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David Baxter PhD

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Chronic pain sufferers not receiving medical treatment for their condition
Queen's University News Centre

Health & Medicine Category - (Kingston, ON) “ About half of those reporting that they suffer from chronic pain in southeastern Ontario say they are not receiving medical treatment for their condition, according to a seven-county survey by a Queen's University pain research team.

And pain is more commonly reported in people with low incomes and lower levels of education.

These are just two of the findings of a new Queen's study, led by Dean Tripp of the Departments of Psychology, Anesthesiology and Urology. The report, funded by Queen's Department of Anesthesiology, is now being prepared for publication.

I believe this clinical snapshot of health-related issues in southeastern Ontario may be representative of other parts of the province, given the diversity of the population, says Dr. Tripp. Perhaps the next step will be to conduct similar studies in other parts of Ontario that may have been missed by census or large scale surveys gathering non-specific information about chronic pain and such health issues."

Forty-three per cent of respondents in the random telephone survey report that they experienced constant or bothersome pain within the past six months. Of this group, 50% reported receiving no medical treatment for their condition “a finding that Dr. Tripp considers alarming. A lot of people in our communities may be suffering in silence, experiencing and fighting pain that is left untreated, he says.

As the severity of pain increases, so does the likelihood of people experiencing depressive symptoms, the survey shows. Respondents who reported high pain/interference (Grade 4) were six times more likely to also report depressive symptoms, compared to respondents who reported low pain/interference (Grade 1).

Other key findings from the survey:
o Medication use is 2.5 times greater among people in the highest pain categories (Grades 3 and 4).
o Those who use pain medication seven or more times per week are twice as likely also to report depressive symptoms.
o Respondents who report 7+medications per week are 2.6 times more likely to report high pain (Grade 3/4) than respondents who report no medication use.
o People who rate their general health as fair or poor are twice as likely to report high pain than those reporting excellent or good health.

We know that pain is an adaptive and necessary internal alarm system for bodily injury in the short-term or acute sense, but when short-term pain becomes chronic, it acts much like an alarm that is stuck on and won't go away, says Dr. Tripp. Although continued chronic pain may be providing little new information to the suffering person in regard to new injury or threat, persistent pain can often promote distress, anger, frustration, and in some cases, depression.

Chronic pain costs the North American economy an estimated $40 billion annually, with an additional $40 billion spent on the management of depression “considered a co-morbid factor with pain, since the two frequently occur together. Pain patients with depression have a greater likelihood of non-recovery and increased healthcare use than pain patients with no depression.

The Queen's research team, including Psychology graduate student Margo McAlister and Epidemiologist Elizabeth VanDenKerkhof, used a chronic pain grading system in the random telephone survey that classifies pain into four distinct categories. We didn't think it was enough to look just at the persistence of the pain, but also how disabling it is, and the level of intensity, Dr. VanDenKerkhof notes.

Of the 1067 respondents, 34% reported persistent pain but of low intensity, with low interference in their lives (Grade 1); 26% reported a high severity of pain, but low interference (Grade 2); 9% had moderately limiting pain with high interference (Grade 3); and 8% had severely limiting pain with high interference (Grade 4).

Statistics from other parts of Canada, using pain grades of 2-4, show that southeastern Ontario has a relatively high rate of chronic pain: 43% compared to an average of 22 to 50% prevalence elsewhere.

?€œOur survey shows that a substantial proportion of the general population in our community suffers from highly interfering and disabling pain, associated with depression, poor health, high health care and medication use, says Dr. Tripp. The high prevalence of our sample suffering from these problems indicates the need for aggressive action to encourage further research and increased funding for multidisciplinary treatment facilities in this region.

Nancy Dorrance, Queen's News & Media Services, 613.533.2869
Lorinda Peterson, Queen's News & Media Services, 613.533.3234
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