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Costs of chronic pain COSTS OF CHRONIC PAIN
Chronic pain is that which is persistent or recurrent and lasts longer than the usual expected time after illness or injury. Low back pain is by far the most common form of chronic pain, comprising about
80 per cent of cases. Millions more suffer other chronic pain conditions such as the excruciating facial pain of trigeminal neuralgia,TMJ (temporo-mandibular joint dysfunction syndrome) affecting the jaw joint, post-herpetic neuralgia and phantom limb pain. Many cope with headaches, arthritis and other musculo-skeletal problems without excessive invalidism, medication, or health care. Unfortunately, a significant number of chronic pain sufferers have a complex variety of feelings, thinking and behaviourial symptoms.The financial costs of chronic pain may well be the highest of any health problem.
It includes the costs of social security payments, treatment, workers compensation and the loss of productivity. In New South Wales, 1984-85 figures showed that 'sprains and strains' accounted for 49.5% of claims for workers compensation, a total of 48,751 cases. The NSW compensation payout had risen from $286 million in 1980 to $666 in 1984-85. Australian Bureau of Statistics (ABS) figures quoted in a leading article on pain in The Bulletin magazine showed that over 20% of compensation claims in Australia were for the condition of Repetitive Strain Injury (RSI) consisting of work related synovitis, bursitis and myofascial pain disorders. A further 20% had other problems of the musculoskeletal system and connective tissues. Apart from industrial deafness at 42% of claims, no other condition exceeded more than 4% of the total.
The ABS survey showed that headache due to unspecified or trivial causes was the most common Australian complaint. Some 10% said they had suffered one in the two week survey period. According to the Arthritis Foundation of Australia, one person in 12 in this country suffers from arthritis. This means that 1.3 million Australians have pain as a major disability. Arthritis accounts for more lost work days (over 7.5 million man hours) than any other medical condition and exceeds those lost due to industrial strikes.
The social costs of chronic pain are even more tragic, with so many young sufferers incapacitated for life, and the subsequent disruption to the family, the individual and society as a whole. Rather than brand sufferers as 'neurotic and hysterical', a more enlightened approach is called for, with early treatment, research and ultimately prevention.
Chronic pain in Australia is also a major issue in law suits and disability-benefit decisions. Whether or not a pain sufferer is typical of a hospital'pain clinic, or of a private practice population, the behaviour of pain patients gradually becomes less consistent with organic pathology.
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Pain
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