- Arthritis in its many manifestations is among the most common chronic conditions, affecting some 53 million adult Americans, and its associated pain often impairs the ability to perform daily activities including work.
- The Healthy People 2030 initiative set a goal of reducing the prevalence of joint pain in the U.S. to about 52%.
- In this analysis of National Health Interview Survey data from 2023, moderate to severe joint pain was reported by 58% of those with arthritis, with no change from 2019 (57%) after adjusting for age distribution.
Federal survey data for 2023 showed an estimated prevalence of moderate to severe joint pain among U.S. adults of 58.5%, suggesting that pain management in arthritis has a long way to go.
Among the participants saying they had been diagnosed with arthritis, 26.1% reported severe joint pain and another 32.4% said they had moderate pain. Adjustment for respondents’ ages altered the combined estimate for moderate-to-severe pain only a little, to 58.2%, according to researchers led by Elizabeth Fallon, PhD, DrPH, of the CDC in Atlanta, using results from the National Health Interview Survey (NHIS), with some 30,000 respondents in each iteration.
Adding in respondents who reported only mild joint pain, the total prevalence of joint pain from arthritis was 75.8%, translating to 40 million American adults, the group reported in Arthritis Care & Research.
These figures are pretty much the same as were the case in 2019, when NHIS data indicated an age-adjusted rate of 56.8% for moderate-to-severe joint pain. Fallon and colleagues noted that the 2023 results therefore reflected no progress at all toward a goal set by the Healthy People 2030 initiative: a national rate of 52.4% for moderate-to-severe joint pain.
“The CDC Clinical Practice Guideline for Prescribing Opioids for Pain recommends multidisciplinary care that maximizes the use of non-opioid and non-pharmacological therapies for pain management, and the American College of Rheumatology recommends educational, behavioral, and physical therapies such as physical/occupational therapy, physical activity/exercise, and weight management for adults with arthritis,” the investigators wrote.
“Yet, referrals to physical therapy are underutilized, many adults with arthritis are either inactive or do not meet physical activity guidelines, and too few have received health care provider advice for physical activity or exercise to manage their arthritis,” they noted.
This should not be an intractable problem, they continued, pointing to a set of 22 arthritis-related interventions developed by the Osteoarthritis Action Alliance. Recognized interventions include various physical activity programs and self-management education programs.
These, Fallon and colleagues wrote, “are proven to improve arthritis symptoms or quality of life among adults with arthritis and can be offered in a variety of community-based settings (e.g., health clinics, veteran-serving organizations, senior centers, YMCAs) or remotely at no or low cost.”
There is some room to quibble with the study’s exact numbers.
NHIS participants are asked whether they have been told by a doctor or other healthcare professional that they have “arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia,” followed by additional questions that focus just on joint pain (excluding neck or back) and its severity. That brings in the potential for recall bias as well as lack of objective validation. Additionally, unlike some other federal surveys, answers are not checked against respondents’ medical records, nor are physical exams performed.
Importantly, the survey also doesn’t ask about healthcare interactions subsequent to diagnosis or treatments that respondents may have received.
Still, the data strongly point to persistent, clinically significant pain for at least half of people who believe they have some form of arthritis.
Other findings from the study included associations between joint pain and other factors, most of which will surprise no one. Respondents who also indicated some degree of poor health or disability were more likely to report joint pain, as were current and former smokers and those with cancer, lung disease, and self-reported anxiety or depression. Against expectations, though, BMI classification was not associated with moderate-to-severe joint pain.
Women and respondents with less education also were more likely to report joint pain. On the other hand, racial/ethnic differences had no apparent effect. Geography also didn’t seem to matter much: rates were higher in the Northeast and South (around 60%) than the Midwest and West (53%-57%), but only the Midwest-South comparison reached statistical significance.
Besides the study’s reliance on respondents’ self-reports, other limitations included that the NHIS only interviews community-dwelling adults and not those in care facilities or the homeless, and each NHIS iteration involves a different set of respondents and thus produces cross-sectional data.
