Some Basic Facts
Pain is a necessary part of life. Short-term pain, especially, is your body’s fire alarm. It is a powerful signal warning you of trouble in your body, forcing you to seek help, to take action.
What it would be like, though, if the fire alarm was stuck on? Imagine how exhausting that would be. As a sufferer of long-term pain, you do not need your imagination here. You know what it is like. You know how often you have gone to doctors and therapists, desperate for someone to shut off your relentless pain. You know the toll that long-term pain has taken on you and your family.
Both long-term pain and short-term pain involve real physical sensations that can vary in intensity - sometimes mild and more of a nuisance, and other times, excruciating. Chronic pain can develop after any type of injury and illness. In some people, repetitive activities in assembly line or computer work can lead to chronic shoulder or wrist pain, as examples. Chronic pain can also develop following a single high impact trauma, such as a car accident. Neck and back injuries are very common causes of chronic pain. Arthritis is also a common cause
Chronic pain has another defining feature - its long-term nature. Day after day, month after month, it can gain the power to wear you down, to weaken you, and to disrupt so many parts of your life. On one level, this is very obvious. Of course, long term is long-term. Anyone can see the logic here. Yet, this is not a simple or minor point.
When pain becomes chronic, it takes on a whole different character. Its impact on your life can be huge, affecting your ability to enjoy even the simplest moments. When pain becomes chronic, it means that there is no instant cure, no immediate medical fix through surgery or medication. Your life has been changed by your injury or illness. You may suffer from multiple chronic pains caused by multiple injuries. If you were hurt in a car accident, for instance, you may suffer from chronic neck, arm and back pain, all at the same time. However, with time, treatment, and proper management, as I will detail throughout this book, your pain and suffering can be reduced substantially. Your life will never be the same, though. You can never go back. And, I don’t need to tell you that this is one of the most challenging parts of any chronic health problem.
In a nutshell, chronic pain is more than just pain. Its long-term nature creates new symptoms, such as poor sleep, fatigue, mood changes, reduced short-term memory, and a variety of new stresses. Ongoing pain is the cause of these additional symptoms, which affect your ability to cope with the pain itself. It becomes a vicious cycle – pain causes stress, which leads to more pain. This is part of what makes chronic pain so complicated – and overwhelming for so many people.
The vicious cycle of long-term pain can also lead to major losses and disruptions to you and your family’s lives. If chronic pain interferes with your capacity to work, for instance, you may lose your job and have difficulty finding a replacement compatible with your limitations. You may be forced to rely on insurance or government benefits to help you live. As you may know, such benefits can be quite low compared to your work income. The increased stresses, caused by these losses and forced changes to your life, make it all the more difficult to manage your never-ending pain.
When you look at this big picture, you can see that long-term pain is
real physical pain, and much more. This is why chronic pain is often referred
to as a syndrome: chronic pain syndrome (or the more recent term, CPS).
The word syndrome means a collection of symptoms, not just a single one.
When pain becomes chronic, it sets off a chain reaction leading to a whole
collection of additional symptoms, stresses, losses, limitations, and
forced life changes.
Research Findings
From research studies over the past 50 years, scientists have learned an enormous amount about the nature of pain and how it affects people. For instance, it is known that 50 to 70 percent of people will experience back pain at some point in their lives. Each year, over 50 million North Americans will suffer from pain caused by traumatic injuries, such as car or work accidents. It has also been documented that over 45 million Canadians and Americans will suffer from muscle pain and over 88 million people from joint pain. Fortunately, these pain symptoms will be temporary for most of these people.
For many others, though, their pain will not go away with time. The Nuprin Pain Report (one of the first large scale studies published in 1985), found that over 12 percent of individuals in the United States had experienced pain on at least 101 days of the preceding year. In 1988, research from a Seattle health maintenance organization, found that 37 percent of people were suffering from recurrent pain and 8 percent reported severe persistent pain. A large-scale investigation from 2001, done in 14 countries, found that 22 percent of people experienced long-term pain. In this international study, back pain, headaches, and joint pain were found to be the most common types of chronic pain. These statistics probably reflect only "the tip of the iceberg," according to world-renowned pain scientists, Turk and Melzack, since many people suffer in silence without seeking medical attention.
The scientific literature has clearly documented the high rate and alarming toll caused by chronic pain for people throughout the world. In several studies, long-term pain has been identified as the leading cause of permanent disability and work loss. Dr. John Bonica, considered the "father of pain therapy", estimated that 50 million North Americans experience pain related disability. In economic terms, losses of productivity, and the costs of treatment, unemployment, and disability benefits for chronic pain sufferers has been estimated at more than $70 billion per year in the United States alone. This is a driving force for researchers, drug companies, government agencies and large disability insurers desperate to find a solution to the chronic pain crisis. The US Congress designated 2001-2010 as the Decade of Pain Control & Research – pain control has now been recognized as a priority.
The following references contain a wealth of additional scientific evidence regarding the nature and extent of chronic pain. More details regarding the extensive and growing research in this field can be found in Unbelievable Pain Control.
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Gatchel, R., Peng, Y., Peters, M., Fuchs, P., & Turk, D. (2007). The biopsychosocial approach to chronic pain: Scientific advances & future directions. Pain, 133[4], 581-624.
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Turk, D., & Melzack, R. (2001). Handbook of pain assessment. Guilford Press: New York.
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Gureje, O., Simon, G., & Von Korff, M. (2001). A cross-sectional study of the course of persistent pain in primary care. Pain, 92, 195-200.
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Gureje, O., Von Korff, M., Simon, G., & Gater, R. (1998). Persistent pain and well-being: A world health original study in primary care. Journal of the American Medical Association, 280[7], 147-151.
These and other scientific articles on almost
any health topic can be found through
the PubMed website:
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Dr. Michael MacDonald is the author of Unbelievable Pain Control: How to Heal and Recover from Chronic Pain and Fibromyalgia and a detailed website about pain that can be found at www.unbelievablepaincontrol.com