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Chronic Pain In America: Roadblocks To Relief

Summary of Findings

Parameters Of Moderate To Severe Chronic Pain

CHRONIC PAIN SUFFERERS HAVE A SERIOUS HEALTH PROBLEM. THE MAJORITY HAVE PAIN THAT IS MORE LIKELY TO BE SEVERE OR VERY SEVERE RATHER THAN MODERATE AND IS THE TYPE THAT FLARES UP FREQUENTLY; THEY HAVE HAD THEIR PAIN FOR MANY YEARS AND FEEL THEIR PAIN ON AVERAGE 6 OUT OF 7 DAYS A WEEK.

"Using a 1 to 10 scale where 1 means no pain at all and 10 means the worst pain imaginable, how severe would you say your pain is?" (SQ. 3) "How long have you been experiencing that pain?" (SQ 2) "Which one of the following statements best describes your pain?" (Q. 1) "Do you feel your pain today?" (Q. 2a) "On about how many of the past 7 days have you felt your pain?" (Q. 2b).

Base: All chronic pain sufferers.

Severity (# of points) Total %
Moderate (5 or 6) 43
Severe (7) 23
Very Severe (8, 9 or 10) 34
Length of time had pain
6 months to 1 year 10
Over 1 year to 5 years 34
Over 5 years 56
Type of pain
Flares up frequently 61
Constant 39
Frequency
Feeling it today 78
Past 7 days mean 5.7


THE MORE SEVERE THEIR PAIN, THE MORE LIKELY IT IS TO BE CONSTANT RATHER THAN FLARING UP FREQUENTLY, TO BE A LONG TIME PROBLEM AND LESS LIKELY TO BE CAUSED BY ARTHRITIS.

Base: All chronic pain sufferers.

  -----Severity of Pain Now-----
  Total % Moderate % Severe % Very Severe %
Type of pain
Flares up frequently 61 77 57 45
Constant 39 23 43 55
Frequency
Feeling it today 78 71 81 84
Past 7 days mean 5.7 5.2 5.9 6.2
Length of time experiencing pain
6 months to 1 year 10 14 9 7
Over 1 year to 5 years 34 37 38 26
Over 5 years 56 49 53 67
Nature/cause of pain
Arthritis 37 45 33 31
Back pain 27 25 26 30
Other 31 26 36 34


55% OF CHRONIC PAIN SUFFERERS SAY THEY HAVE THEIR PAIN UNDER CONTROL; BUT, HAVING PAIN UNDER CONTROL VARIES INVERSELY WITH THE SEVERITY OF THE PAIN - ONLY 39% OF THOSE WITH VERY SEVERE PAIN SAY THEY HAVE IT UNDER CONTROL VERSUS 70% OF THOSE WITH MODERATE PAIN. IT IS IMPORTANT TO NOTE THAT CONTROL DOES NOT VARY SIGNIFICANTLY BY AGE OR SEX OF THE SUFFERER.

"Using a 1 to 10 scale where 1 means no pain at all and 10 means the worst pain imaginable, how severe would you say your pain is?"(Q. S3) "Is your pain pretty much under control now, or not?" (Q. 3a)

Base: All chronic pain sufferers.

  -----Severity of Pain Now-----
Total % Moderate % Severe % Very Severe %
Have pain under control 55 70 51 39
Do not have pain under control 41 26 46 58
Don't know 3 3 3 3


IT TAKES TIME TO GET CHRONIC PAIN UNDER CONTROL. AMONG THOSE HAVING THEIR PAIN UNDER CONTROL, IT TOOK THE MAJORITY AT LEAST 6 MONTHS TO REACH THAT POINT. HOWEVER, THE MORE SEVERE THE PAIN THE LONGER IT TAKES TO GET IT UNDER CONTROL; IT TOOK AT LEAST 6 MONTHS FOR ALMOST 70% OF THOSE WITH VERY SEVERE PAIN TO REACH THAT POINT VERSUS JUST OVER HALF OF THOSE WITH MODERATE PAIN.

"About how long did it take to reach a point where you had your pain pretty much under control?" (Q. 3b)

Base: All chronic pain sufferers saying their pain is pretty much under control.

  -----Severity of Pain Now-----
  Total % Moderate % Severe % Very Severe %
Less than 3 months 23 30 13 19
3 to 5 months 11 13 12 6
6 months to 1 year 21 19 20 24
Over 1 year 38 28 44 46
Don't know 7 6 11 6


PAIN CAN BECOME MORE ACUTE EVEN WHEN IT IS UNDER CONTROL; 40% OF CURRENT VERY SEVERE CASES WERE PREVIOUSLY MODERATE OR SEVERE. THE SHIFT AMONG CURRENT SEVERE CASES IS A 'WASH' WITH ALMOST JUST AS MANY CASES BECOMING LESS ACUTE THAN MORE ACUTE. THE GREATEST SUCCESS STORY IS AMONG CURRENT MODERATE PAIN CASES WHERE ALMOST ONE HALF ARE NOW LESS SEVERE.

"Using a 1 to 10 scale where 1 means no pain at all and 10 means the worst pain imaginable, how severe would you say your pain was before you reached a point before it was pretty much under control?" (Q. 3c)

Base: All chronic pain sufferers saying their pain is pretty much under control.

