Chronic pain is one of the most widespread and costly health problems in the world, and much of it may be more treatable than people assume.
Understanding the scale of chronic pain, and how our understanding of it has changed, is the first step towards doing something about it. This post looks at the size of the problem, and at the good news hidden inside the science.
For the wider picture, see our companion posts: What is the difference between useful and useless pain? and Science Supports Hypnosis for Pain Control.
How big is the problem?
Chronic pain is one of the most common reasons adults seek medical care, and it is linked to numerous physical and mental health conditions, high health care costs, and lost productivity (Institute of Medicine, 2011).
Just how common is it? In the United States, the most recent national data show that around one in four adults, about 24%, live with chronic pain, and roughly 8.5% experience high-impact chronic pain that limits daily life or work (Lucas and Sohi, 2024). The figure is higher in some groups, reaching about 36% of adults aged 65 and over. That is up from around 20% just a few years earlier (Dahlhamer et al., 2018), so the burden appears to be growing rather than shrinking.
Chronic pain is strongly linked to reduced quality of life. It is associated with restrictions in mobility and daily activity, dependence on opioids, and higher rates of anxiety and depression. A recent meta-analysis found that roughly 40% of adults with chronic pain have clinically significant depression and anxiety (Aaron et al., 2025).
The economic scale is striking. In the United States alone, chronic pain has been estimated to cost between $560 billion and $635 billion each year in direct medical costs, lost productivity, and disability, more than the annual cost of heart disease, cancer, or diabetes (Gaskin and Richard, 2012).
Despite an abundance of painkillers and a wide range of physical therapies, chronic pain remains the daily experience of hundreds of millions of people, and new cases continue to arise at a high rate (Nahin et al., 2023).
Is there any good news?
Yes. Our scientific understanding of pain has changed significantly over the last few decades, and that is opening up new solutions.
For years, experts treated pain as a purely biomedical problem, a matter of tissue damage, genetics or system dysfunction alone. Many people, and some clinicians, still think about their own pain this way. You can hear it in the language: "my back", "my fibromyalgia", "crushed discs", "trapped nerves", things "worn out".
Treating pain as purely physical leads to a search for a physical cause, sometimes to excessive investigation, and to treating findings that may in fact be incidental. Modern research has changed the picture. Two ideas in particular have made a real difference.
The biopsychosocial model
The first update to the traditional view is that pain is never purely physical, and should not be explained by the biomedical model alone (Gatchel et al., 2007).
The updated model is biopsychosocial. As the name suggests, pain has three sets of contributing factors, not one:
- Biological: tissue damage, genetics, system dysfunction.
- Psychological: perceptions, thoughts, emotions, beliefs, coping behaviours.
- Social: socioeconomic status, care and support, environment.
All three domains play a part in the creation, maintenance and reduction of pain. Purely biomedical solutions, such as painkillers and physical manipulation, that ignore the psychological and social factors miss much of the chronic pain problem. Once we know these factors matter, we can begin to address them.
Pain as an output of the brain
The second major shift is that pain is now understood as an output produced by the brain, rather than simply an input arriving from the body.
The brain receives signals from the nervous system, and if it judges those signals to signify a threat, it produces pain. It does this because it is a protector, trying to keep you safe (Moseley and Butler, 2015). This is useful when the threat is genuine, especially in the acute phase.
It becomes a problem when the danger has passed and healing has begun, but the brain still perceives a threat. The more threat the brain perceives, the more the pain signal is amplified, and when the perceived threat decreases, so does the pain. This amplification, sometimes called central sensitisation, works a little like a "pain dial" in the central nervous system (Woolf, 2011).
When the signal is turned up, the body often shifts into a protective state of bracing and tension, which generates anxiety and fear, along with a rise in stress hormones such as adrenaline and cortisol.
Cortisol is essential for survival after injury. But prolonged or excessive cortisol has a downside: it breaks down protein in muscle, interferes with the replacement of calcium in bone, and suppresses the immune system, which over time can help create the conditions for several kinds of chronic pain (Kaur et al., 2025).
To turn this around, we need to understand why the brain continues to treat the body as being under threat, and then change that message. Hypnotherapy offers a range of tools to do exactly that, and The Arrow Technique, developed by Freddy Jacquin, is an excellent choice.
Frequently asked questions
How common is chronic pain?
In the United States, the most recent national data indicate that about 24% of adults, roughly one in four, live with chronic pain, and around 8.5% have high-impact chronic pain that limits daily life (Lucas and Sohi, 2024). It becomes more common with age, affecting about 36% of those aged 65 and over.
Is chronic pain really just physical?
No. Current understanding treats pain as biopsychosocial, shaped by biological, psychological and social factors together (Gatchel et al., 2007). Purely physical treatments that ignore the psychological and social side address only part of the problem.
What does it mean that pain is an output of the brain?
It means the brain produces pain as a protective response when it judges the body to be under threat, rather than pain being a simple readout of tissue damage. When the brain keeps perceiving a threat after healing, it can keep amplifying pain, a process linked to central sensitisation (Woolf, 2011; Moseley and Butler, 2015). Changing that perceived threat can reduce the pain.
Can hypnotherapy help with chronic pain?
It can be a valuable part of a wider plan. Because pain is shaped by psychological factors and by the brain's sense of threat, approaches that work with the mind, such as hypnosis and self-hypnosis, can help turn the "pain dial" down. See Science Supports Hypnosis for Pain Control for the evidence. Always seek appropriate medical assessment first.
Learn The Arrow Technique
To go deeper, trial the Jacquin Hypnosis Academy training platform free for 14 days, and read What is the difference between useful and useless pain? and Science Supports Hypnosis for Pain Control.
References
Aaron, R. V., Ravyts, S. G., Carnahan, N. D., Bhattiprolu, K., Harte, N., McCaulley, C. C., et al. (2025). Prevalence of depression and anxiety among adults with chronic pain: A systematic review and meta-analysis. JAMA Network Open, 8(3), e250268. https://doi.org/10.1001/jamanetworkopen.2025.0268
Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., et al. (2018). Prevalence of chronic pain and high-impact chronic pain among adults, United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 67(36), 1001-1006. https://doi.org/10.15585/mmwr.mm6736a2
Gaskin, D. J., & Richard, P. (2012). The economic costs of pain in the United States. The Journal of Pain, 13(8), 715-724. https://doi.org/10.1016/j.jpain.2012.03.009
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133(4), 581-624. https://doi.org/10.1037/0033-2909.133.4.581
Institute of Medicine. (2011). Relieving pain in America: A blueprint for transforming prevention, care, education, and research. National Academies Press. https://doi.org/10.17226/13172
Kaur, J., Gandhi, J., & Sharma, S. (2025). Physiology, cortisol. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538239/
Lucas, J. W., & Sohi, I. (2024). Chronic pain and high-impact chronic pain in U.S. adults, 2023 (NCHS Data Brief No. 518). National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db518.htm
Moseley, G. L., & Butler, D. S. (2015). Fifteen years of explaining pain: The past, present, and future. The Journal of Pain, 16(9), 807-813. https://doi.org/10.1016/j.jpain.2015.05.005
Nahin, R. L., Feinberg, T., Kapos, F. P., & Terman, G. W. (2023). Estimated rates of incident and persistent chronic pain among US adults, 2019-2020. JAMA Network Open, 6(5), e2313563. https://doi.org/10.1001/jamanetworkopen.2023.13563
Woolf, C. J. (2011). Central sensitization: Implications for the diagnosis and treatment of pain. Pain, 152(3 Suppl), S2-S15. https://doi.org/10.1016/j.pain.2010.09.030