The American Academy of Pain Medicine

AAPM Facts and Figures on Pain

• Overview
• What is Chronic Pain? 

Overview

Pain is associated with a wide range of injury and disease, and is sometimes the disease itself. Some conditions may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be conditions in which pain constitutes the primary problem, such as neuropathic pains or headaches.

Millions suffer from acute or chronic pain every year and the effects of pain exact a tremendous cost on our country in health care costs, rehabilitation and lost worker productivity as well as the emotional and financial burden it places on patients and their families. The costs of unrelieved pain can result in longer hospital stays, increased rates of rehospitalization, increased outpatient visits, and decreased ability to function fully leading to lost income and insurance coverage. As such, patient?s unrelieved chronic pain problems often result in an inability to work and maintain health insurance. Reduced productivity due to pain costs employers somewhere between $60 and $100 billion annually yet NIH barely spends 1% of its funding on research focused primarily on pain.

Much more needs to be done to meet these challenges and to increase public awareness of them.

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What is Chronic Pain?

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap -- sprained back, serious infection, or there may be an ongoing cause of pain -- arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself). 


Incidence of Pain, as Compared to Major Conditions

Pain affects more Americans than diabetes, heart disease and cancer combined. The chart below depicts the number of pain sufferers compared to other major health conditions.

The Burden of Pain on Every Day Life

• The annual cost of chronic pain in the United States, including healthcare expenses, lost income, and lost productivity, is estimated to be $100 billion.
• More than half of all hospitalized patients experienced pain in the last days of their lives3 and although therapies are present to alleviate most pain for those dying of cancer, research shows that 50-75% of patients die in moderate to severe pain.
• An estimated 20% of American adults (42 million people) report that pain or physical discomfort disrupts their sleep a few nights a week or more.

Commonly-Reported Pain Conditions

• When asked about four common types of pain, respondents of a National Institute of Health Statistics survey indicated that low back pain was the most common (27%), followed by severe headache or migraine pain (15%), neck pain (15%) and facial ache or pain (4%).
• Back pain is the leading cause of disability in Americans under 45 years old. More than 26 million Americans between the ages of 20-64 experience frequent back pain.
• Adults with low back pain are often in worse physical and mental health than people who do not have low back pain: 28% of adults with low back pain report limited activity due to a chronic condition, as compared to 10% of adults who do not have low back pain. Also, adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain.

Highlights from the National Center for Health Statistics Report: Health, United States, 2006, Special Feature on Pain

• More than one-quarter of Americans (26%) age 20 years and over - or, an estimated 76.5 million Americans - report that they have had a problem with pain of any sort that persisted for more than 24 hours in duration. [NOTE: this number does not account for acute pain].
• Adults age 45-64 years were the most likely to report pain lasting more than 24 hours (30%). Twenty-five percent (25%) of young adults age 20-44 reported pain, and adults age 65 and over were the least likely to report pain (21%).

Control Over Chronic Pain

• More than half of respondents (51%) felt they had little or no control over their pain.
• Six out of ten patients (60%) said they experience breakthrough pain one or more times daily, severely impacting their quality of life and overall well-being.

Impact on Quality of Life

• Almost two-thirds (59%) reported an impact on their overall enjoyment of life.
• More than three quarters of patients (77%) reported feeling depressed.
• 70% said they have trouble concentrating.
• 74% said their energy level is impacted by their pain.
• 86% reported an inability to sleep well.

Lost Productive Time and Cost Due to Common Pain Conditions in the United States Workforce
Data from the American Productivity Audit, a computer assisted telephone survey of health and work, of 28,902 working adults between August, 2001 and July 2002, was used to estimate lost productive time due to headache, arthritis, back pain, and other musculoskeletal conditions expressed in hours per worker per week and calculated in US dollars.

• Over half (52.7%) of the workforce surveyed reported having headache, back pain, arthritis, or other musculoskeletal pain in the past two weeks, and 12.7% of all workforce lost productive time in a two-week period due to pain.
• Headache (5.4%) was the most common pain condition prompting lost productive time: followed by back pain (3.2%), arthritis pain (2%) and other musculoskeletal pain (2%).
• Overall, workers lost an average of 4.6 hours per week of productive time due to a pain condition.
• Other musculoskeletal pain (5.5 hours/week) and arthritis or back pain (5.2 hours/week) produced the largest amounts of lost productive time.
• Headache produced, on average, 3.5 hours of lost productive time per week.
• Age did not seem to attenuate the findings.
• Lost productive time from common painful conditions was estimated to be $61.2 billion per year, while 76.6% of lost productive time was explained by reduced work performance, not absenteeism.

America Speaks: Pain in America
2003 survey conducted by Peter D. Hart Research Associates as a nationwide survey for Research! America. The purpose of this study was to assess the view of Americans about pain in America. The survey's objectives included gauging Americans' perceptions of how pain sufferers and the medical community deal with the problems of chronic pain.
Dealing with Pain

• Among the major adjustments that chronic pain sufferers have made are such serious steps as taking disability leave from work (20%), changing jobs altogether (17%), getting help with activities of daily living (13%) and moving to a home that is easier to manage (13%).

A Visit to the Doctor

• Most pain sufferers (63%) have seen their family doctor for help.
• Forty percent made an appointment with a specialist, such as an orthopedist.
• Twenty Five percent have visited a chiropractor or a doctor that specializes in pain management (15%).
• While 43% of pain sufferers have been to only one type of doctor for their pain, a large proportion (38%) have consulted more than one practitioner in the medical community.
• Treatments for pain have yielded mixed results. Although 58% of those who took prescription medication say that doing so was very fairly effective for their pain, only 41% of those who took over-the-counter

The Pain Gap

• Seven in ten Americans feel that pain research and management should be one of the medical community's top few priorities (16%) or a high priority (55%)
• Almost six in 10 adults (57%) say they would be willing to pay one dollar more per week in taxes to increase federal funding for the scientific research into the causes and treatment of pain.