Untying chronic pain: prevalence and societal burden of chronic pain stages in the general population - a cross-sectional survey

Abstract

BackgroundChronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys.MethodsA cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses.Results2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]).ConclusionChronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.

Prevalence of Chronic Pain in a Large Integrated Healthcare Delivery System in the U.S.A

“…Medical comorbidities as defined by the Charlson scale were present in more than one‐third of patients. Although these data are broadly consistent with what has been reported in the literature, our results either extend or differ from those in the literature in several respects.…”

Towards a science and practice of resilience in the face of pain

“…In particular, pain may give rise to high levels of distress and even depression (Breivik et al, 2006;Miller and Cano, 2009). Furthermore, research has shown that a substantial number of adults and children/adolescents with chronic pain report high levels of disability (Goubert et al, 2004a;Häuser et al, 2014;Vervoort et al, 2014).…”

“…Studies using the Graded Chronic Pain Scale of von Korff and colleagues (1992) have shown that 7.5% to 8.4% of adults reporting persistent (back) pain (Goubert et al, 2004a;Reid et al, 2011;Häuser et al, 2014) function well with high-intensity pain. As well, a recent study in 10650 schoolchildren showed that 19% of children reported pain of high intensity but low disability (Vervoort et al, 2014).…”

Severity of chronic pain in an elderly population in Sweden—impact on costs and quality of life

“…Some studies, including studies that focus on health care use, indicate that very large costs are associated with chronic pain and especially severe chronic pain. 12,18,23,27,40 However, very little is known about health care costs in the elderly population. Obviously, the elderly rarely require sick leave, so these costs are marginal.…”