How studying chronic pain amongst immigrants highlights their health precarity

Valérie-Anne Chantrain, PhD student (Faculty of Medecine and Health sciences, University of Antwerp/Faculté des Sciences de la Motricité, Université Catholique de Louvain)

Chronic pain is a complex phenomenon that has been fascinating scientists for a long time. Its evaluation is advised to be done – inter alia – on a biopsychosocial way as factors such as gender, age, marital status, or education level are known to influence the development of pain and its personal experience. Socio-demographic factors influence pain as well and need to be taken into account. For instance, previous publications showed that individuals from Eastern cultures report higher pain tolerance than those from the West1 or some cultures tend to be more expressive than others leading their citizens to report higher amount of pain, to identical pain stimuli2,3

Chronic pain is recognised as a disorder by the World Health Organization (WHO) and its presence therefore reflects individual’ health status. 

In 2020, the number of worldwide migrants was estimated at 281 million, to wit 3.60% of the global population which is three times more than in the 1970s. They are a consequent part of immigrants and their health status is a sizeable public health issue4

A literature review published by Kim HJ et al. in 20195 analysed studies evaluating pain in ethnic minorities and showed that these latter - in US and Europe countries - have lower pain tolerance than white individuals. They identified the role of pain catastrophising as an important mediator of pain sensitivity and advise the enhancement of pain management programs amongst ethnic minorities. Overall, this literature review shows that being immigrant - having limited access to education, information or health care, amongst others – induces pain sensitivity. This is not a new issue. More recently, Dragioti et al. studied the risk of developing chronic pain regarding their citizen status amongst more than 15.000 individuals in Sweden6. After re-evaluating them one year later, they concluded that immigrants may have an increased risk for chronic pain, widespread pain and severe pain and that this is partly mediated by their mood status6. They claim for better targeted interventions tailored to the socio-economic and psychological status of immigrants with chronic pain. 

Chronic pain is studied in many health domains and its presence is usually believed to be related to underlying diseases. Pain scientists demonstrated long time ago the bidirectional relationship between pain and biopsychosocial factors. In this blogpost, you can find small piece of interesting research amongst pain in immigrants, highlighting their tendency to develop pain and showing their health insecurity - in a population that is increasing. 

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​Children from Taro island carry lighter items from IOM’s delivery of food aid funded by USAID, with transport support from the United Nations. © IOM 2013/Joe LOWRY


1. Brena SF, Sanders SH, Motoyama H. American and Japanese chronic low back pain patients: cross-cultural similarities and differences. Clin J Pain. Jun 1990;6(2):118-124. 

2. Petrelli A, Di Napoli A, Perez M, Gargiulo L. [The health status of the immigrant population in Italy: evidence from multipurpose surveys of the Italian National Institute of Statistics (Istat)]. Epidemiol Prev. May-Aug 2017;41(3-4 (Suppl 1)):1-68. 

3. Lyman M. The painful truth : The New Science of why we hurt and how we can heal. London, UK: Bantam Press; 2021. 

4. (IOM) IOfM. World migration report 2020. In: Marie McAuliffe (IOM) BKJNU, ed. Geneva, Switzerland: International Organization for Migration; 2020. 

5. Kim HJ, Greenspan JD, Ohrbach R, et al. Racial/ethnic differences in experimental pain sensitivity and associated factors - Cardiovascular responsiveness and psychological status. PLoS One. 2019;14(4):e0215534. 

6. Dragioti E, Tsamakis K, Larsson B, Gerdle B. Predictive association between immigration status and chronic pain in the general population: results from the SwePain cohort. BMC Public Health. Sep 29 2020;20(1):1462.