  -----Severity of Pain Now-----
  Total % Moderate % Severe % Very Severe %
Severity before it was under control
Moderate or less 41 49 37 24
Severe 16 14 19 16
Very severe 41 35 42 58


THE QUALITY OF LIFE HAS IMPROVED SIGNIFICANTLY AMONG THOSE WHO HAVE THEIR PAIN UNDER CONTROL.

"For each of the following activities, please tell me whether you could do it all the time, some of the time or never before your pain was pretty much under control?" (Q. 3d) "For each of the following activities, please tell me whether you can do it right now all the time, some of the time or never because of your pain?" (Q. 19)

Base: All chronic pain sufferers saying their pain is pretty much under control. All chronic pain sufferers saying their pain is not pretty much under control. Percent saying they can not do it all the time.

  ---Pretty much under control---
  Before % After % Point Diff. # Not under Control %
Exercising 81 70 +11 81
Sleeping 73 59 +14 79
Doing chores at home 71 50 +21 65
Doing usual hobbies/leisure activities 71 52 +19 67
Participating in social activities 70 51 +19 65
Walking 61 49 +12 59
Concentrating 59 35 +24 49
Having sex 58 45 +13 54
Maintaining relationships with family/friends 42 23 +19 31
Doing full days work at job 41 28 +13 41
Caring for your children 23 16 +7 20


WHEN PAIN IS UNDER CONTROL, THERE IS A SIGNIFICANT POSITIVE IMPROVEMENT IN A CHRONIC PAIN SUFFERER'S EMOTIONAL WELL-BEING.

"How did you feel before your pain was pretty much under control?" (Q. 3e) "How do you feel emotionally now?" (Q. 20)

Base: All chronic pain sufferers saying their pain is pretty much under control. All chronic pain sufferers saying their pain is not pretty much under control.

  ---Pretty much under control---
  (a) Before % (b) After % Change (b-a) # Pain Not Controlled %
Somewhat positive about life 71 89 +18 81
Irritable, cranky 65 22 -43 35
Depressed 45 13 -32 25
Happy, upbeat 41 84 +43 66
Listless 40 11 -29 27
Useless/worthless 28 7 -21 18
Unable to cope 20 7 -13 11


WHETHER OR NOT PAIN IS UNDER CONTROL, VERY SEVERE PAIN STILL HAS A MAJOR NEGATIVE IMPACT ON QUALITY OF LIFE.

"For each of the following activities, please tell me whether you can do it right now all the time, some of the time or never because of your pain?" (Q. 19)

Base: All chronic pain sufferers. Percent saying they can not do it all the time right now (some of the time/never).

  -----Severity of Pain Now-----
  Total % Moderate % Severe % Very Severe %
Exercising 75 68 82 80
Sleeping 68 56 76 79
Doing usual hobbies/leisure activities 59 51 65 66
Participating in social activities 58 47 61 69
Doing chores at home 57 44 60 70
Walking 53 44 57 64
Having sex 50 44 47 58
Concentrating 42 35 42 50
Maintaining relationships with family/friends 26 19 30 35
Doing full days work at job 34 27 32 46
Care for children 17 16 18 20


WHETHER OR NOT PAIN IS UNDER CONTROL, VERY SEVERE PAIN STILL HAS A MAJOR NEGATIVE IMPACT ON A CHRONIC PAIN SUFFERER'S EMOTIONAL WELL-BEING.

"How do you feel emotionally now?" (Q. 20)

Base: All chronic pain sufferers.

  -----Severity of Pain Now-----
  Total % Moderate % Severe % Very Severe %
Somewhat positive about life 85 88 87 81
Happy, upbeat 76 84 71 68
Irritable, cranky 27 20 29 35
Depressed 18 12 20 25
Listless 18 12 20 25
Useless/worthless 12 8 8 19
Unable to cope 9 6 7 13


CHRONIC PAIN SUFFERERS PERCEIVE POSITIVE AND HELPFUL SUPPORT FROM THE PEOPLE MOST IMPORTANT TO THEM; HOWEVER, EMPLOYERS ARE NOT AS SUPPORTIVE AS CLOSE FAMILY AND FRIENDS OR DOCTORS.

"Different people can have different reactions to your pain such as your employer, family, friends or doctor. What is (PERSONS) reaction to your pain?" (Q. 22)

Base: All chronic pain sufferers.

  Closest Family Member % Closest Friend % Employer % Doctor %
Very understanding 87 89 64 87
Supportive, ask how they can help 78 75 48 63
Say you are handling it well 75 81 60 76
Help with your chores/tasks 69 49 26 8
Encourage you to do things, take your mind off your pain 57 61 38 53
Are tired of hearing it from you 18 8 9 4
Don't understand at all what its like 16 13 19 10
Should be stoic, stop complaining 11 5 11 4
Ignore your concerns/complaints 11 7 15 5
Get angry with you 10 3 7 2
Its all in your mind/imagining it 7 4 6 5
You're milking it for all its worth 5 3 7 1
Using drugs as a crutch 2 1 * 1
Becoming addicted to drugs 2 1 0 1


On to: Role of the Medical Profession

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