A global study analyzing self-reported pain from 6,125,459 participants in 118 countries found that women consistently report higher prevalence of pain than men across 11 distinct anatomical sites. The sites identified were the head, face, neck and shoulders, hands and wrists, elbows, feet and ankles, knees, chest, back, abdomen, and hips. The single most prevalent pain location overall was the back, reported by 40% of participants.
The size of the gap between sexes varied by pain type and anatomical site. The study’s authors and external experts interpret this pattern as evidence that no single mechanism likely explains all sex differences in pain prevalence; instead, multiple biological, social, and psychosocial contributors probably interact to produce the observed differences.
Investigators and commenting clinicians outlined several overlapping explanations for the higher reported pain prevalence in women. These include:
Biological factors: sex hormones and differences in immune function and nervous-system pain processing are cited as potential contributors.
Reproductive and sex-specific conditions: disorders that disproportionately affect women, such as dysmenorrhea, endometriosis, and other pelvic pain conditions, likely contribute to higher abdominal and pelvic pain prevalence.
Immune-pathway differences shown in preclinical research: animal-model studies referenced by the researchers indicate that males and females may recruit different immune cells and pathways in pain hypersensitivity. The source notes that some research implicates microglia more in males and T-cell activity more in females for particular neuropathic pain pathways, although much of this evidence is preclinical.
Psychosocial and healthcare factors: higher rates of depression, anxiety, trauma exposure, caregiving burden, occupational exposures, and variability in access to timely diagnosis and treatment may all influence higher reported pain in women. Differences in symptom reporting and healthcare use are also considered relevant.
Pain amplification and nociplastic mechanisms: the report notes that nociplastic pain (dull, deep, persistent pain and amplified pain processing) and conditions like fibromyalgia — more commonly observed in women — may help explain greater severity and extent of pain in female populations.
The authors and commentators emphasize that these explanations are complementary rather than mutually exclusive. They also caution that some mechanistic evidence remains largely from rodent models, and translating those findings to humans requires further research.
Across both sexes, the study found that the most rapid increases in prevalence for many musculoskeletal pain sites occur before age 55. However, this does not imply that pain is highest before 55; in many conditions — notably back, hip, and knee pain — prevalence continues to rise into older age, with peak reporting often around or after age 75.
Researchers propose that early and middle adulthood are periods when exposures that contribute to later pain accumulate. Examples include occupational and physical workload, injuries, repetitive strain, weight gain and metabolic disease, stress, and sleep disruption. These cumulative factors may sensitize the nervous system over time, producing an accelerated rise in reported pain before midlife.
Experts also emphasize that the underlying data are largely cross-sectional, showing population age patterns rather than individual longitudinal change. Therefore, interpretation should distinguish between period prevalence and chronicity.
The study’s age- and sex-based findings suggest potential windows for earlier prevention and intervention, particularly in adults in their 20s through 40s. Clinicians commenting on the work recommend a multifaceted, individualized approach to pain management that begins with thorough evaluation to identify treatable causes.
Key management principles highlighted in the source include:
Focus on restoring function and movement through structured physical activity and physical therapy.
Use multidisciplinary therapies where appropriate, including exercise, cognitive behavioral therapy (CBT), acceptance and commitment therapy, mindfulness, and pharmacological treatments when indicated.
Address modifiable risk factors such as sleep quality, smoking cessation, weight management, and treatment of mood disorders, as these can affect pain intensity and quality.
Emphasize functional goals (better mobility, quality of life, return to work, activities of daily living) rather than aiming solely for complete elimination of pain.
The source stresses that exercise is beneficial for reducing pain and improving function, and no single exercise type is universally superior so long as the activity is regular and tailored to the individual.
Authors of the study called attention to significant gaps in global pain data. They reported difficulty accessing suitable datasets from lower-Human Development Index (HDI) regions, particularly parts of sub-Saharan Africa, Southeast Asia, and other underrepresented areas. Contributing factors include limited cohort studies, resource constraints for data storage and maintenance, and reduced research infrastructure and data sharing capacity.
The study team advocates for greater investment in collecting and maintaining high-quality pain data globally to better understand age-specific burden, regional differences, and appropriate prevention and treatment strategies. Without more representative data, it is harder to determine why pain burden is high at particular ages and which interventions will be most effective internationally.
Clinicians quoted or paraphrased in the source advised patients against simply accepting chronic pain or masking it with medication alone. Recommended steps include:
Seek a thorough clinical evaluation to identify possible sources and types of pain, because effective treatment depends on accurate diagnosis.
Prioritize restoring function through physical therapy and consistent exercise regimens.
Consider behavioral strategies such as CBT and acceptance and commitment therapy to change how pain is processed and experienced by the nervous system.
Address modifiable lifestyle factors — sleep, smoking, weight, and mood — which can influence pain intensity and recovery.
Set realistic, functional goals that improve daily living and quality of life rather than expecting complete pain eradication.
These clinical recommendations reflect the study’s broader implication that prevention and management efforts should be lifespan-informed and individualized.
Note: The source is a news report summarizing a Nature Medicine study and expert commentary. Specific study methods, statistical details, and complete data tables were not reproduced in the source article and therefore are not reported here.