Prevalence and Predictors of High-Impact Chronic Pain in the General German Population

The Graded Chronic Pain Scale-Revised (GCPS-R) enables a standardised measure of chronic pain severity. Only sparse data are available on the prevalence of chronic pain stages assessed by the GCPS-R and the predictors of high-impact chronic pain (HICP) in the general European population.

A cross-sectional cohort study surveyed 2498 people ≥ 16 years living in Germany in 2025. Self-reported measures were obtained for demographic variables, chronic pain stages and disease load (Patient Health Questionnaire 4 and chronic illness). Potential predictors of HICP (age, gender, education, net income, probable depressive and anxiety disorder, chronic illness) compared to no and mild-impact and to bothersome chronic pain were assessed by adjusted univariate and multivariate logistic regression analyses.

Response rate was 37.9%. The prevalence of chronic pain present most or every day prior to 3 months was 11.4 (95% CI, 7.7% to 15.1%) of which 1.1% (-2.9% to 5.0%) with mild impact chronic pain; 3.3% (-0.6% to 7.2%) with bothersome impact chronic pain; and 7.1% (3.3% to 10.9%) with HICP. HICP compared to no and mild chronic pain was predicted in multivariate-adjusted analysis by age, lower educational level, lower income, probable anxiety and/or depressive disorder and chronic illness. Multivariate-adjusted analysis did not show significant associations of HICP with the selected variables when compared to bothersome pain.

Biological, psychological and social factors are associated with HICP. Targeted pain services for populations at highest risk for HICP need to be developed.

The prevalence of bothersome and high-impact chronic pain rather than prevalence rates of any chronic pain might provide evidence in support of pain specialist care. Identifying risk factors of high-impact chronic pain in specific populations could lead to an improved understanding of the risk factors, causes and consequences of chronic pain. European public health policies could be influenced by gathering data on high-impact chronic pain in other European countries.