Prevalence and Types of Chronic Pain among Insured Individuals with Tic Disorders

Background: Tic disorders are neurodevelopmental disorders characterized by motor and vocal tics. Individuals with tic disorders can experience pain due to tics. Objective: We compared the prevalence and types of chronic pain among insured individuals with and without tic disorders. Methods: We analyzed data for enrollees 6 to 64 years with and without tic disorders during 2016 to 2021 using the Merative MarketScan commercial and Medicaid databases via Treatment Pathways, an online analytic tool. We compared the prevalence of any chronic pain and nine specific types of chronic pain (eg, headache) during the year following tic disorder diagnosis or a random office visit for the comparison group (into 2023, as needed). We calculated prevalence ratios, 95% confidence intervals, and corresponding P-values using SAS software. Results: Among enrollees with commercial and Medicaid insurance, we identified 27,262 and 19,980 individuals with tic disorders, respectively. Overall, approximately 20% (21.4% commercial; 22.5% Medicaid) of individuals with tic disorders had any chronic pain. After stratifying by insurance type, age, and sex, prevalences of any pain and each pain type assessed were 1.1 to 7.5 times higher among those with tic disorders than those without tic disorders (P < 0.0001). Headache, especially migraine, was notably more common among those with compared to those without tic disorders. Conclusions: Information about the prevalence and types of chronic pain among individuals with tic disorders across the lifespan may inform clinical guidelines and practice for appropriate pain assessment and management and help educate healthcare providers, individuals with tic disorders, and their caregivers.