Health Survey for England, 2024

This report includes results from the 2024 Health Survey for England (HSE) describing chronic pain in adults.

Detailed tables accompanying this report can be accessed here. 

• 26% of adults reported chronic pain and 13% reported high impact chronic pain.
• Prevalence of both chronic pain and high impact chronic pain was higher among women (29% chronic pain; 15% high impact chronic pain) than among men (22% chronic pain; 11% high impact chronic pain).
• Older people were more likely than younger people to report chronic pain, with prevalence increasing from 12% among those aged 16 to 24 to 40% among those aged 75 and over.
• The proportion of adults with chronic pain was highest in the most deprived areas (36%) and lowest in the least deprived areas (19%).
• Pain in the arms, hands, hips, legs or feet was the most common site of pain among adults with chronic pain (71%).
• Among adults with chronic pain, the top three most reported longstanding conditions were musculoskeletal conditions (39%), mental, behavioural and neurodevelopmental disorders (25%), and heart and circulatory system conditions (16%).
• Compared with those who did not have chronic pain, after controlling for differences in age, those with chronic pain had lower levels of mental wellbeing (a mean WEMWBS score of 45.8 compared with 52.3 among those who did not have chronic pain) and were more likely to feel lonely at least some of the time (32% compared with 18% of those who did not have chronic pain).

According to the National Institute for Health and Care Excellence (NICE) Chronic pain refers to pain, an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage that typically endures for at least three months (NICE, 2021).

Chronic pain can have far-reaching consequences for its sufferers, including a lower quality of life, impacts on mental health, job losses, and it can limit daily activities (Breivik et al. 2006; Donaldson, 2009). Chronic pain is a common reason for seeking healthcare; it is estimated that up to 50% of GP consultations are related to pain (Kang et al. 2023) and around £4.76 billion per year is spent on treating and managing musculoskeletal conditions (Greenhalgh et al. 2020).

Questions about pain were asked of all adult participants in the main HSE interview. In 2024, participants were asked: ‘over the past three months, how often did you have pain?’. If participants reported having pain most days or every day, they were classed as having chronic pain. 

Participants who reported that they had pain most days or every day were then asked more detailed questions about their pain. These questions included questions on how limiting their pain was and which area of the body the pain was in.

Participants were classified as having high impact chronic pain if they reported that the pain interfered with their life or work activities most days or every day.

Note that HSE questions on pain and the definition of chronic pain changed between 2017 and 2024. In HSE 2024, chronic pain was defined as pain experienced most days or every day within the last three months, while in HSE 2011 and 2017 chronic pain was defined as ‘pain or discomfort that had troubled the participant all of the time, or on and off, for more than the last three months’ (see the HSE 2017 report on Adult Health for details). As a result, direct comparisons cannot be made with earlier HSE data on chronic pain or high impact chronic pain.

26% of adults reported chronic pain and 13% reported high impact chronic pain. Survey estimates are subject to a margin of error (see ‘About the survey estimates’ in the Introduction to this report). Prevalence in the wider population is likely to be between 24.7% and 27.0% for chronic pain, and between 12.4% and 14.1% for high impact chronic pain, referred to as the 95% confidence interval.

The prevalence of chronic pain was higher among women (29%) than men (22%). The prevalence of high impact chronic pain was also higher among women (15%) than men (11%). 

Prevalence of chronic pain increased with age, from 12% of those aged 16 to 24 to 40% of those aged 75 and over. A similar pattern was observed for those with high impact chronic pain: 4% of those aged 16 to 24 reported high impact chronic pain compared with 23% of those aged 75 and over.

The patterns of association between age and chronic pain and between age and high impact chronic pain were similar for men and women.

For more information: Table 1 and Table A1

Data has been age-standardised to take into account different age profiles across different areas.

When controlling for age, the prevalence of chronic pain increased with area deprivation. The proportion of adults with chronic pain was highest in the most deprived areas (36%) and lowest in the least deprived areas (19%). 

