Islamabad: Nearly 16 percent of adults screened in a Pakistani study reported chronic pain, while 93 percent of those affected had never consulted a pain-management specialist, highlighting serious gaps in awareness and access to care.
The study, published in the Journal of the Pakistan Medical Association, identified 757 people with chronic pain among 4,801 participating adults. Only 16 percent of those with chronic pain said their pain was completely controlled.
The effects extended beyond physical discomfort: 56 percent said pain affected their daily activities, 58 percent reported insomnia and 33 percent said they had been diagnosed with depression. The findings show how persistent pain can disrupt everyday life while treatment needs remain unmet.
Brig Dr Asif Kiyani, a pain-management specialist in Rawalpindi, said limited public awareness of specialist pain services was a major barrier to patients seeking appropriate care.
He said delays in reaching pain-management specialists could prolong suffering and worsen problems with sleep, movement and routine daily activities.
Pakistan’s wider pain burden is illustrated by a 2026 study in Frontiers in Medicine, which estimated that around 13.9 million people had low back pain in 2021. Using Global Burden of Disease data, the study also estimated 1.56 million years lived with disability, a measure of health lost because of pain-related limitations.
That estimate included pain lasting at least one day and therefore covered both short-term and longer episodes. It should not be read as a count of people with chronic pain, which generally refers to pain persisting or recurring for more than three months.
Despite this burden, a separate Aga Khan University survey found that 78 of 118 tertiary hospitals surveyed lacked dedicated pain services. Published in JPMA in 2023, it found such services at only 17 of 45 public hospitals and 23 of 73 private hospitals.
The shortage affected both sectors, while available services were largely concentrated in major cities. The survey identified 18 facilities offering pain services in Punjab and 14 in Sindh, with none identified in Gilgit-Baltistan.
Researchers Usama Ahmed and Gauhar Afshan counted 73 doctors providing pain services at the surveyed facilities, including 70 anaesthesiologists. However, they did not verify separate qualifications in pain medicine, meaning the figure cannot establish how many formally qualified pain specialists practise in Pakistan.
An updated official national count of doctors with recognised pain-medicine qualifications could not be independently verified from publicly available sources. Only nine hospitals in the 2022 survey offered advanced pain training, indicating limited opportunities to expand specialist capacity.
Chronic pain includes back, neck and joint pain; nerve pain; cancer-related pain; persistent pain after surgery or injury; chronic headache and facial pain; and abdominal or pelvic pain. Conditions such as fibromyalgia can also cause widespread pain.
Experts say care may involve anaesthesiologists with pain training, rehabilitation physicians and, depending on the condition, neurologists, rheumatologists or oncologists. Physiotherapists, psychologists, psychiatrists and nurses can help patients manage movement problems, sleep disturbances, emotional distress and impaired daily functioning.
Public-sector examples include an outpatient pain clinic listed by Allied Hospital Faisalabad and pain assessment and intervention services documented at Combined Military Hospital Mangla in a 2025 study. Aga Khan University Hospital and Liaquat National Hospital in Karachi describe dedicated pain services, while Shifa International Hospital in Islamabad offers pain-management fellowship training.
Available treatments include medication review, rehabilitation, image-guided nerve and joint injections, epidural injections and, at selected centres, radiofrequency procedures. Aga Khan University also offers a CPSP-accredited two-year programme leading to an FCPS qualification in Pain Medicine.
Cancer pain presents additional difficulties. Studies have documented regulatory and supply barriers that restrict access to morphine for cancer palliation in Pakistan. A 2017 review published in Pain and Therapy identified costly private services, weak referral coordination and inadequate pain education as major obstacles to care.
“WHO guidance for chronic primary low back pain recommends education, exercise, psychological therapies and appropriate medicines as part of coordinated care,” Brig Dr Kiyani said. “Stronger primary care, professional training, patient self-management, public awareness and accessible treatment are essential to improving pain care in Pakistan.”