Chronic pain over time among Syrian refugees resettled in Norway

Abstract Background Chronic pain disproportionately impacts vulnerable groups such as migrants and refugees. This study investigates the long-term changes in chronic pain experienced by Syrian refugees in Norway and explores the factors influencing these changes. Methods This prospective cohort study used data from the CHART and Integration for Health studies, with data collection at three points: in Lebanon (Wave-1), one year (Wave-2), and four years post-arrival in Norway (Wave-3). All participants who completed surveys at these timepoints were included (n = 132). Chronic pain was measured by asking about pain lasting at least six months. Mixed-effects logistic regression was used to examine changes in prevalence and assess how age, gender, educational level (categorized as low, ≤9 years, and high, >9 years), and mental health symptoms (anxiety, depression, and post-traumatic disorders) affect these changes. Results Between Wave-1 and Wave-3, the proportion of participants reporting chronic pain increased from 31% to 53%, with an odds ratio of 3.6 (95% CI 2.2 - 5.8). There was an interaction between changes in chronic pain over time and participants’ educational level, where the increase in pain prevalence over time was more pronounced among participants with lower educational levels than higher levels. No modification with the other factors were detected. Conclusions The study observed an increase in the number of participants reporting chronic pain over time. Low educational level at baseline emerged as a useful indicator for identifying those at higher risk of chronic pain. Understanding this correlation can be crucial for guiding preventive strategies and optimizing resource allocation to assist those most vulnerable. Key messages • Chronic pain disproportionately impacts vulnerable groups such as refugees. • Refugees with lower education levels at baseline were more likely to experience chronic pain over time.