Chronic Pain: An Overview–September 2015

Chronic Pain: An Overview–September 2015


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A Growing Public Health Concern

Chronic pain affects 100 million Americans according to the American Academy of Pain Medicine (AAPM). That’s more than those with diabetes (25.8 million), heart disease (16.3 million), stroke (7 million) and cancer (11.9 million) combined.

Experiencing pain can take a toll on everyday life. The AAPM reports that about four in 10 Americans have pain that interferes with their mood, activities, sleep, ability to work or enjoyment of life.


 

Chronic Pain Series

Stay tuned for future newsletters on these types of chronic pain:

  • Neuropathic pain (tingling, burning, stabbing pain involving the nervous system).
  • Muscle pain (neck, back, legs etc.)
  • Inflammatory pain (redness, swelling and pain associated with an infection, irritation or injury in a specific location).
  • Mechanical/compressive pain (any kind of back pain caused by stress and strain on the spinal column).

 

Is It Chronic?

Pain is an unpleasant sensory or emotional experience. When it resolves quickly, it is called acute pain (think pain after surgery or with broken bones). With acute pain, the nervous system sends signals to the brain alerting us to take care of ourselves. When pain persists, it is called chronic or persistent pain. The nervous system keeps sending pain signals for weeks, months or even years. Chronic pain can be caused by conditions such as rheumatoid arthritis and peripheral neuropathy; an injury or accident; or can occur without any past injury or illness.

Whether your pain is considered chronic pain depends upon who you ask. Some pain experts define chronic pain as pain that lasts for three months; others say six months or even 12 months. The International Association for the Study of Pain provides an alternate definition: pain that continues after the expected healing period.

Chronic Pain

Because of its prevalence, seriousness, cost, risk of overuse of opioid medications, and need for prevention, chronic pain is considered a public health concern. In a study published in The Journal of Pain, Johns Hopkins University health economists reported that chronic pain costs from $560 to $635 billion a year. This study sought to evaluate the total cost of chronic pain on society; it quantified healthcare costs associated with treating chronic pain ($261-$300 billion) as well as the value of lost productivity such as absences and lost wages ($299 to $335 billion).

Experts expect the number of people affected by chronic pain to continue to grow. The most common conditions reported are low back pain, severe headache or migraine pain and neck pain. Chronic pain is a major driver behind doctor visits, use of medications, cause of disability, and a key reason for loss of quality of life and productivity.

Loss of productivity can refer to missed days (sick days) or disability days but also as reduced work performance. Participants in the American Productivity Audit reported losing on average 4.6 hours per week of productive time at work due to a pain condition. Those with musculoskeletal pain cited 5.5 hours per week of lost productive time and headache caused 3.5 hours per week of lost productivity.

Since trouble sleeping is a common concern, the effects of sleeplessness can cause a recurring cycle of fatigue, difficulty with concentration and low energy levels. It’s no wonder then that depression and a lack of enjoyment of life are common challenges for those in chronic pain. In an American Pain Foundation survey of chronic pain sufferers, 86 percent said they were unable to sleep well, 70 percent had trouble concentrating, 74 percent described that their energy was affected by their pain, and 77 percent of participants said they felt depressed.

There are many approaches to treating chronic pain, including prescription and over-the-counter (OTC) medications and numerous alternative strategies. OTC medications such as ibuprofen and acetaminophen can offer pain relief and are generally safe for most people to take (see box). A variety of prescription drugs are also available. Many pain sufferers try various approaches to discover what works best for them. For example, one KnovaSolutions member said he felt better after taking ibuprofen at night so he could rest, going to exercise classes twice a week and using a heating pad for his low back pain. Another reported that massage, acupuncture and yoga helped reduce her migraine pain.

A Note of Caution

Prescription medicines called opioids (or narcotics) are powerful pain killers. Because they can cause physical dependence, providers often recommend them for short-term use, such as for acute pain. Besides the risk of dependence, it is possible to develop tolerance for pain relievers, which results in the need for increasing doses to receive the same level of relief.

Opioid use and misuse in the U.S. have risen dramatically since the 1990s. The U.S. Centers for Disease Control analyzed prescribing data from pharmacies that showed that healthcare providers wrote 259 million prescriptions for opioids in 2012 and that 46 people died each day that year from an overdose of opioids. Because opioids are increasingly used illegally, it is important for people with valid prescriptions to store their medications out of the reach of others. A National Survey on Drug Use and Health found that 29 percent of people over 12 years who used illicit drugs for the first time began by using prescriptions drugs for non-medical purposes.

If you or someone in your family struggles with chronic pain, your KnovaSolutions nurse is a source for additional information and support. Please come back to our website monthly to see more newsletters about chronic pain and other topics. Let us know how we can help — 800/355-0885.

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We encourage you to leave a comment or question below and a KnovaSolutions nurse or pharmacist will reply.


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3 Responses to Chronic Pain: An Overview–September 2015

  1. Thanks for the information it helps to understand that I am not the only one now I wish that there was a solution to get rid of the pain not just bandage it

    • Thank you for your comment. Forty years is a long time to struggle with chronic pain and it sounds like you have tried many of the different strategies for coping with pain. A National Pain Strategy was released in 2016 by the Department of Health and Human Services. This was the first coordinated effort to make quality pain care a nationwide priority; it proposed improved access to quality care and better tracking to determine which therapies are most effective. We are hopeful that efforts to focus public attention on the problem of chronic pain will bring to light new approaches for pain treatment. Most of our members who have found relief from chronic pain attribute the success not to one approach, but rather to a combination of strategies that work hand-in-hand. We hope you will continue to try the various methods for management of pain, and hopefully find that some combination that provides at least a bit of relief.

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