April 20, 2021
Chronic pain is one of the most common conditions in the United States, but its exact prevalence has been difficult to determine.
The addition of a series of questions about pain to the National Health Interview Survey in 2019 has provided a clearer picture of just how many Americans are experiencing chronic pain.
Slightly more than 50 million U.S. adults report experiencing pain on most days, affecting their daily functioning and productivity, according to a new data analysis of the survey. It was conducted by researchers from Boston's Brigham and Women's Hospital and Mass Eye and Ear.
The study, published in Pain, found 20.5% of U.S. adults experience chronic pain. The most common sources are the back, hips, knees and feet. Physical therapy and massage therapy are the most frequent treatments used.
People with chronic pain miss significantly more work compared to people without it — 10.3 days per year versus 2.8, the data showed. That amounts to an estimated $300 billion in lost productivity and $79.9 billion in lost wages every year.
"Chronic pain is a serious condition that affects millions of Americans," said R. Jason Yong, medical director of the Pain Management Center at Brigham and Women's Hospital. "Other studies have touched on this fact, but data from pain clinics, hospitals and other providers tends to only provide information on people seeking out medical attention. Having the NHIS data to validate previous studies is incredibly impactful."
People with chronic pain also reported more limitations to their daily functioning and engagement in social activities.
"The impetus for our study arose from the day-to-day clinical finding that many of our chronic sinusitis patients also reported headache, migraine and other forms of chronic pain," said senior author Neil Bhattacharyya, an otolaryngologist at Mass Eye and Ear.
"We decided to look at the bigger picture of chronic pain, and we were somewhat surprised at the large-scale presence of chronic pain in the US."
The 2019 survey, conducted by the Centers For Disease Control and Prevention, included data from 31,997 U.S. adults. The researchers plan on using the data for further analysis on specific trends related to pain and how it is treated.
Understanding the connection between chronic pain and opioid addiction is of particular interest. The prescribing of opioid pain relievers in the last several decades has contributed to the surge in opioid addictions and overdose deaths, according to The National Institute on Drug Abuse.
Managing chronic pain is often challenging because pain is subjective and its cause isn't always easily diagnosed and treated, experts say.
Many people living with chronic pain, like those with Complex Regional Pain Syndrome, often feel like there is a stigma attached to their conditions because family and friends don't understand how truly debilitating their pain can be.
"Pain medicine is relatively young as a field, and it encompasses specialties including emergency medicine, anesthesia, psychiatry, neurology, physiatry and radiology," Yong said. "We need all of the tools in our armamentarium to treat patients suffering from chronic pain."
Harvard cardiologist Dr. Herbert Benson conceptualizes treatment for any chronic condition as a three-legged stool.
The first leg of the stool is made up of interventional treatments such as surgeries and injections. The second leg is made of medications to treat the condition. The third leg is the strategies that patients can personally take to manage their conditions. This includes education on their conditions, counseling to treat depression and anxiety, and making lifestyle changes that can reduce the pain.
According to the Mayo Clinic, reducing stress, getting a good night's sleep, healthy eating and regular exercise all can help reduce pain.