OR 0.75; CI 0.61\u20130.92) and increase abandonment due to financial barriers (OR 1.57; CI 1.07\u20132.31). Unlike a few countries (e.g., Spain and Denmark) that have recorded a generally increasing trend in CP prevalence, our figures confirm a quite stable national epidemiological pattern. Our estimates underscore the need for careful management of CP and its psychosocial burden. Since data were collected just before the COVID-19 pandemic, they may represent a crucial baseline for monitoring post-pandemic trends.<\/jats:p>","DOI":"10.3390\/ijerph22091395","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T08:06:32Z","timestamp":1757318792000},"page":"1395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Chronic Pain Prevalence and Psychosocial Burden in the Italian Population from the 2019 European Health Interview Survey"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-5385","authenticated-orcid":false,"given":"Alice","family":"Maraschini","sequence":"first","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Statistical Service, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-018X","authenticated-orcid":false,"given":"Michael","family":"Tenti","sequence":"additional","affiliation":[{"name":"Fondazione ISAL, Institute for Research on Pain, 47921 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Raffaeli","sequence":"additional","affiliation":[{"name":"Fondazione ISAL, Institute for Research on Pain, 47921 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7788-5386","authenticated-orcid":false,"given":"Laura","family":"Iannucci","sequence":"additional","affiliation":[{"name":"ISTAT\u2014National Institute of Statistics, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8649-9839","authenticated-orcid":false,"given":"Lidia","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"ISTAT\u2014National Institute of Statistics, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8017-7452","authenticated-orcid":false,"given":"Alessandra","family":"Burgio","sequence":"additional","affiliation":[{"name":"ISTAT\u2014National Institute of Statistics, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-9989","authenticated-orcid":false,"given":"Giada","family":"Minelli","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Statistical Service, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5771-7772","authenticated-orcid":false,"given":"Corrado","family":"Fagnani","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Centre for Behavioural Sciences and Mental Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4837-4549","authenticated-orcid":false,"given":"Emanuela","family":"Medda","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Centre for Behavioural Sciences and Mental Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Ferri","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Centre for Behavioural Sciences and Mental Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-5515","authenticated-orcid":false,"given":"Miriam","family":"Salemi","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Centre for Behavioural Sciences and Mental Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilia","family":"Toccaceli","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanit\u00e0, Centre for Behavioural Sciences and Mental Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Goldberg, D.S., and McGee, S.J. (2011). Pain as a Global Public Health Priority. BMC Public Health, 11.","DOI":"10.1186\/1471-2458-11-770"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A Classification of Chronic Pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1097\/j.pain.0000000000001009","article-title":"Defining Chronic Pain in Epidemiological Studies: A Systematic Review and Meta-Analysis","volume":"158","author":"Landmark","year":"2017","journal-title":"Pain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.jpain.2014.05.009","article-title":"Prevalence of Persistent Pain in the U.S. Adult Population: New Data from the 2010 National Health Interview Survey","volume":"15","author":"Kennedy","year":"2014","journal-title":"J. Pain"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","article-title":"Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults\u2014United States, 2016","volume":"67","author":"Dahlhamer","year":"2018","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1097\/j.pain.0000000000002291","article-title":"Prevalence of Chronic Pain among Adults in the United States","volume":"163","author":"Yong","year":"2022","journal-title":"Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey of Chronic Pain in Europe: Prevalence, Impact on Daily Life, and Treatment","volume":"10","author":"Breivik","year":"2006","journal-title":"Eur. J. