Disability

Chronic pain, more than 10 million people in Italy suffer from it

The social cost between health costs, loss of productivity, care, family burden reaches EUR 61.9 billion per year

by Ilaria Parlanti

3 December 2025

4' min read

Translated by AI

Versione italiana

Key points

Sufferers' data
What chronic pain really is: a system issue
How much it costs us, really
Pain with gender inequality
Social and Clinical Gaslighting

4' min read

Translated by AI

Versione italiana

Clefts in the side. Pinpricks that seem to pierce the skin. Stabbing in the lumbar spine. The feeling that someone is setting me on fire from the inside - the fuse of a firework lit in the synapses of my peripheral nerves - from my spinal cord injury to the tips of my toes. For nine years and 310 days my central system has been sending out pain impulses even when it should not. Twenty-four hours a day, seven days a week: there is not a moment when the pain is not there. Day, night, at aperitifs, at public holidays, at those times when you are with friends and family and act as if nothing is wrong. Then there are nights like these, when I can't reach my hand for the bottle of Toradol. I am 28 years old, diagnosed with a very rare disease at birth, 26 spinal surgeries.

The data of those who suffer

But if you think mine is an extreme situation, you are wrong. I am not alone. And let me tell you: chronic pain changes lives, often without mercy. According to the Italian Association for the Study of Pain (AISD), based on the results of the European Health Interview Survey 2019, in Italy about 24.1 per cent of the adult population - that is, about 10.5 million people - declares that they have been suffering from persistent pain for at least three months, which is then the necessary condition to be able to speak of an overt diagnosis of chronic pain. Widening the view, in the Western world, according to the International Association for the Study of Pain (IASP), about 1 in 5 adults live with chronic pain. A figure that makes chronic pain a public health emergency. A concrete example: globally, musculoskeletal conditions, i.e. back pain, arthritis, arthrosis, neck pain, afflict about 1.7 billion people and represent the leading cause of disability worldwide.

But what do these numbers mean? Beyond abstraction, there are people, faces, stories, names and lives that suffer. Very often, who stop pursuing their dreams and projects, who cancel themselves out, who accept mere survival because they have no other choice. This is the crux of the matter: there is no alternative. Who were we before the pain? And who have we become now?

In Italy: a huge silent mass that needs to talk. Going beyond the numbers, there are three most surprising conclusions we draw from the statistics: pain tends to increase with age; 29-30% of patients report 'severe or very severe' pain; in about 13% of cases, there is no precise diagnosis: the pain exists, but the cause remains mysterious.

We are almost one in three. Yet, who talks about us? Who looks after us? And it all revolves around a question that medicine still cannot explain: what is chronic pain really?

What chronic pain really is: a system issue

Chronic pain does not always arise from an obvious fracture. It can be a legacy of surgery, a consequence of trauma, or associated with chronic diseases such as arthritis, arthrosis, musculoskeletal disorders. In my case, it is the result of surgery, a spinal cord injury, incorrect surgical posture, and an overloaded central nervous system.

Diagnosis, however, is not enough. Integrated care is often lacking: physiotherapy, rehabilitation, psychological accompaniment, pain treatment. And in acute cases, the solution cannot be a pill. Not to mention the interventional attempts: denervation, laser, iontophoresis, spinal cord neurostimulation, radiofrequency, pens. The pain does not go away and how much does this cost in psychological, social, emotional and financial terms?

How much it costs us, really

As if suffering were not enough, those living with chronic pain also bear a huge economic burden. According to the Censis / Grünenthal report 'Living without pain', the social cost - including healthcare costs, loss of productivity, care, family burden - reaches EUR 61.9 billion per year.

On average, each patient spends around EUR 6,300 a year, a figure that for many means sacrifices, cuts on treatment, work, leisure time. It is not the only debt we pay, also in terms of dignity. And then too often chronic pain sufferers are not believed: by family members, by colleagues, by doctors. And in this sense, too, we can speak of a gender gap: because it is women who suffer the greatest scepticism.

Pain with gender inequality

Chronic pain is not equally distributed. In Italy - and elsewhere - it is women who bear the brunt. According to the AISD/EHIS study, about 60.7% of people suffering from chronic pain are women.

Some research in the field (and the IASP itself) is finally turning the spotlight on these disparities - biological, hormonal, but also cultural and social. For decades, pharmacological and medical research has been directed only at male bodies. It is therefore not enough to know how many people are suffering right now, one must also ask who is being listened to. How many of those women find doctors who take them seriously? How many get a diagnosis, a treatment plan, accompaniment?

Social and Clinical Gaslighting

For many, the battle is also about having our pain acknowledged. To be believed, simply, for what we say, for what we live. I have often been told: 'It's all in your head', 'It's stress', 'Maybe you exaggerate'. When you have pain that you cannot see, it is easy to become invisible.

This mechanism - trivialisation, belittling, denial of experienced pain - is part of a broader phenomenon: the gaslighting of chronic pain. Cases in which a woman's pain is stigmatised as 'hypersensitivity', 'emotionality', 'stress' are not uncommon. And the consequence is a double fracture: one in the body and one in confidence.

But then what can we do? We need a paradigm shift: listening, caring, generosity. As a society, we can no longer ignore our silence. And we need to start with the real training of health workers so that they recognise chronic pain, even when analyses show nothing. Moreover, territorial multidisciplinary paths would be necessary, combining physiotherapy, mental health, pain treatment; more research on gender differences in pain perception and management; access to non-drug treatment, rehabilitation, pain education, continuous relief; listening and support spaces for those who suffer, maybe associated with patients' associations, against isolation and stigma.

I believe it is time to stop considering chronic pain as a 'private evil': it is a matter of public health, of social rights. It is a question of dignity.