Pain is classified as acute or chronic, based on its duration.  Chronic pain is defined as pain lasting 3-6 months or more.  Acute pain usually is caused by injury or trauma, and it stops once the injury is healed. The two must be treated differently.  With chronic pain, the pain itself is the disease, and it does not respond to such standard therapies as surgery, medication, or bed rest.

Prevalence of Chronic Pain Among Americans

Results from the “American Productivity Audit,” presented at the IASP/10^th World Congress on Pain in 2002, provided the first direct estimates of LPT from these pain conditions. Researchers found lost productivity time — i.e. work absence and reduced performance at work-averaged 5.9 hours per week for arthritis, 5.8 hours per week for back pain, 3.6 hours per week for headache, and 6.6 hours per week for other musculoskeletal pain.

It has been estimated that 21.7% of adult Americans, or 34 million people, experience mild to moderate chronic pain to the degree that they seek relief from a physician.  Pain is the second most common reason people visit physicians - topped only by colds and upper respiratory infections. 

The National Institutes of Health claims that 40 million Americans are unable to find relief from their pain, which is chronic.  Other sources say the right figure is 50 million. It may not be quite that high.

One of the more significant findings of this study was that it is estimated that  9% of the U.S. adult population suffers from moderate to severe non-cancer related chronic pain. However, a newer Prevention Magazine/CBS News poll found that 12% had been diagnosed with chronic pain.  U.S. adult population estimates available from the government would indicate that there are approximately 19-20 million chronic pain sufferers in the United States. 

Chronic pain sufferers seek treatment because they are unable to perform daily activities, sleep, work, exercise, or concentrate.  Because of chronic pain, one-third of sufferers are not able to work or perform routine activities for one out of every three days of the year.  Of the people suffering from chronic pain, 60% are women.

 Treatments

Marketdata estimates that there are 3,549 pain programs, clinics, centers and/or specialists now active in the field, up from 3,411 in 1997 and 2,356 in 1995.   Added to this figure, there are an undetermined number of chiropractors, stress and biofeedback centers, massage therapists, physical therapists, dentists, radiologists,  HMOs/PPOs, and acupuncturists who also treat pain patients and who frequently call themselves pain "clinics".  Obviously, the terminology in the field is a little loose, and is the source of some of the image problems pain facilities face.

An estimated 9 million Americans were treated by pain clinics, centers, and solo practitioners such as chiropractors, anesthesiologists, and biofeedback therapists in 2002. Fully 7.1 million of these people are treated by anesthesiologists who provide nerve blocks, mostly on an outpatient basis. No doubt, many more are in need of treatment but don't receive it due to inadequate health insurance, denial of treatment by their insurers, ignorance of available facilities, etc. 

Chronic pain sufferers are having difficulty finding doctors who can effectively treat their pain, since almost one half have changed doctors since their pain began; almost a fourth have made at  least three changes. The primary reasons for a change are the doctor not taking their pain seriously enough, the doctor's unwillingness to treat it aggressively, the doctor's lack of knowledge about pain and the fact they still had too much pain.

A Chronic Comprehensive Pain Management Program should address the needs of persons with complaints of enduring pain which has not responded to previous appropriate medical and/or surgical treatment and which interferes with the person’s physical, psychological, social, and/or vocational functioning. 

The best pain management clinics (usually the most costly) utilize a comprehensive multidisciplinary team of specialists, including the following......MD, anesthesiologist, physiatrists....   doctors specializing in rehabilitation,  psychologists,  physical therapists, occupational/vocational therapists,  therapeutic recreation specialists, dietitians, social workers, nurses, biofeedback and stress management specialists, and  neurologists.

The 2003 Marketdatya survey found an average value or cost per visit of $571.94 for multidisciplinary  programs and an average of $378.77 for anesthesiologists. The total combined group average cost per visit is $502.40. Furthermore, this survey determined that the “typical” pain patient makes 9.7 visits to a pain program. Consequently, the average cost of treatment in 2003 was $4,873.

Types of Chronic Pain

Myofascial Pain

This type pain is characterized by the existence of "trigger points" in specific muscle areas, in any part of the body.  Myofascial pain can be trauma-related.  A 2003 Marketdata survey found that 18% of pain patients were treated for this condition (vs. 24% in 2001).

