1) How many people are in pain?
Nearly four in 10 Americans age 18 or older – 42% – experience pain each day, according to a recent Gallup Organization survey. The survey, released in June 1999, also found approximately nine in 10 American adults – 89% – experience pain each month. Another survey published in the British medical journal Lancet found 46.5% of the population age 25 and older suffers from chronic pain. In the United States alone, an estimated 40 to 50 million Americans suffer from chronic pain, which accounts for more than 80% of all physician visits. Each year, another 25 million people experience acute pain.

2) What is the impact of chronic pain on society?
In addition to the devastating toll pain takes on a person’s relationships, employment and enjoyment of life, chronic pain costs the nation an estimated $70 billion a year in medical claims, disability and lost productivity. The Nuprin Report, a 1986 survey of pain in the United States, noted four billion work days are lost each year resulting in a financial loss of $79 billion per year to the U.S. economy.

3) What is the difference between chronic pain and acute pain?
Acute pain, or eudynia, is pain that represents an underlying disease process. It is a warning pain that is expected to occur secondary to an underlying disease or injury. Such pain can be mild to severe in intensity, but generally goes away or lessens as the underlying cause is treated or otherwise resolved.
Chronic pain, or maldynia, represents changes in the peripheral or central nervous system that cause the pain to become a disease in and of itself. Such pain no longer serves as a warning for underlying disease or injury and can totally destroy a person’s life. Chronic pain can range from mild to severe in intensity and can last indefinitely if not treated appropriately. Recent research has demonstrated that undertreated eudynia can lead to maldynia.

4) What are the most common types of acute or chronic pain?
While pain has hundreds of causes, the conditions most associated with pain are:

  • Arthritis
  • Headaches
  • Neck and back problems
  • Cancer
  • Neuropathies—Pain from damaged or diseased nerves in the body.
  • Complex Regional Pain Syndrome (CRPS) – An often-disabling condition, the cause of which is unknown. While causes and symptoms vary widely, the one overriding symptom common to everyone with CRPS is severe pain that seems out of proportion to the injury or illness with which it is associated.
  • Irritable Bowel Syndrome
  • Pelvic Pain Disorder and Interstitial Cystitis (chronic bladder pain)
  • Shingles (post-herpetic neuralgia)
  • Soft Tissue Pain—For example, fibromyalgia, a common syndrome indicating widespread pain in fibrous tissues, muscles, tendons and other connective tissues.

5) What is the best way to treat pain?
Just as there is no one cause of pain, there is no single treatment option. How pain is treated depends upon the diagnosis, symptoms, the apparent cause of pain and a multitude of other factors. However, untreated acute pain (eudynia) can definitely lead to the development of chronic pain (maldynia). If pain persists longer than an expected period of time, it is best to consult with a Pain Medicine practitioner.
A listing of Pain Medicine physicians can be found on the American Academy of Pain Medicine Web site, www.painmed.org. A list of doctors who have been credentialed and certified as Pain Medicine specialists by the American Board of Pain Medicine (ABPM) is available on the ABPM Web site, www.abpm.org.
General information about pain treatment by condition or category can be found on the National Pain Foundation Web site, www.nationalpainfoundation.org.

6) How does chronic pain affect children?
It is estimated that as many as 20% of children may be affected by chronic pain, which may predispose them to ongoing pain as adults.

7) What are the issues associated with children and pain?
Among the barriers to effective pain relief for children is the belief that children, particularly infants, don’t feel pain the same way adults do. A lack of assessment guidelines, fears about side effects of pain medications, and the belief by some that pain builds character in children contribute to the undertreatment of children in pain.

8) What is Pain Medicine?
Pain Medicine is a distinct medical specialty that was recognized by the American Medical Association in 1988. Pain Medicine is concerned with the study of pain, prevention of pain, and the evaluation, treatment and rehabilitation of persons in pain. Practitioners typically take an integrated, multi-disciplinary approach to pain management. The American Academy of Pain Medicine (AAPM) is the primary professional organization for physicians practicing Pain Medicine in the United States. The AAPM has approximately 1,300 members.

9) What role does the Pain Medicine physician play?
The Pain Medicine physician may serve as a consultant to other physicians and to public and private agencies or serve as a patient’s principal treating physician. He or she may provide care at various levels, such as direct treatment, prescribing medication, prescribing rehabilitation services, performing pain-relieving procedures, counseling patients and families, directing a multidisciplinary team, and coordinating care with other health care providers. Pain Medicine physicians work in a variety of settings and are qualified to treat the entire range of pain experienced by patients.

10) How does one find a qualified pain physician?
If one’s own physician is unable to provide a reference to a qualified Pain Medicine doctor, a listing of Pain Medicine physicians can be found on the American Academy of Pain Medicine Web site, www.painmed.org. A list of physicians credentialed and certified by the American Board of Pain Medicine (ABPM) can be found on the ABPM Web side, www.abpm.org. In addition, a number of other professional organizations, in general or specialty categories, can offer assistance in locating health care professionals or facilities that help manage pain. Visit the National Pain Foundation Web site – www.nationalpainfoundation.org
– for the names, addresses, phone numbers and e-mail addresses of professional organizations.

11) What is the federal government doing to support research on pain?
The 106th Congress declared the first decade of the new millennium the “Decade of Pain Control and Research.” It is only the second congressionally declared medical decade, the first being the “Decade of the Brain” in the 1990s.

12) Where can one find information about pain issues, management and support?
The National Pain Foundation, www.nationalpainfoundation.org, and the American Academy of Pain Medicine, www.painmed.org, provide comprehensive information about pain management, issues and support, including listings of other organizations that can help people in pain. For additional information, contact the NPF Executive Director Mary Pat Aardrup at (303) 783-8899 or by e-mail at aardrup@nationalpainfoundation.org.

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