Predictors of Pain

A recent review on the epidemiology of chronic pain (not limited to postsurgical pain) featured the following table listing factors associated with the development of chronic pain:⁴ 

There a modifiable and nonmodifiable risk factors for developing chronic pain. Some nonmodifiable factors include a patient’s genetics, ethnicity, age, and sex which studies show can be related to the type of pain. For example, older adults tend to develop osteoarthritic forms of chronic pain than young patients who develop chronic post-surgical pain. 

Other factors such as smoking and alcohol use are shown to correlate with chronic pain development. There is also a link between physical activity, nutrition (including vitamin D deficiency), weight, and sleep. 

Mental illness can be linked with chronic pain, with 20-50% of patients chronic pain also suffering from depression. It is likely that one magnifies the other. Similarly, patients with anxiety and post-traumatic stress disorder are more likely to see their primary care doctor for chronic pain concerns.  

What this reinforces is that chronic pain is formed from an interplay of sociological, biological, and emotional experiences.


Demographic Age
  Ethnicity and cultural background
  Socio-economic background
  Employment status and occupational factors
Lifestyle and behavior Smoking
  Physical activity
  Sunshine and vitamin D
Clinical Pain
  Multi-morbidity and mortality
  Mental health
  Surgical and medicinal interventions
Other Attitudes and beliefs about pain
  History of violent injury, abuse, or interpersonal violence



Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019 Aug;123(2):e273-e283. doi: 10.1016/j.bja.2019.03.023. Epub 2019 May 10. PMID: 31079836; PMCID: PMC6676152.

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