There was also an association between area deprivation and prevalence of high impact chronic pain. For both men and women, the prevalence of high impact chronic pain was lowest in the least deprived areas (7% among men; 9% among women) and highest in the most deprived areas (21% among men; 25% among women). Among women, the increase in prevalence of high impact chronic pain increased steadily with level of area deprivation. Among men, the prevalence of high impact chronic pain was between 7% and 11% in the first four IMD quintiles, raising almost two-fold to 21% in the most deprived quintile.

For more information: Table 3

Participants identified as having chronic pain were asked ‘where is this pain or discomfort?’. Participants could select multiple answers. Answer categories included:

• back pain
• neck or shoulder pain
• headache, facial or dental pain
• stomach ache or abdominal pain
• pain in arms, hands, hips, legs or feet
• chest pain
• other pain

The most common site of pain among those with chronic pain was in the arms, hands, hips, legs or feet (71%), followed by back pain (52%), and neck or shoulder pain (39%).

Among those with chronic pain, women were more likely than men to report:

• back pain (54% and 49% respectively) 
• neck or shoulder pain (42% and 35% respectively) 
• headache, facial or dental pain (25% and 15% respectively)
• stomach ache or abdominal pain (25% and 16% respectively) 

The proportions reporting pain in the arms, hands, legs or feet, chest pain, and other pain were similar across men and women. 

Experiencing pain at three or more sites was more common among women (39%) than men (29%). 

For more information: Table 5

Longstanding conditions are defined as physical or mental health conditions or illnesses lasting or expected to last 12 months or more. Participants could record up to six conditions and so the overall prevalence of longstanding conditions is lower than the combined prevalence of individual conditions.

Data has been age-standardised to take into account different age profiles across those who had and did not have longstanding conditions.

When controlling for age, adults who had chronic pain were more likely to report having two or more longstanding conditions (45%) than those who did not have chronic pain (15%). 

Among those with chronic pain, the three most commonly reported longstanding conditions were musculoskeletal conditions (39%), mental, behavioural and neurodevelopmental disorders (25%), and heart and circulatory system conditions (16%).

Similarly, those with high impact chronic pain were more likely to report two or more longstanding conditions than those who did not have high impact chronic pain (57% and 18% respectively). The three most commonly reported longstanding conditions among those with high impact chronic pain were also musculoskeletal conditions (49%), mental, behavioural and neurodevelopmental disorders (31%), and heart and circulatory system conditions (19%).

For more information: Table 6

Participants were classified as either employed (completed some work in the reference week or were temporarily away from their job, such as being on holiday); unemployed (and therefore looking and available for work); or economically inactive (including those who are unable to work due to disability or illness, students, retired, or looking after the home). The standard International Labour Organisation definition was used and is described more fully in the HSE 2024 Methods report, available on the first page. 

Data has been age-standardised to take into account different age profiles across different types of employment status.

When controlling for age, prevalence of chronic pain was associated with employment status, with more pronounced differences among women than men. Among women, 43% of those with chronic pain were employed compared with 58% of those who did not have chronic pain. Among men, the difference was smaller, with 57% of those with chronic pain in employment compared with 63% of those who did not have chronic pain.

In age-standardised analyses, high impact chronic pain prevalence was also associated with employment status. Unlike for chronic pain, the patterns of association with employment status were similar for men and women. Among all adults, those with high impact chronic pain were less likely to be in employment (38%) than those who did not have high impact chronic pain (61%). 

For more information: Table 4

In HSE 2024, information on physical activity was collected using the Short-Form International Physical Activity Questionnaire (IPAQ). This questionnaire defines activity levels based on reported moderate or vigorous physical activity (MVPA). Participants reporting below 30 minutes MVPA per week were defined as ‘inactive’ whereas those reporting 30 minutes or more MVPA per week were defined as ‘active’. This definition is comparable to physical activity as reported using IPAQ in HSE 2022. Note that this definition differs from the UK Chief Medical Officers' Physical Activity Guidelines for sufficient levels of aerobic activity (at least 150 minutes/week of MVPA).

