A Clinical Description of Chronic Pain in a General Population Using ICD-10 and ICD-11 (The HUNT Pain Examination Study)

The purpose was to present a total description, distribution, and ranking of chronic pain conditions in the general population. This was based on structured clinical examinations of a random sample from a population-based survey (HUNT3) with a calculated oversampling of participants with chronic pain. Supplemented with access to hospital reports, the examination was performed by expe-rienced physicians and psychologists using a consistent definition of chronic pain as well as ICD-10-and the new ICD-11-classification. The main findings were that a higher proportion of the 551 partici-pants had chronic pain assessed by clinical examination (399) than by self-report in a survey the same day (337). Among those with examination-verified chronic pain estimated from HUNT3 to represent 27.9% of the general population, 63% had chronic primary pain, 81% musculoskeletal pain, and 77% more than one chronic pain condition. When separating chronic primary from chronic secondary pain according to ICD-11, the weighted prevalence was 17.7% for chronic pain conditions of unknown and 10.2% of known cause. When all the participants' conditions were accounted for, the most prevalent was nonspecific low back (10.8%) and neck pain (7.6%). Participants with chronic primary pain did not have significantly more psychopathology than those with chronic secondary pain: 14.5% versus 12.5%. Perspective: Since this study confirms the high prevalence in self-report surveys and indicates that two thirds of chronic pain conditions cannot be explained by underlying diseases, this huge health and societal problem should be solved primarily on a public health level directed toward prevention and rehabilitation. (c) 2021 by United States Association for the Study of Pain, Inc.

Automated summary

The purpose of this study was to provide a comprehensive overview, distribution, and ranking of chronic pain conditions in the general population. The findings showed that a higher proportion of participants had chronic pain based on clinical examination compared to self-report in a survey. Among those with examination-verified chronic pain, the majority had chronic primary pain, musculoskeletal pain, and multiple chronic pain conditions. The study also revealed that two-thirds of chronic pain conditions could not be explained by underlying diseases. The most prevalent chronic pain conditions were nonspecific low back pain and neck pain. There was no significant difference in psychopathology between participants with chronic primary pain and chronic secondary pain. Therefore, this study highlights the importance of addressing chronic pain as a public health issue and focusing on prevention and rehabilitation.