Persistent Pain in Wales: Prevalence and Healthcare Utilisation from a Population-Scale Retrospective Cohort Study

What is this about?
Persistent pain—long-term pain lasting over three months—is a major issue for many people and puts pressure on the NHS. In 2023, the Welsh Government made persistent pain a national priority. To support this, our researchers have worked in collaboration with NHS Wales Performance and Improvement, as well as Powys Living Well Service to do a piece of research around this topic. This will   help to guide future health services and policies.

What did the study look at?
This research used anonymised health records from across Wales between 2010 and 2023. It focused on people with signs of persistent pain and compared them to people without.

Who was included?
The study looked at anonymous data for people registered with GPs in Wales who share their data with the SAIL Databank. Three groups with persistent pain were identified:

• Those with a pain diagnosis in their records.
• Those prescribed strong painkillers (e.g. opioids, gabapentinoids) for at least 3 months.
• Those referred to specialist pain services.

A fourth group, who didn’t meet any of these criteria, acted as a comparison.

Key Findings

• How common is persistent pain?
  Around 15% of the population of Wales are living with persistent pain.
  • 10% had a pain-related diagnosis.
  • 7.3% were on long-term pain medication.
  • 1.85% had seen a specialist for pain.
• Who is most affected?
  • Older people (especially aged 61–70), women, and those living in poorer areas were more likely to experience persistent pain.
  • People with persistent pain also tended to have other health problems and higher levels of frailty.
• Use of NHS services:
  • People with persistent pain had 63% more GP appointments and prescriptions than people without.
  • Those referred to pain clinics were often younger and less frail than those not referred—suggesting some may be missing out on specialist care.
• Changes over time:
  • There was a slight reduction in frequency of persistent pain, possibly due to changes in how GPs record pain or new prescribing practices.
  • Even after adjusting for age and other factors, healthcare use continued to rise among people with persistent pain, especially GP visits and hospital admissions.

What does this mean?

• Unmet need: Older and more deprived people may not be getting the specialist care they need.
• Health inequalities: Patterns in pain and service use reflect wider social inequalities.
• NHS planning: Persistent pain places a growing demand on NHS services 

What should be done?

Based on the findings from this study, the following recommendations around policy and service provision have been recommended:

• Improve how persistent pain is recorded and identified in GP practices.
• Tackle barriers that prevent people—especially older or poorer individuals—from getting specialist pain support.
• Listen to patients’ own experiences and include them when designing services.

Written by Libby Humphris, Public Partnership Group Co-lead

To read the full report, click here.