Fibromyalgia

This is a muscle condition seen in many women aged 25-60.  Here, the theory is that there is a symmetrical distribution of 17-18 "tender points" in the body. Stress and sleep disorders may be conditions from which people suffer.  However, no objective test defines this condition (or myofascial pain for that matter), and this condition may also be interrelated to lower back pain conditions.

Repetitive Stress Injuries (RSIs)  

The Marketdata 2003 survey found that only 1.4% of pain patients were treated for RSI (vs. 8.5% in 2001).  By some estimates, about 14 million people have visited a doctor for RSI of the hand and perhaps another 40 million have experienced symptoms but did not seek professional help.  According to the Bureau of Labor Statistics, RSIs of all types account for 60% of all reported occupational illnesses.

RSIs are muscular or skeletal injuries to the hand, wrist, and other areas which take the brunt of repetitive motion.   RSI may also be known as a "cumulative-trauma disorder”. It is now well accepted medically that RSIs are work-induced or aggravated. Carpal tunnel syndrome is a condition in which the nerves serving the hands are compressed.  Certain computer keyboards may be too high or improperly designed, straining the wrists. The majority of lawsuits being filed are by reporters, data processors, and telephone operators. Although RSIs mainly affect blue collar workers, they are becoming more commonplace in offices.

It is claimed that carpal tunnel affects 8 million Americans, with only 23% of CTS patients returning to work after their surgeries. The condition occurs most often in women aged 30-60 years, but it also occurs in men and in all age groups.  Medications used to treat carpal tunnel syndrome include diuretics and NSAIDS.  The carpal tunnel may be injected with corticosteroids and in some cases this provides dramatic relief of symptoms.

Back Pain

Back pain is still a huge problem in America. In addition, back pain ranks second only to headaches as the most frequent pain location. More than 65 million Americans experience low back pain every year. Four out of five adults will experience at least one bout of back pain at some time in their life.

Arthritis

According to the CDC, arthritis and chronic joint symptoms affect nearly 70 million Americans, or about one of every three adults, making it one of the most prevalent diseases in the United States. As the population ages, this number will increase dramatically. According to a 1999 CDC report, arthritis is the source of at least 44 million visits to health care providers, 744,000 hospitalizations, and 4 million days of hospital care per year.

For More Information

American Academy of Pain Management

13947 Mono Way, Suite A

Sonora, CA  95370    (209-533-9744)        

www.aapainmanage.org

American Chronic Pain Association

P.O. Box 850

Rocklin, CA  95677   (916-632-0922)

(Support group, self-help organization for pain patients with 850 local chapters,    publishes a newsletter and workbook, has 5,000 consumers on their mail list)

American Pain Foundation

201 N. Charles Street, Suite 710

Baltimore, Maryland 21201-4111     (410-783-7292)  

www.painfoundation.org

(Serves as a coordinator for patient support organizations, public education about pain)

American Pain Society (part of I.A.S.P.)

4700 West Lake Ave.

Glenview, IL  60025-1485   (847-375-4715)   

www.ampainsoc.org

(Member of Intl. Assn. for Study of Pain, multidisciplinary group of physicians and pain management experts, has annual member directory, newsletter (APS Journal),    conferences. Also publishes Pain Forum.)

National Chronic Pain Outreach Association, Inc.

P.O. Box 274

Millboro, VA  24460    (301-652-4948) 

(Members include: MDs, patients and spouses, physical therapists, others. Information clearinghouse, makes referrals, publishes newsletters.)

Some Other Resources

Lawrence Gold
certified Hanna somatic educator
Creative Director
The Institute for Somatic Study and Development

Website Creator:
Somatics on the Web
www.somatics.com
awareness@somatics.com

The Association for Hanna Somatic Education
925 Golden Gate Drive
Napa, CA 94945

Somatics on the Web Description: the largest and most complete access point to information about, and practitioners of, clinical somatic education, a new procedure for enduring relief of musculo-skeletal injuries and stress-related pain that has resisted standard therapeutics. Information, Practitioners, Self-help Programs Web address: http://www.somatics.com

Additional links:

Understanding More about Pain Management:  http://www.somatics.com/pain_management.htm

- WebMd

- drkoop.com

- National Institutes of Health (ww.nlm.nih.gov/medlineplus)