Data has been age-standardised to take into account different age profiles across those with different activity levels.

When controlling for age, the proportion of those who were active was lower (66%) among those with chronic pain than among those not reporting chronic pain (77%). Similarly, those with high impact chronic pain were less likely to be active than those who did not have high impact chronic pain (54% and 77% respectively). 

For more information: Table 2

The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was used to measure wellbeing. A higher WEMWBS score indicates higher positive mental wellbeing. The lowest score possible is 14 and the highest score possible is 70. 

Data has been age-standardised to take into account associations between age and wellbeing scores.

After controlling for age, experiencing chronic pain was associated with lower mental wellbeing scores, with a mean WEMWBS score of 45.8 among those with chronic pain compared with 52.3 among those who did not experience chronic pain. The mean wellbeing score among adults who reported high impact chronic pain (41.5) was also lower than among those who did not experience high impact chronic pain (51.9). The associations between chronic pain and wellbeing scores and between high impact chronic pain and wellbeing scores were similar for men and women.

For more information: Table 7

Self-assessed health-related quality of life was measured using Visual Analogue Scales (VAS) scores. A higher score is associated with a better health state, with possible values ranging between 0 and 100.

Data has been age-standardised to take into account associations between age and self-assessed health-reported quality of life.

After taking differences by age into account, experiencing chronic pain was associated with lower self-assessed health-related quality of life. The VAS mean score was 64.4 among those with chronic pain compared with 82.6 among those who did not report chronic pain. High impact chronic pain was also associated with lower self-assessed health-related quality of life, with a VAS mean score of 52.9 among those with high impact chronic pain and 81.2 among those who did not have high impact chronic pain. These associations were similar for men and women.

For more information: Table 8

In HSE 2024 survey participants were asked to assess the levels of problems they had that day across five dimensions of health. These were mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. For each dimension of health, participants were asked to indicate which one of five statements best described their health ‘today’. The statements ranged from no problems or issues with that aspect of their health to extreme levels of pain/discomfort or anxiety/depression or being unable to walk about/wash or dress themselves/doing their usual activities.

Data has been age-standardised to take into account associations between age and reported levels of problems.

When controlling for age, those with chronic pain were more likely than those who did not have chronic pain to report at least some level of problems across all five areas asked about. Those who had high impact chronic pain were also more likely than those who did not have high impact chronic pain to do so.

Among adults with chronic pain and high impact chronic pain, respectively:

• 93% and 96% reported moderate or extreme levels of general pain or discomfort 
• 54% and 74% reported at least some problems in walking
• 53% and 75% reported problems in performing their usual activities
• 54% and 67% reported feeling moderately or extremely anxious or depressed
• 24% and 46% reported problems with self-care

There were no statistically significant differences between men and women with chronic pain in reporting problems in any of these areas. 

For more information: Table 9

Self-reported loneliness was measured with the question ‘how often do you feel lonely?’. The response options were: ‘Never feel lonely’, ‘Hardly ever feel lonely’, ‘Occasionally feel lonely’, ‘Feel lonely some of the time’, and ‘Often or always feel lonely’.

Data has been age-standardised to take into account associations between age and reported loneliness.

When controlling for age, prevalence of chronic pain was associated with a higher likelihood of reporting feeling lonely at least some of the time. This association was more pronounced among women than men. Among women, 36% of those with chronic pain reported feeling lonely at least some of the time, compared with 19% of those who did not have chronic pain. Among men, these figures were 26% and 18% respectively.

A similar pattern was observed between loneliness and prevalence of high impact chronic pain, though patterns here were similar for men and women. Among adults with high impact chronic pain, 38% reported feeling lonely at least some of the time. This compared with 20% of those who did not experience high impact chronic pain.

For more information: Table 10