A new nationwide survey by RusanMed, an initiative of Rusan Healthcare, has revealed a stark picture of pain management in India, with over 52 percent of doctors reporting that pain care services are either unavailable or grossly inadequate in rural and underserved regions. The survey also highlighted widespread patient self-medication, delayed treatment-seeking behaviour, and a significant lack of formal training in pain management among medical professionals.

Conducted in 2025, the independent survey engaged 746 medical professionals from across the country, more than doubling participation from the previous year. The findings underscore systemic challenges and a growing consensus among healthcare providers that pain management must be recognised as a dedicated medical speciality within India’s healthcare system — a view strongly supported by 44 percent of respondents.

Doctors overwhelmingly cited lack of awareness and education (44.4 percent), along with the absence of specialised pain clinics (34.6 percent), as the biggest barriers to effective pain care. Nearly 47 percent of respondents said patients tend to delay seeking medical help, with another 30.2 percent noting that patients “always” delay assessment and treatment for pain.

This often leads to cases becoming severe before any intervention is sought, with 51.6 percent of doctors reporting that patients typically seek help only when their pain reaches a 7 or 8 on the pain scale.

The survey also exposed the extent to which patients turn to self-medication before consulting a doctor. Nearly 32 percent of doctors said this happens often, while another 31.8 percent said it occurs sometimes. The most common remedies include over-the-counter analgesics (69.6 percent), pain balms (49.3 percent), and home or herbal remedies (39.1 percent). Only 12.1 percent of respondents said patients rarely self-medicate.

Another significant trend highlighted in the survey is the migration of patients from rural to urban areas in search of specialised pain care. About 50.3 percent of doctors said their rural patients sometimes travel to city hospitals for relief, while 22 percent said such travel is a frequent occurrence.

The top three factors contributing to this include the lack of trained healthcare professionals (52.8 percent), insufficient patient awareness (48 percent), and the absence of dedicated pain clinics (43 percent).

Despite these challenges, the survey identified several promising solutions. Telemedicine was seen as a key enabler for improving access in remote regions, with 41.3 percent of doctors rating it as effective and 20.1 percent as very effective. In terms of clinical strategies, multimodal therapy (47.6 percent) and patient education and counselling (36.7 percent) were cited as the most effective methods for managing pain.

To improve awareness and access in Tier 2 and Tier 3 cities, doctors recommended training programmes for general practitioners (38.2 percent), establishment of regional pain clinics (36.6 percent), and government support for affordable medications (35.9 percent).

Despite the clear need for more specialists, many doctors remain hesitant to pursue pain management as a career. The survey found that this reluctance is primarily due to the lack of formal training opportunities (40.2 percent), perceived low financial viability (39.4 percent), and limited institutional support (36.6 percent) for managing chronic pain.

Commenting on the survey, Malavika Kaura Saxena, Chief Marketing Officer at Rusan Healthcare, said the findings reaffirm the urgent need to make pain care a public health priority. “Through this one-of-a-kind nationwide survey, we sought to capture the real voices of doctors across India. The overwhelming participation shows how critical the issue has become,” she said. “We hope these insights will spark meaningful dialogue and policy action.”

The survey included a geographically diverse sample, with 42.1 percent of respondents from Tier 2 cities, 40.1 percent from Tier 1, 14.6 percent from Tier 3 towns, and 6.4 percent from rural regions. Most respondents were affiliated with private institutions and nursing homes (70.8 percent), followed by corporate hospitals (16.4 percent) and government facilities (11.3 percent).

In terms of experience, the majority had 5 to 10 years of clinical practice (33.9 percent), followed by 11 to 20 years (23.9 percent) and under five years (23.3 percent).

RusanMed says it will continue working with healthcare stakeholders to advance structured pain management systems across India, and to advocate for greater education, accessibility, and institutional support in what remains one of the most under-addressed areas of Indian healthcare.