Economics of chronic pain: How can science guide health policy?

Excerpt

Prevalence estimates between 15-40% of the general population have been reported in epidemiologic studies of chronic noncancer pain1 which includes headache, arthritis, fibromyalgia, low back and neck, post-traumatic, neuropathic, visceral and other causes of pain. Recognizing the biopsychosocial complexity of chronic pain and the fact that diagnosis and/or cure of underlying conditions is often unsuccessful, John Bonica et al. pioneered the concept of multidisciplinary pain clinics over 50 years ago to manage these devastating conditions.2 Although chronic pain generally presents first to primary care practitioners, pain clinic referrals are made often for resistance to first-line treatments, severe unremitting pain and/or complex psychosocial situations. A wide variety of chronic pain treatment interventions are aimed at reducing pain, improving mood, promoting better physical, occupational, and social function, and teaching individual and family coping skills. A longstanding recognition of the value of pain clinics together with an increasing prevalence of chronic pain have led to growth in demand, waiting list size, and international concerns over limited pain treatment resources.3 ^, 4 In Canada, a task force was recently established to study pain treatment waiting times.4 In this issue of the Journal, STOP-PAIN Research Group investigators report on the biopsychosocial5 and economic6 burden of pain in individuals waiting to consult with a pain specialist. …