Chronic pain is associated with disability: results from a large, population-based survey in South Africa

Chronic pain significantly contributes to global disability, but data from South Africa and other low- and middle-income countries are limited.

We assessed the association between chronic pain (pain/discomfort ≥3 months) and disability using data from a large, population-based household survey. As an exploratory analysis, we also assessed for differences between individuals with high-impact chronic pain (HICP) (chronic pain with significant disability) to those with low-impact chronic pain (chronic pain with no disabilities) in demographics and health status variables.

This cross-sectional, descriptive, secondary analysis used data collected in the 2016 South African Demographic and Health Survey, including 10336 adults. Disability was assessed using the Washington Group on Disability items. Statistical analyses were conducted using R v4.2.0 with the survey package.

Chronic pain prevalence was 18.3% (95% confidence interval [CI]: 16.9-19.7), with 27.8% (95% CI: 25.2-30.5) of individuals with chronic pain experiencing some form of disability. Chronic pain was associated with difficulties in cognition (adjusted odds ratio = 1.74 [95% CI: 1.41-2.14]) and mobility (AOR = 2.07 [95% CI: 1.70-2.52]), but not self-care (AOR = 1.07 [95% CI: 0.71-1.62]). The HICP group represented 1.7% (95% CI: 1.4-2.0) of the population and 9.2% (95%: 7.7-10.7) of those with chronic pain. Compared to the low-impact chronic pain group, the HICP group tended to be older and were more likely to be female, to receive a government grant, and to perceive their health as poor.

Weak and moderately strong positive associations were found between chronic pain and greater cognitive and mobility disability, respectively.