Part two of The Conversation’s series on pain has been published – a look at the cost of chronic pain:
Pain drain: the economic and social costs of chronic pain
In Australia, the burden of musculoskeletal conditions – the most common reason for chronic pain – exceeds that of all other chronic conditions.
The cost of these conditions to the Australian economy in 2012 was more than $A55 billion. Back pain and osteoarthritis, the most common of musculoskeletal conditions, accounted for 52% and 41% of cost respectively.
Pain management is one of the most neglected aspects of health care; our failure to adequately address chronic pain is a major driver of its economic and social burden.
Unfortunately, federal and state governments are yet to adopt a national policy for preventing and dealing with chronic pain. Moreover, the policy landscape remains fragmented by state, region, hospital and health network priorities.
For pain, it is no different. Without the crucial step of an implementation plan and importantly, action, the health care system will continue to produce poor patient outcomes with significant economic impact.
But here is the rub – the things that healthcare providers say can have long lasting and detrimental impacts on pain, the things that healthcare professionals think and believe might lead to sub-optimal treatment and outcomes, the well-intentioned things that doctors do can backfire and make the problem worse when patients see and hear the results of medical imaging, and just having health care providers as people in your life might make the problem worse.
Perhaps before governments adopt a chronic pain policy they need a. Really. Good. Understanding of. People* in Pain!
*Thanks to the commenter below for pointing out this very important amendment.
Tim, I would like to amend your final sentence to now read: “Perhaps before governments adopt a chronic pain policy they need a. Really. Good. Understanding of. People in Pain!
That would require another self-promoting link, but i think i could manage that… But, yes, a very good reminder that we can not reify and then divorce this thing ‘pain’ from the people who experience it.
How many “modern” concepts are there in this 1902 excerpt from the great Santanelli’s ‘Law of Suggestion’?
“I could tell you of myriads of experiments
which demonstrate beyond all question that the
body is entirely controlled by the mind; that pain
is a thought, and the thing we are most afraid of
is that which our mothers, fathers, brothers,
sisters and friends have done the best to build in
Pain is a bugaboo.
Your body is a house and an unwelcome neighbor calls. You try to smile ; ofttimes do. You invite him in and treat him with the best you have.
So let it be with pain, if he is going to enter the
house, instead of running away, meet him and sit
down and talk to him. You will forget his
unpleasantness, because there is good in all, and
if you are looking for good you can find it, but
if you are looking for “bad,” you can find “bad””.
And this excerpt?
“Pain…You feel it in the brain. Oh, yes. In the brain;…
Baby comes crying to mother—she
has hurt her hand ; mamma kisses it and the baby
goes away smiling; the mother being scientific
….instead of nursing the pretty thought that a
kiss from mamma will remove pain, teaches the
child to be afraid, and adds attributes—including
the doctor—and by and by the child has associated
with the thought of doctor only a man who gives
nasty medicine and hurts. Teach the children
that pain is something to be laughed at; fail to
add attributes to pain— arouse thoughts of “no
Through his own exhaustive experiments, he discovered in 1902
the importance of danger and safety beliefs, expectancy, fear,
‘experiential avoidance’ and catastrophizing. He also talks about exercise
and diet and of course the power of hypnosis…but I get the feeling we’re too busy reinventing the wheel.
The thing is, this is the most basic end of his discoveries. It goes into great depth
if anyone is interested.