Multisite pain follows five trajectories in older Chinese adults
In 23,376 older adults tracked over nine years, trajectories ranged from persistent minimal pain in 44.9% to high increasing pain in 9.6%.
European Journal of Pain
Researchers analyzed five waves of data from 23,376 Chinese adults aged 45 years and older in the China Health and Retirement Longitudinal Study between 2011 and 2020. Participants reported pain across 15 anatomical sites in at least two waves. Trajectory modeling identified five distinct patterns: persistent minimal (44.9%), low fluctuating (18.6%), low-rising (16.9%), moderate persistent (10.0%), and high increasing (9.6%). Two trajectories followed non-monotonic courses. Among participants reporting pain in consecutive waves, at least one site recurred in 65% to 98% of wave pairs, most frequently the lower back, knees, and leg. However, the identical set of painful sites recurred in fewer than 12%. Higher depressive symptoms, greater comorbidity, female sex, and lower education were each associated with higher-burden trajectories.
Why it matters
Chronic pain is a leading driver of late-life disability. Demonstrating that multisite pain accumulates around a stable anatomical core provides a clearer physical basis for pain burden and could improve early risk stratification in aging populations.
Caveats
The findings rely on observational, self-reported pain counts from a single national cohort. The analysis was also limited to participants who provided pain data across at least two survey waves.
The paper
Third Affiliated Hospital of Zhengzhou University
European Journal of Pain · 30 Sep 2026