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Health Care, Health Disparities, Health Reform, Healthcare, Mental Health, Mental Health Care, Mental Illness, Public Health, Science, Society, Uncategorized, Women's Health

Chronic Pain: The Invisible Epidemic Affecting Millions Of Americans

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Living with chronic pain — from lower back problems to fibromyalgia, arthritis or migraines — is a daily struggle, made even more difficult when sufferers feel misunderstood by the people around them.

And sadly, chronic pain is incredibly common. Twenty-five million U.S. adults suffer from pain on a daily basis, according to an August report by the National Center for Complementary and Integrative Health, published in the Journal of Pain. Forty million adults suffer from severe levels of pain, though less regularly, than the chronic sufferers. In total, about 100 million Americans are affected by chronic pain, the report says.

“The number of people who suffer from severe and lasting pain is striking,” Dr. Josephine Briggs, director of NCCIH, said in a statement.

Those who report severe chronic pain (levels 3 or 4 on the survey’s pain scale) have worse health, suffer from more disability and use more health care services than individuals who suffered from lower pain thresholds (levels 1 or 2). The report, which was part of the 2012 National Health Interview Survey, included information from 8,781 adults between 2007 and 2012.

Here are some of the key takeaways:

Treatment can be a challenge 

There’s no one-size-fits-all approach to treating chronic pain. Prescription painkillers, which are among the few treatments covered by health insurance, work for some people, but many of these drugs have side effects and can be addictive.

Thirty-three percent of adults reported using alternative pain-management and health treatments in 2012. Yoga, which is now practiced by 10 percent of adults, has seen huge gains in popularity over the last five years, according to the report. Other mind-and-body treatments, such as massage therapy, acupuncture and relaxation therapy, have held steady in popularity or declined slightly since 2007.

Because pain is so personal and subjective, these pain-management techniques may work for some people and not for others, according to the NIH. Some studies have shown that yoga and stretching, can ease lower-back pain. On the other hand, the scientific evidence that melatonin can reduce pain, is fairly weak, according to the Mayo Clinic.

There’s a link between chronic pain and depression

“Approximately one-third to three-quarters of people with chronic pain experience moderate to severe depression,” Michael Clark, a psychiatrist and director of the pain treatment program at Johns Hopkins Hospital told The Washington Post. “Both depression and chronic pain share some of the same neurotransmitters and nerve pathways. So pain is worse, function is poor, response to pain treatment is diminished and their prognosis is worse until they can get their depression under better control.”

This gap between the intense experience of having constant pain and the inability of others to understand that pain, can drive a wedge in social relationships and take a dramatic toll on the lives of sufferers, says author and chronic pain expert Toni Bernhard.

“Being repeatedly told that we look and sound fine can lead us to think it’s our fault that we’re sick or in pain,” Bernhard wrote in Psychology Today. “We can be overcome with guilt, as if we’re failing those we care about, and we can feel embarrassed that we’re not living up to what we’ve convinced ourselves other people are expecting of us. The culture around us reinforces these feelings of guilt and embarrassment by sending the message that no one need be sick or in pain. We’re bombarded by news stories and advertisements telling us that we need only do this or do that in order to be healthy.”

Doctors aren’t adequately trained to treat chronic pain

The Institute of Medicine (IOM) says that primary care providers should perform the majority of care and management of patients with chronic pain. Specialty care services should be reserved for more complex cases.

But according to the IOM, many health care professionals are not fully prepared to provide pain care, or to guide patients in managing their own chronic pain. “For example,” the IOM said in a 2011 report, “only five of the nation’s 133 medical schools require courses on pain, and just 17 offer elective courses.”

To address these training shortfalls, the IOM recommends that “licensing and certification exams should include assessment of pain-related knowledge and capabilities,” and that “programs that train specialists or offer training in advanced pain care need to be expanded.”

While the results of the new survey aren’t necessarily heartening — chronic pain is still a major health problem for Americans — here’s to hoping that more data about pain today will translate into new treatments options in the future.

 

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