OBJECTIVES: Multimorbidity and chronic pain often co-exist. Managing pain with a multimodal approach that includes non-pharmacologic treatment and non-opioid therapy is recommended to prevent serious risks associated with opioids. The objective of this study was to estimate the prevalence of types of pain treatment and analyze their associations with multimorbidity using a US nationally representative survey.

METHODS: Data was collected from the 2020 National Health Interview Survey on adults with chronic pain and chronic conditions (N=12,028). Chronic Pain management was grouped into four categories: opioid therapy; multimodal pain management without opioids; pain management with monotherapy; no pain treatment. Chi-square tests and multivariable multinomial logistic regressions were used to analyze the association of multimorbidity with types of pain treatment after controlling for age, sex, social determinants of health (SDoH), and lifestyle characteristics.

RESULTS: Nearly 60.9 million adults (68.0%) had multimorbidity. Those with multimorbidity were more likely to report severe pain (22.8% vs. 11.1%) and use opioids for chronic pain (9.2% vs. 3.2%). In adjusted multinomial logistic regressions with “pain management with monotherapy” as the reference group, those with multimorbidity were more likely to be on opioids (AOR=1.63, 95% CI=1.23, 2.17). Those with severe pain were more likely use opioid therapy (AOR=19.36, 95% CI=13.35, 28.06) than those with little pain. Those with low income and education were less likely to have multimodal pain management without opioids.

CONCLUSIONS: Seven in 10 adults had multimorbidity. Those with multimorbidity reported severe pain and relied on opioids for pain control. Regardless of multimorbidity status, SDoH was associated with types of chronic pain management.