For the Public
The bane of chronic pain
The prevalence and impact of chronic pain is staggering. The U.S. Institute of Medicine’s report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research (2011), estimated that 100 million people in the U.S. suffer with chronic pain1. Recent Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics (NCHS) data report substantial rates of pain from various causes, including severe headache or migraine (16.1 percent), low back pain (28.1 percent), neck pain (15.1 percent), knee pain (19.5 percent), shoulder pain (9 percent), finger pain (7.6 percent), and hip pain (7.1 percent)2. The report also estimated that chronic pain costs society $560 billion to $635 billion annually. This encompasses not only medical costs, but also the cost of lost productivity including days of work missed ($11.6 billion-$12.7 billion), hours of work lost ($95.2 billion-$96.5 billion), and lost wages of ($190.6 billion-$226.3 billion).
The widespread prevalence of chronic pain is only part of the story. The individual suffering is often relentless and devastating. Among interviewee comments presented in the IOM report are the following:
“It is so much more than just pain intensity. Over time, many [patients] find the effects of living with chronic pain impact their ability to work, engage in recreational and social activities, and, for some, [perform] the most basic everyday activities that people just take for granted. Not surprisingly, pain begins to chip away at their mood, often leaving them angry, frustrated, anxious, and/or depressed. Our families suffer along with us, and many relationships are forever altered.”3
“The pain level from this thing is in the 10 category, and I don’t say 10 lightly. There is no way to function. It involves clawing at the air and screaming into a pillow for 24 hours at a crack. … Years and years.”4
The IOM report summarizes several salient points regarding the bane of pain in the U.S. and worldwide:
• Understanding the experience and impact of pain:
— Pain is a major problem for individuals, families, and society, with an increasing prevalence, cost, and impact on quality of life and health status.
— The experience of acute and chronic pain is unique and varies widely among individuals. Pain is influenced by genetics, early life experiences, mood and psychological state, coexisting medical conditions, and environments.
— National surveys and numerous research studies have shown that pain is more prevalent and less likely to be adequately treated in certain population groups, including the elderly, women, children, and racial and ethnic minorities.
— While pain sometimes can serve as a warning sign that protects individuals from further harm, chronic pain is harmful and impairs productivity and quality of life.
— When acute pain persists and becomes chronic, it may in some cases become a disease in its own right, resulting in dysfunction in the central nervous system and requiring a comprehensive treatment approach.
• Improving the assessment and treatment of pain:
— Ongoing pain has been underreported, underdiagnosed, and undertreated in nearly all health care settings.
— Individuals with pain that reduces quality of life should be encouraged to seek help.
— Because there are multiple contributors to and broad effects of chronic pain, comprehensive assessment and treatment are likely to produce the best results.5
A key finding in the IOM report is the following:
“Research to translate advances into effective therapies for pain is a continuing need. The committee finds that significant advances have been made in understanding the basic mechanisms of nociception and pain, leading to new potential targets for future pain assessment and treatment strategies. Furthermore, recent advances in the neurosciences, biomarkers, and the behavioral sciences have validated a comprehensive approach to the management of pain that includes the individual’s inherent biology, behavior, and psychological makeup and reactions, as well as environmental influences. However, data and knowledge gaps in pain research remain that have prevented such research advances from being translated into safe and effective therapies. Addressing these gaps will require a cultural transformation in the view of and approach to pain research, involving basic, translational, and clinical researchers; federal funding and regulatory agencies; and private organizations.”6
The CACPR will aid in this cultural transformation by advancing the broad perspective made possible by collaborations among the basic, translational, and clinical scientists and practitioners that constitute our center.
1) Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011.
http://books.nap.edu/openbook.php?record_id=13172&page=1.
2) Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington, D.C. (page 62)
http://books.nap.edu/openbook.php?record_id=13172&page=62
3) Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington, D.C. (page 24)
http://books.nap.edu/openbook.php?record_id=13172&page=24
4) Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington, D.C. (page 85)
http://books.nap.edu/openbook.php?record_id=13172&page=85
5) Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington, D.C. (page 48)
http://books.nap.edu/openbook.php?record_id=13172&page=48
6) Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington, D.C. (page 12)
http://books.nap.edu/openbook.php?record_id=13172&page=12
We recommend the following resource for additional information:
The Chronic Pain Research Alliance