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.pain.2007.08.013","article-title":"Prevalence of Chronic Pain with Neuropathic Characteristics in the General Population","volume":"136","author":"Bouhassira","year":"2008","journal-title":"Pain"},{"key":"ref_9","first-page":"46","article-title":"Prevalence of chronic pain in Germany. A representative survey of the general population","volume":"27","author":"Schmutzer","year":"2013","journal-title":"Schmerz"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1002\/ejp.1886","article-title":"Increasing Prevalence of Chronic Non-Cancer Pain in Denmark from 2000 to 2017: A Population-Based Survey","volume":"26","author":"Ekholm","year":"2022","journal-title":"Eur. J. Pain"},{"key":"ref_11","first-page":"e4705","article-title":"Prevalence and Epidemiological Characteristics of Chronic Pain in the Spanish Population. Results from the Pain Barometer","volume":"29","author":"Salazar","year":"2024","journal-title":"Eur. J. Pain"},{"key":"ref_12","first-page":"705","article-title":"Population-Based Study of Central Post-Stroke Pain in Rimini District, Italy","volume":"6","author":"Raffaeli","year":"2013","journal-title":"J. Pain Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s10194-015-0584-7","article-title":"Impact of Headache Disorders in Italy and the Public-Health and Policy Implications: A Population-Based Study within the Eurolight Project","volume":"16","author":"Allena","year":"2015","journal-title":"J. Headache Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2577","DOI":"10.2147\/JPR.S136292","article-title":"Assessment of Chronic Pain and Access to Pain Therapy: A Cross-Sectional Population-Based Study","volume":"10","author":"Frumento","year":"2017","journal-title":"J. Pain Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fagnani, C., Toccaceli, V., Tenti, M., Medda, E., Ferri, M., Stazi, M.A., and Raffaeli, W. (2022). An Italian Twin Study of Non-Cancer Chronic Pain as a Wide Phenotype and Its Intensity. Medicina, 58.","DOI":"10.3390\/medicina58111522"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years Lived with Disability (YLDs) for 1160 Sequelae of 289 Diseases and Injuries 1990\u20132010: A Systematic Analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global Incidence, Prevalence, Years Lived with Disability (YLDs), Disability-Adjusted Life-Years (DALYs), and Healthy Life Expectancy (HALE) for 371 Diseases and Injuries in 204 Countries and Territories and 811 Subnational Locations, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"457","DOI":"10.2147\/JPR.S105892","article-title":"A Review of Chronic Pain Impact on Patients, Their Social Environment and the Health Care System","volume":"9","author":"Ojeda","year":"2016","journal-title":"J. Pain Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.pmn.2021.03.009","article-title":"A Narrative Review of the Assessment of Depression in Chronic Pain","volume":"23","author":"Tenti","year":"2022","journal-title":"Pain Manag. Nurses"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/S0140-6736(21)00393-7","article-title":"Chronic Pain: An Update on Burden, Best Practices, and New Advances","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Breivik, H., Eisenberg, E., and O\u2019Brien, T. (2013). The Individual and Societal Burden of Chronic Pain in Europe: The Case for Strategic Prioritisation and Action to Improve Knowledge and Availability of Appropriate Care. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-1229"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1097\/j.pain.0000000000003056","article-title":"Co-Occurrence of Chronic Pain and Anxiety\/Depression Symptoms in U.S. Adults: Prevalence, Functional Impacts, and Opportunities","volume":"165","author":"Brady","year":"2024","journal-title":"Pain"},{"key":"ref_23","unstructured":"European Union (2018). Eurostat European Health Interview Survey (EHIS Wave 3), Methodological Manual."},{"key":"ref_24","unstructured":"Tinto, A. (2005). Implementing the Instrument in the Survey and Procedures for Analysis, Guidelines for the Development and Criteria for the Adoption of Health Survey Instruments."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.2147\/JPR.S362510","article-title":"Development and Validation of the Italian ?Brief Five-Item Chronic Pain Questionnaire? For Epidemiological Studies","volume":"15","author":"Toccaceli","year":"2022","journal-title":"J. Pain Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Berger, N., Van Oyen, H., Cambois, E., Fouweather, T., Jagger, C., Nusselder, W., and Robine, J.-M. (2015). Assessing the Validity of the Global Activity Limitation Indicator in Fourteen European Countries. BMC Med. Res. Methodol., 15.","DOI":"10.1186\/1471-2288-15-1"},{"key":"ref_27","unstructured":"European Union (2022). Eurostat Quality Report of the Third Wave of the European Health Interview Survey."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0304-3959(00)00296-7","article-title":"The Relationship of Gender to Pain, Pain Behavior, and Disability in Osteoarthritis Patients: The Role of Catastrophizing","volume":"87","author":"Keefe","year":"2000","journal-title":"Pain"},{"key":"ref_29","first-page":"1369","article-title":"Chronic Musculoskeletal Pain, Prevalence Rates, and Sociodemographic Associations in a Swedish Population Study","volume":"28","author":"Bergman","year":"2001","journal-title":"J. Rheumatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/00007632-200301150-00010","article-title":"Clinical Characteristics of Chronic Back Pain as a Function of Gender and Oral Opioid Use","volume":"28","author":"Fillingim","year":"2003","journal-title":"Spine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jpain.2008.05.005","article-title":"Common Chronic Pain Conditions in Developed and Developing Countries: Gender and Age Differences and Comorbidity with Depression-Anxiety Disorders","volume":"9","author":"Tsang","year":"2008","journal-title":"J. Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jpain.2008.12.001","article-title":"3rd Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings","volume":"10","author":"Fillingim","year":"2009","journal-title":"J. Pain"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.jpain.2012.05.012","article-title":"Epidemiology of Chronic Pain: A Population-Based Nationwide Study on Its Prevalence, Characteristics and Associated Disability in Portugal","volume":"13","author":"Azevedo","year":"2012","journal-title":"J. Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.3899\/jrheum.111393","article-title":"Sex Differences in Pain Scores and Localization in Inflammatory Arthritis: A Systematic Review and Metaanalysis","volume":"39","author":"Barnabe","year":"2012","journal-title":"J. Rheumatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1016\/j.pain.2012.07.023","article-title":"The Burden of Chronic Pain: A Cross-Sectional Survey Focussing on Diseases, Immigration, and Opioid Use","volume":"153","author":"Kurita","year":"2012","journal-title":"Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1038\/nrn3360","article-title":"Sex Differences in Pain and Pain Inhibition: Multiple Explanations of a Controversial Phenomenon","volume":"13","author":"Mogil","year":"2012","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_37","first-page":"184","article-title":"Gender Differences in Pain and Its Relief","volume":"52","author":"Pieretti","year":"2016","journal-title":"Ann. Ist. Super. Sanita"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/jnr.23831","article-title":"Sex Differences in Neuroimmunity and Pain","volume":"95","author":"Rosen","year":"2017","journal-title":"J. Neurosci. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/bja\/aet127","article-title":"Sex Differences in Pain: A Brief Review of Clinical and Experimental Findings","volume":"111","author":"Bartley","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/S0304-3959(99)00284-5","article-title":"Cognitive Factors and the Experience of Pain and Suffering in Older Persons","volume":"85","author":"Gibson","year":"2000","journal-title":"Pain"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0749-0690(05)70078-1","article-title":"The Epidemiology of Pain in Elderly People","volume":"17","author":"Helme","year":"2001","journal-title":"Clin. Geriatr. Med."},{"key":"ref_42","unstructured":"ISTAT BES (2024). Equitable and Sustainable Well-Being in Italy."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic Pain: A Review of Its Epidemiology and Associated Factors in Population-Based Studies","volume":"123","author":"Mills","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1093\/eurpub\/ckaa063","article-title":"Measuring Multimorbidity Inequality across Italy through the Multisource Comorbidity Score: A Nationwide Study","volume":"30","author":"Corrao","year":"2020","journal-title":"Eur. J. Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"26335565211005870","DOI":"10.1177\/26335565211005870","article-title":"Prevalence of Chronic Pain in LTCs and Multimorbidity: A Cross-Sectional Study Using UK Biobank","volume":"11","author":"McQueenie","year":"2021","journal-title":"J. Multimorb. Comorbidity"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1017\/S1744133114000012","article-title":"How Health Care Regionalisation in Italy Is Widening the North-South Gap","volume":"9","author":"Toth","year":"2014","journal-title":"Health Econ. Policy Law"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/fampra\/18.3.292","article-title":"The Impact of Chronic Pain in the Community","volume":"18","author":"Smith","year":"2001","journal-title":"Fam. Pract."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.jpsychires.2009.10.013","article-title":"Chronic Pain and Major Depressive Disorder in the General Population","volume":"44","author":"Ohayon","year":"2010","journal-title":"J. Psychiatr. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jpsychores.2012.05.008","article-title":"Direct and Indirect Costs in Persons with Chronic Back Pain and Comorbid Mental Disorders\u2014A Systematic Review","volume":"73","author":"Baumeister","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1097\/j.pain.0000000000003340","article-title":"The Unmet Mental Health Needs of U.S. Adults Living with Chronic Pain","volume":"165","author":"Brady","year":"2024","journal-title":"Pain"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2737","DOI":"10.1097\/j.pain.0000000000002264","article-title":"Association of Chronic Pain with Comorbidities and Health Care Utilization: A Retrospective Cohort Study Using Health Administrative Data","volume":"162","author":"Foley","year":"2021","journal-title":"Pain"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.pain.2004.05.020","article-title":"Chronic Pain and Frequent Use of Health Care","volume":"111","author":"Blyth","year":"2004","journal-title":"Pain"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/MLR.0b013e3182a53e4e","article-title":"Chronic Pain and Health Services Utilization: Is There Overuse of Diagnostic Tests and Inequalities in Nonpharmacologic Treatment Methods Utilization?","volume":"51","author":"Azevedo","year":"2013","journal-title":"Med. Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1080\/03007995.2023.2271862","article-title":"Estimating the Direct Healthcare Utilization and Cost of Musculoskeletal Pain among People with Comorbidity: A Retrospective Electronic Health Record Study","volume":"39","author":"Png","year":"2023","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1016\/j.pain.2010.12.036","article-title":"A Population-Based Survey of Chronic Pain and Its Treatment with Prescription Drugs","volume":"152","author":"Toblin","year":"2011","journal-title":"Pain"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.pain.2012.02.018","article-title":"Persistent Postsurgical Pain in a General Population: Prevalence and Predictors in the Troms\u00f8 Study","volume":"153","author":"Johansen","year":"2012","journal-title":"Pain"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S1470-2045(23)00646-0","article-title":"Complete Cancer Prevalence in Europe in 2020 by Disease Duration and Country (EUROCARE-6): A Population-Based Study","volume":"25","author":"Demuru","year":"2024","journal-title":"Lancet Oncol."