The High Cost of Chronic Pain (excerpts)

http://www.webmd.com/pain-management/chronic-back-pain/cost-of-pain?page=1

According to the American Chronic Pain Association, pain is the No. 1 cause of adult disability in the U.S. At least one out of six people live with chronic pain.

A 2003 study published in The Journal of the American Medical Association put the cost at $61.2 billion per year. But that's only the money drained from U.S. businesses because of productivity lost from employees in pain. It only included arthritis, back pain, headache, and other musculoskeletal pain; other kinds of chronic pain were excluded.

And while looking at pain's bottom line is important, no price can be put on the enormous suffering it causes.

"The costs are incalculable," says Christopher L. Edwards, PhD, assistant professor of psychiatry at Duke University School of Medicine.

Pain has a high social cost for the sufferer, too. Because pain is a personal and subjective experience, it can lead to problems with family and co-workers. While you may be in terrible distress, the people around you just can't see or feel what you're going through.

"I think people in pain sometimes get unfairly dismissed by family and co-workers" Robert Bonakdar, MD, tells WebMD, "especially when they don't have an outward sign of suffering, like a cast or a bandage." Bonakdar is the director of integrative pain management at the Scripps Center for Integrative Medicine, La Jolla, Calif.

Cohen says this is toughest for people who suffer from painful syndromes, like fibromyalgia, irritable bowel syndrome (IBS), and complex regional pain syndrome.

"There's much less sympathy and understanding for these elusive syndromes," says Cohen. While Edwards says that the treatment for pain can often lead to as much stigma as the pain itself.

"When people hear that you're taking a narcotic pain reliever like methadone," he says, "they associate it with addicts." That can lead people to make some very wrong assumptions about you."

Edwards adds that there's confusion between dependence on a drug and addiction to it.

"If you take any drug regularly, your body will get used to it," he says. "That's called dependence and it's very different from addiction. I'm an asthmatic and I'm dependent on my inhaler. Without it I'm on the floor gasping. But that does not mean I'm addicted to it."

But pain specialists agree we haven't done enough.

"Pain management in the 21st century is more than just improving your rating on a [1 to 10] pain score," Cohen tells WebMD. "It's about how well you can function, your mood, your and your quality of life." It's about allowing someone to be active and productive again.

"I see patients who say that treatment has reduced their pain from an 8 to a 4," says Bonakdar. "That's great, but they're still depressed, they can't sleep, and they're mentally foggy. We need to treat the whole person, not just the pain."

As a pain sufferer, you have to speak up. The costs of pain -- emotionally and financially, personally and societally -- are simply too high to ignore. So tell your doctor about your pain. Explain how it limits you. If your treatment isn't working, ask what alternatives you can try.

"The bottom line is that people need to take a more active role with their health care providers and demand treatment," Cowan tells WebMD. "You have a right to have your pain managed."