A Chronic Pain Crisis
Pulling back the veil on the public health crisis that is chronic pain.
Between March 29 to April 12, 2022, U.S. Pain Foundation conducted a survey of 2,378 individuals to better understand the public health crisis of chronic pain. Respondents included 2,275 people with chronic pain (96%), defined as pain lasting three months or more, as well as 72 caregivers (3%) and 31 health care professionals (1%).
Topics explored included types of pain, ability to work, patient-provider relationships, cost, treatment options, concerns about side effects, mental health, COVID-19, and mobility issues.
The results underscore the devastating impact of chronic pain on quality of life.
1. Chronic pain has devastating consequences on function, quality of life, and mental health.
- More than half (52%) said their average pain level is 7 or more on a scale of 1-10.
- 99% said pain has restricted their ability to engage in routine activities, like exercise, household chores, sleeping, and socializing.
- 95% of respondents had at least one comorbidity.
- More than two-thirds (71%) of respondents said they considered themselves disabled.
- Only 18% are employed full-time.
- 60% said they feel anxiety-like symptoms daily or a few times a week, and a similar portion (59%) feel depression-like symptoms daily or a few times a week.
- 79% said they feel stigmatized because of pain.
2. At best, people with pain feel their health care providers are not equipped to manage their pain effectively; at worst, people with pain feel unsupported and stigmatized.
- Approximately 63% of respondents felt stigmatized by their providers.
- Patients report that core competencies expected of providers treating pain are lacking.
- 24% “rarely” or “never” felt validated or listened to;
- 69% either did not feel, or only “rarely” or “sometimes” felt that their provider was on a team with them; and,
- 53% answered “no” or only “sometimes” when asked if their provider helped them understand options for managing their pain.
- When asked about their top pain policy issue, the most common answer was increased pain education for providers (41%), tied with wanting new medications for chronic pain.
- 71% of caregivers said “provider attitudes” are the top barrier to care.
3. Medications remain the most effective treatment option, but people with pain face significant barriers in accessing certain drugs.
- Nearly all respondents (79%) currently take prescription medications.
- A majority (77%) said prescription medications are the most helpful treatment in managing their pain.
- One-quarter (24%) said no side effect would prevent them from trying a medication to manage pain.
- Nearly half of respondents take opioid medications (47%), although three-quarters of that group report a range of substantial barriers to obtaining their medications. Barriers faced by those taking opioid medications include: decreased doses, stigmatization, and providers refusing to fill medications or outright refusing to treat the person with pain at all.
- Nearly all (94%) of those taking opioids said they attribute these barriers to the 2016 CDC opioid guideline.
- Roughly one-fifth (19%) of people with pain currently use medical cannabis.
- 43% of individuals in states where it is illegal said they would try medical cannabis if it were legalized.
4. Multidisciplinary approaches, particularly self-management techniques, are under-recognized components of effective pain management.
- Multidisciplinary approaches were widely employed, with the top strategies including activity restriction or modification (73%), stress reduction techniques (42%), heat therapy (41%), and meditation and mindfulness (40%).
- Activity restriction or modification is the most-used specific “therapy” of any kind across all categories, aside from prescription medications as an entire category (79%).
- Similarly, prescriptions were reported as the most helpful category of treatment (77%); self-management techniques as a whole were next at 31%, above OTC medications (27%), assistive devices or braces (24%), supplements, vitamins, or herbs (22%), medical cannabis (21%), mind-body and behavioral health options (20%), and interventional procedures and surgeries (17%).
- Less than one-fifth (19%) of people with pain had heard of the Pain Management Best Practices Report, a national set of recommendations that outlines the importance of multidisciplinary pain care.
5. Due to high out-of-pocket costs—coupled with pain’s drastic impact on the ability to work—cost remains the primary barrier to pain care.
- Approximately one-third (33%) of people with pain had a total annual household income of less than $35,000.
- According to people with pain, the leading barrier to treatment was cost (49%).
- Nearly half (41%) of people with pain said they felt insurance coverage decisions are driven by cost, not by what was in their best interest medically.