},{"key":"ref_58","first-page":"16","article-title":"Il Dolore Cronico Da Cancro in Italia Dall\u2019indagine Europea Sulla Salute 2019","volume":"5","author":"Toccaceli","year":"2024","journal-title":"Boll. Epidemiol. Naz."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/AJP.0000000000000354","article-title":"Fibromyalgia and Chronic Pain Syndromes: A White Paper Detailing Current Challenges in the Field","volume":"32","author":"Arnold","year":"2016","journal-title":"Clin. J. Pain"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"827","DOI":"10.2147\/JPR.S303186","article-title":"Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice","volume":"14","author":"Raffaeli","year":"2021","journal-title":"J. Pain Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2147\/IJWH.S224891","article-title":"Current Challenges in the Management of Chronic Pelvic Pain in Women: From Bench to Bedside","volume":"14","author":"Conde","year":"2022","journal-title":"Int. J. Womens Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1053\/jpmn.2000.5833","article-title":"The New JCAHO Pain Standards: Implications for Pain Management Nurses","volume":"1","author":"Berry","year":"2000","journal-title":"Pain Manag. Nurses"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.pmn.2010.12.006","article-title":"Chronic Pain: The Help-Seeking Behavior, Attitudes, and Beliefs of Older Adults Living in the Community","volume":"12","author":"Cornally","year":"2011","journal-title":"Pain Manag. Nurs."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Jinks, C., Ong, B.N., and Richardson, J. (2007). A Mixed Methods Study to Investigate Needs Assessment for Knee Pain and Disability: Population and Individual Perspectives. BMC Musculoskelet. Disord., 8.","DOI":"10.1186\/1471-2474-8-59"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/01.NAJ.0000370157.33223.6d","article-title":"Culture\u2019s Effects on Pain Assessment and Management","volume":"110","author":"Narayan","year":"2010","journal-title":"Am. J. Nurs."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"King, N.B., and Fraser, V. (2013). Untreated Pain, Narcotics Regulation, and Global Health Ideologies. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001411"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1185\/03007995.2010.545813","article-title":"Epidemiology of Chronic Non-Cancer Pain in Europe: Narrative Review of Prevalence, Pain Treatments and Pain Impact","volume":"27","author":"Reid","year":"2011","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Thorstensson, C.A., Gooberman-Hill, R., Adamson, J., Williams, S., and Dieppe, P. (2009). Help-Seeking Behaviour among People Living with Chronic Hip or Knee Pain in the Community. BMC Musculoskelet. Disord., 10.","DOI":"10.1186\/1471-2474-10-153"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1136\/ard.2003.010223","article-title":"Musculoskeletal Pain in Europe: Its Impact and a Comparison of Population and Medical Perceptions of Treatment in Eight European Countries","volume":"63","author":"Woolf","year":"2004","journal-title":"Ann. Rheum. Dis."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Natoli, S., Vittori, A., Cascella, M., Innamorato, M., Finco, G., Giarratano, A., Marinangeli, F., and Cuomo, A. (2022). Raising Awareness on the Clinical and Social Relevance of Adequate Chronic Pain Care. Int. J. Environ. Res. Public. Health, 20.","DOI":"10.3390\/ijerph20010551"},{"key":"ref_71","first-page":"1","article-title":"The Healthcare Service in Italy: Regional Variability","volume":"20","author":"Cicchetti","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1097\/j.pain.0000000000002886","article-title":"Chronic Pain in Chile: First Prevalence Report of Noncancer Chronic Pain, Fibromyalgia, and Neuropathic Pain and Its Associated Factors","volume":"164","author":"Cid","year":"2023","journal-title":"Pain"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1097\/j.pain.0000000000001844","article-title":"Almost 1 in 5 South African Adults Have Chronic Pain: A Prevalence Study Conducted in a Large Nationally Representative Sample","volume":"161","author":"Kamerman","year":"2020","journal-title":"Pain"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/j.pain.0000000000002705","article-title":"Prevalence of Pain and Its Treatment among Older Adults in India: A Nationally Representative Population-Based Study","volume":"164","author":"Mohanty","year":"2023","journal-title":"Pain"},{"key":"ref_75","unstructured":"Zajacova, A., and Grol-Prokopczyk, H. (2024). Pain among US Adults before, during, and after the COVID-19 Pandemic. medRxiv."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/9\/1395\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:41:15Z","timestamp":1760035275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/9\/1395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,6]]},"references-count":75,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["ijerph22091395"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22091395","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,6]]}}}