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NIH: Disability as common with chronic pain as with some other illness

September 5, 2018 GMT

About 11 million adults nationwide have high-impact chronic pain — characterized by pain lasting for three months or longer, and resulting in at least one major activity restriction. And a new study by the National Institutes of Health shows that disability is as likely for those who have suffered chronic pain as it is for patients of kidney failure, emphysema or stroke.

The study — conducted by scientists at the National Center for Complementary and Integrative Health and the National Institute of Neurological Disorders and Stroke at the National Institutes of Health as well as the Kaiser Permanente Washington Health Research Institute, Seattle — was published in the Journal of Pain.

“The multidimensional nature of chronic pain is not reflected in commonly used operational definitions based solely on pain duration, resulting in inordinately high prevalence estimates that limit our ability to effectively address chronic pain on a national level,” said Mark Pitcher, one of the authors of the study, in a news release.

The high-impact chronic pain population constitutes some 4.8 percent of the U.S. adult population. According to researchers, about 83 percent of people with this pain were unable to work for a living, and one-third had difficulty with self-care activities such as washing themselves and getting dressed.

While prior research has assessed the impact of pain using questions that ask how much pain interferes with life activities, scientists believe it is likely that those with severe pain had a hard time realizing how much more difficult it was for them to carry out important life activities. So, the new study used an alternative approach, which assessed activity limitations and participation restrictions using general disability questions without reference to pain experience.

“It is crucial that we fully understand how people’s lives are affected by chronic pain. It will help improve care for individuals living with chronic pain and strategically guide our research programs that aim to reduce the burden of pain at the population level,” said Linda Porter, Ph.D., director of the Office of Pain Policy at NINDS in the news release. “The findings from this study are a strong step toward these goals.”

The study used nationally representative data from the 2011 National Health Interview Survey to assess the prevalence, psychosocial characteristics, health status and health care usage of the chronic pain population. The study also determined the degree of contribution made by other chronic health conditions to activity limitations and participation restrictions. Statistical analyses were performed on merged datasets that represented a weighted population size of approximately 220.3 million non-institutionalized adults.

The research, according to the NIH, ultimately highlights the role of pain-related disability as a key indicator of pain impact. Experts said the study’s findings could improve treatments, and provide much-needed information to policymakers.