Effective pain management requires an accurate assessment of pain.
An autonomous Disease
Generally, pain is considered to be chronic if it persists more than three to six months, although it may demonstrate characteristics of chronic pain much earlier. In contrast to acute pain, chronic pain has lost its warning and protective function and becomes a disease in its own right.
Chronic pain is a very common disease. In Europe it strikes almost one in five (19 per cent) adults, and its prevalence is on the rise.1 An in-depth survey of almost 5000 people indicated that one-third of these European chronic pain sufferers are in severe pain, and almost half have constant pain.1
Chronic Pain greatly impairs Patients’ Quality of Life
A patient’s quality of life can be tremendously affected if chronic pain is not appropriately treated. In addition to constantly suffering from pain, the patient may experience consequences like sleeping disorders, reduced mobility or depression. For these patients, pain means being handicapped physically, socially and psychologically:
- Two-thirds of pain sufferers are less able or unable to sleep
- About 60 per cent of patients with chronic pain are less able or unable to work outside their homes
- One in five chronic pain sufferers have been diagnosed with depression as a result of their pain
- About 40% of patients with chronic pain are less able or unable to have sexual relations
- About 25% of patients with chronic pain are less able or unable to maintain relationships with family and friends1
In addition to its impact on patients’ quality of life, chronic pain is also a substantial financial burden for society. Chronic pain is one of the most cost-intensive forms of suffering in industrialised countries. Across the EU chronic pain accounts for nearly 500 million lost working days every year – costing the European economy around €34 billion2. One in five chronic pain sufferers have lost a job as a result of their pain.1
1 Breivik H et al.: Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 2006; 10:287-333
2 Wiffen P: Pain – there is a lot of it. Eur J Hosp Pharm; 2013; 20:1
Pathophysiology and Conditions
Hypersensitivity as an identifying feature
Chronic pain is a complex phenomenon. It results from a sustained sensory abnormality caused by an ongoing peripheral process such as chronic inflammation; however, it can also occur independently of the trigger that initiated it. A general distinctive feature is hypersensitivity, which can result from two principles: either the response to an injurious stimulus is increased, resulting in exaggerated and prolonged pain, or the thresholds are reduced, leading to pain production in response to normally non-injurious stimuli. In both cases, the responsive pain system is altered, resulting in chronic pain.1 The longer the pain lasts, the lower the chance of an entire normalisation of the nervous system.
Typical chronic pain conditions are: low back pain, neuropathic pain, arthritis pain, osteoporotic pain and cancer-related pain.
1 Woolf CJ: Somatic Pain – Pathogenesis and Prevention. British Journal of Anaesthesia, 1995; 75:169-76Explore common chronic pain conditions
M--UK-11-18-0001 Date of Preparation December 2018