Pain increases more rapidly before the age of 55

One of the most significant conclusions that can be drawn from this study is that pain should not be considered a single disease; rather, there are different types of pain that arise at different stages of life and follow different trajectories—as observed in this study—likely due to multiple pathophysiological mechanisms that cause distinct diseases. 

The finding in this study that certain types of pain—such as visceral pain or migraines—are observed at younger ages is likely due to their association with specific hormonal levels, which would adequately explain the inverted U-shaped trajectory observed in this study, whereas pain localized in the lumbar spine, hips, and knees follows a linear trajectory into old age because it is more closely related to aging and physical strain—another distinct pathophysiological mechanism that leads to different diseases and other types of pain. 

Another significant finding of this study relates to modifiable risk factors such as smoking, obesity, and low income, which carry greater weight in high-income areas compared to more economically disadvantaged areas where other factors predominate. This information is important when implementing preventive measures, as these measures must vary depending on the geographic area. 

A well-known fact, also observed in this study, is that pain is more common in women than in men, as can also be seen in all the pain trajectories described. 

The differences in pain observed across different geographic regions and levels of development among the populations analyzed in this study confirm the findings of previous studies. 

The authors correctly acknowledge the most significant limitations of this study, the most relevant of which is its cross-sectional design. Although this study also compares the course of generalized pain with that of pain in other isolated locations and finds that they follow similar courses, it must be borne in mind that, in many cases, pain in isolated locations may occur within the context of chronic generalized pain—for example, fibromyalgia—where it is common to observe sequential pain in different locations throughout the patient’s life. This can lead to the erroneous conclusion that the course is the same in both conditions because, in reality, we are talking about the same condition.