About 1 in 4 American adults live with chronic pain. In 2023, that figure was 24.3% of the adult population, which translates to roughly 60 million people in the United States alone. Of those, 8.5% experience what’s classified as “high-impact” chronic pain, meaning it frequently limits their ability to work or carry out daily activities.
What Counts as Chronic Pain
Chronic pain is defined as pain that persists or recurs for longer than three months. That’s the threshold set by the International Association for the Study of Pain, and it’s the line that separates a lingering injury from a condition in its own right. The CDC measures it by asking adults how often they’ve experienced pain over the past three months. People who answer “most days” or “every day” are counted as having chronic pain.
High-impact chronic pain is a narrower category. These are people who not only have persistent pain but report that it limits their life or work activities most days or every day. About 83% of people in this group are unable to work for a living, and roughly one-third have difficulty with basic self-care like bathing and getting dressed.
Who Is Most Affected
Chronic pain doesn’t hit all groups equally. The 2023 CDC data reveals clear patterns across age, sex, race, and geography.
Age is the strongest predictor. Among adults 18 to 29, just 12.3% report chronic pain. By age 65 and older, that number jumps to 36%. High-impact chronic pain follows the same curve, rising from 3% in the youngest group to 13.5% among older adults.
Women are slightly more likely than men to experience chronic pain (25.4% vs. 23.2%) and noticeably more likely to have high-impact chronic pain (9.6% vs. 7.3%). That gap widens further in the high-impact category, where women are about 30% more likely than men to report pain that limits their daily functioning.
Racial and ethnic disparities are stark. American Indian and Alaska Native adults report the highest rates of chronic pain at 30.7%, followed by white non-Hispanic adults. Asian adults have the lowest rates at 11.8%. Hispanic adults fall in between at 17.1%. These gaps persist in the high-impact category as well: 12.7% for American Indian and Alaska Native adults compared to just 2.6% for Asian adults.
The Urban-Rural Divide
Where you live also matters. Chronic pain rates climb steadily as you move from cities to rural areas. In large metropolitan centers, 20.5% of adults report chronic pain. In nonmetropolitan (rural) areas, that figure rises to 31.4%, more than 10 percentage points higher. High-impact chronic pain follows the same pattern, going from 7.3% in cities to 11.5% in rural communities.
Several factors likely drive this gap. Rural areas tend to have older populations, higher rates of physically demanding work, less access to healthcare, and higher poverty rates, all of which are independently linked to chronic pain.
The Link Between Chronic Pain and Depression
Chronic pain and mental health are tightly intertwined. About 35% of people with chronic pain also have depression, a rate far higher than in the general population. Community-based studies put the overlap somewhere between 11% and 20%, while clinical settings report even higher numbers. The relationship runs both directions: pain increases the risk of developing depression, and depression can make existing pain feel worse and harder to manage.
Anxiety shows a similar pattern. When pain becomes a constant presence, it narrows the scope of what feels possible. Social isolation, sleep disruption, and the loss of identity that comes with not being able to work or participate in activities all compound the psychological toll.
Economic and Workforce Costs
Chronic pain is one of the most expensive health conditions in the United States. A landmark analysis estimated the total annual cost at $560 to $635 billion (in 2010 dollars), a figure that would be significantly higher adjusted for today’s prices. That total breaks down into $261 to $300 billion in additional healthcare spending and $299 to $335 billion in lost productivity.
For individual workers, the impact is measurable week to week. On average, workers with a pain condition lose 4.6 hours of productive time per week. That’s not always time spent at home. Much of it is “presenteeism,” showing up to work but being unable to perform at full capacity because of pain. Over a year, those lost hours add up to the equivalent of nearly three full work weeks per person.
A Global Perspective
Most detailed statistics come from the United States, but chronic pain is a worldwide issue. The World Health Organization and other international bodies estimate that roughly 20% of adults globally live with some form of chronic pain, with about 10% newly diagnosed each year. Rates vary considerably by country, shaped by differences in healthcare access, occupational hazards, life expectancy, and how surveys define and measure pain. Low- and middle-income countries often report lower prevalence in surveys, but this likely reflects underdiagnosis and limited access to care rather than genuinely lower rates.
In the U.S., the numbers have remained stubbornly stable over the past decade despite growing awareness and new treatment approaches. Chronic pain remains one of the most common reasons adults seek medical care, more prevalent than diabetes, heart disease, or cancer.