New UCT research uncovers the connection between chronic pain and disability
A new study from University of Cape Town (UCT) has found that chronic pain is both widespread and strongly linked to disability, shedding fresh light on a major but often overlooked public health issue in South Africa.
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A new study from University of Cape Town (UCT) has found that chronic pain is both widespread and strongly linked to disability, shedding fresh light on a major but often overlooked public health issue in South Africa.
Published in the journal PAIN Reports, the research analysed data from more than 10 000 adults and offers one of the most detailed national pictures to date of how ongoing pain affects daily life.
The findings confirm that 18.3% of South African adults live with chronic pain, defined as pain lasting three months or longer. Among those individuals, 27.8% experience some form of disability.
The study found a strong relationship between chronic pain and key areas of functioning. People living with chronic pain were significantly more likely to report cognitive difficulties, including problems with thinking, memory and concentration. The research also found a moderate to strong association between chronic pain and mobility challenges, meaning individuals often struggled to walk, move around or perform physical tasks. However, the study did not find a strong link between chronic pain and self-care activities such as washing or dressing.
A smaller subgroup, described as high-impact chronic pain (HICP), accounted for 1.7% of the population, roughly one in 10 people living with chronic pain. This group reported more severe limitations in daily functioning and poorer overall health, and tended to be older, more likely female, more likely to receive government grants and more likely to report poor health.
Researchers conducted a cross-sectional analysis using data from the South African Demographic and Health Survey conducted in 2016, which included 10 336 adults. Disability was measured using internationally recognised Washington Group tools, and statistical analysis was carried out using R software.
Lead author Dr Murray McDonald said the findings address a longstanding gap in local data.
“Chronic pain is a leading cause of disability worldwide, but very little national data has existed for South Africa until now. This study confirms that chronic pain is not only common but also has a meaningful impact on people’s ability to think clearly and move freely,” he said.
“These limitations can affect every aspect of daily life, from employment and education to social participation and overall quality of life. The fact that more than a quarter of people with chronic pain experience disability shows that the impact of chronic pain is far broader than pain alone.”
McDonald added that chronic pain is often “invisible” and misunderstood, and said the findings strengthen the case for recognising it as a significant public health issue.
Co-author Professor Romy Parker, who leads the Pain Management Unit in UCT’s Department of Anaesthesia and Perioperative Medicine, said the study fills an important gap in understanding the burden of chronic pain in low- and middle-income countries.
“For too long, chronic pain has been under recognised in low- and middle-income countries, despite its strong connection to disability and reduced quality of life. The fact that nearly one in five adults in South Africa lives with chronic pain should be viewed as a call to action for health systems, policymakers, employers and the public,” she said.
Parker said the identification of the high-impact chronic pain subgroup is particularly significant. These individuals have much greater levels of disability and poorer health overall, and understanding their needs is essential for designing effective interventions.
She added that the study highlights how chronic pain affects both physical and mental functioning. The strong association with cognitive and mobility difficulties suggests that chronic pain affects both physical and mental functioning, reinforcing that the experience is multidimensional and extends far beyond the site of pain.
Based on the findings, the researchers recommend that chronic pain be integrated into national health planning, with improved data collection on treatment access and barriers to care. They also call for targeted interventions to support people living with high-impact chronic pain.
The study is titled Chronic pain is associated with disability: results from a large, population-based survey in South Africa.