Last month, the National Institutes of Health (NIH) released the results of one of the largest population studies ever about pain. About 40 million U.S. residents experience severe pain, and more than 25 million are in pain every day.
It’s hardly a surprise that the study, published in The Journal of Pain, concluded that people with severe pain were more likely to have worse health status, use more health care and suffer from more disability than people with less severe pain.
As reported by KaiserHealthNews.org (KHN), Richard Nahin, the lead author of the analysis, said, “If people are in the most severe category of pain, whatever treatment they are getting may be inadequate.”
Pain is tricky to understand and treat for several reasons. Everyone’s experience of pain is different. There’s no objective test to measure or diagnose it. And cultural differences sometimes influence how patients report it — the study, for example, showed Hispanics and Asians are less likely to report pain. But that doesn’t mean it isn’t significant or shouldn’t be treated.
Treating pain isn’t just about what happens to a person physically — emotional and cognitive factors also are involved. Treatment generally is about managing symptoms, and that can require a variety of interventions.
KHN reported about one pain patient, Paul Gileno, who has experienced chronic pain since he broke his back 12 years ago. Gileno founded the U.S. Pain Foundation, an advocacy group.
He underwent several surgeries, and tried many different pain meds. Today, he uses acupuncture, meditation and follows a certain diet to manage his pain. He’s still in pain every day, but those interventions enable him to take less prescription medicine.
“After I saw the last neurologist and the last doctor and they said, ‘Listen we’ve done everything we can do and I don’t think your pain is going to go away,’ I had to come to terms that I would have chronic pain for the rest of my life,” Gileno said. “Pain comes with a lot of baggage. It comes with depression. It comes with feeling judged and you feel less of a person. You become very isolated.”
“You need to keep trying these different modalities because you never want to give up hoping that your pain can be reduced or go away,” he told KHN.
Dr. Sean Morrison is a geriatrician and director of Palliative Care at Mount Sinai Hospital in New York. As people get older, they suffer more medical problems and, often, more pain. Morrison noted that pain affects more than just the patient. “… it has a significant impact on caregivers who are caring for people who have pain.”
And as effective treatments are developed for more diseases, more people will suffer the side effects of pain. “Many of the cancer drugs we use now result in permanent nerve injury and resulting neuropathic pain which is very difficult to treat,” Morrison told KHN.
In addition, Morrison’s concerned that as law enforcement cracks down on prescription drug abuse, it’s becoming more difficult for legitimate pain patients to get the medicines they need, as scrutiny tightens on physicians and pharmacists. The drugs that are abused, he pointed out, are the same ones that are appropriate for a large segment of the patient population. “…people in pain,” Morrison said, “are the unintended victims of the war of drugs.”
To learn more about living and coping with pain, see Patrick’s newsletter, “Managing Chronic Pain.”