ICD-11 and Chronic Pain
What is ICD-11?
The International Statistical Classification of Diseases and Related Health Problems (ICD) is the global standard for diagnosing and coding health conditions. It is used by healthcare systems to guide treatment decisions, generate health statistics, support insurance and reimbursement processes, and enable international comparisons of health data.
The ICD allows for:
- Recording individual health conditions at the desired level of detail. This is why it is used in many health systems to support diagnosing conditions and determining which treatment is received.
- Generating healthcare statistics and reimbursement information.
- Sharing and comparing health information between hospitals, regions, settings, and countries.
- Comparing data in the same country across different time periods.
The World Health Organisation (WHO) updates the ICD at regular intervals to reflect the current state of health knowledge. The WHO convenes subject experts, international societies for the medical areas and professions, patients, and their organisations to inform revisions. On 25 May 2019, the World Health Assembly (WHA) adopted the ICD-11, and this latest revision came into effect on 1 January 2022.
The ICD-11 is the first classification system to include a systematic representation of chronic pain, and is publicly available via the WHO website.
To learn more, please see the following materials:
Why ICD-11 matters for the European pain community
The European Pain Federation EFIC supports the widespread adoption of ICD-11 across Europe, as it offers real benefits for clinicians, researchers, educators, patients, and policymakers.
Clinical practice
- Provides clear diagnostic criteria for different types of chronic pain.
- Supports treatment planning based on pain mechanism and duration.
- Encourages the biopsychosocial approach to pain management.
Research and data collection
- Enables standardised coding, enhancing data comparability across national and international studies.
- Supports surveillance of chronic pain trends and their health impacts.
- Supports the inclusion of pain as a reportable public health issue.
Pain education and training
- Informs EFIC's educational activities, including the EFIC Academy and the EFIC Pain Exams.
- Offers a standardised language to teach pain classification and coding.
- Equips professionals with the tools needed to implement ICD-11 in everyday practice.
Policy and advocacy
- Strengthens the case for better access to pain care and reimbursement policies.
- Assists national and regional decision-makers in recognising chronic pain as a health priority.
- Reinforces the view of chronic pain as a disease entity in its own right, not just a symptom of other conditions.
ICD-11 classification of chronic pain
In ICD-11, chronic pain is classified under "MG30 - Chronic Pain", and subdivided into seven main diagnostic categories:
| ICD-11 code | Category | Description |
|---|---|---|
| MG30.0 | Chronic primary pain | Pain as a disease in its own right, without a clear underlying condition (e.g. fibromyalgia, nonspecific low back pain). |
| MG30.1 | Chronic cancer-related pain | Pain caused by cancer or cancer treatment. |
| MG30.2 | Chronic post-surgical or post-traumatic pain | Pain that persists beyond normal healing after surgery or trauma. |
| MG30.3 | Chronic neuropathic pain | Pain due to a lesion or disease of the somatosensory nervous system. |
| MG30.4 | Chronic secondary headache or orofacial pain | Chronic pain in the head, face, or neck caused by a known condition. |
| MG30.5 | Chronic secondary visceral pain | Chronic pain related to internal organs. |
| MG30.6 | Chronic secondary musculoskeletal pain | Chronic pain related to conditions such as arthritis or spinal disorders. |
These categories were developed by a task force led by the International Association for the Study of Pain (IASP) and officially adopted by WHO in 2019.
Implementing ICD-11 in clinical and academic settings
ICD-11 is available for implementation, and several European countries are integrating it into their national coding systems.
EFIC encourages healthcare professionals and educators to:
- Explore the ICD-11 system via the WHO ICD-11 Browser.
- Begin using ICD-11 codes in documentation where permitted.
- Incorporate ICD-11 concepts into clinical protocols, research methodology, and educational materials.
- Join the EFIC Academy to advance your knowledge on pain classification and assessment.
Recommended resources
These resources offer further information, guidance, and evidence:
- WHO ICD-11 Browser: official reference with searchable codes and descriptions available in 13 different languages. Also includes a coding tool which allows advanced searching.
- IASP ICD-11 Classification Resources: expert papers, background materials, and recorded talks.
- ICD-11 page on the Societal Impact of Pain (SIP) Platform: resources on the impact and relevance of ICD-11 for the pain community.
- EFIC Academy: online modules and webinars on chronic pain classification and clinical application.
- European Journal of Pain: peer-reviewed articles on ICD-11 implementation and research applications.
- Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Korwisi B, Kosek E, Lavand'homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang SJ. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019 Jan;160(1):19-27. DOI: 10.1097/j.pain.0000000000001384