DEFINING PAIN

A highly subjective and intensely personal experience, pain eludes easy definition and transcends the often sterile language of medical literature.

Kathryn Padgett, Ph.D., co-founder and former executive director of the American Academy of Pain Management, has described pain as "a silent epidemic" that affects an estimated 50 million Americans.

"Pain is far more than neural transmission and sensory transduction," Padgett wrote in a Special Message from the Director that was posted on the AAPM website. "Pain is a complex melange of emotions, culture, experience, spirit, and sensation."

For purposes of diagnosis and treatment, the broad category of pain is often separated into two distinct subdivisions:

• Acute pain lasts less than six months, and usually occurs as a result of trauma, disease, or some other condition that can be addressed and treated.
• Chronic pain lasts for more than six months, endures even after any causal conditions have been remedied, and can have debilitating effects on an individual's quality of life.

The National Institute of Neurological Disorders and Stroke describes the difference in terms of both function and duration:

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different.

Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap - sprained back, serious infection - or there may be an ongoing cause of pain - arthritis, cancer, ear infection - but some people suffer chronic pain in the absence of any past injury or evidence of body damage.

Dr. Timothy Walker, medical director at Twelve Oaks Recovery Center, one of the nation's premiere programs for the treatment of chronic pain, says that the Twelve Oaks philosophy involves addressing pain as a separate and unique medical condition.

"Chronic pain is a disease entity just like diabetes," Walker said.

THE SCOPE OF THE PROBLEM

According to the American Pain Foundation, pain exerts a considerable negative influence on the physical, psychological, and financial well-being of both individual Americans and the nation as a whole:

• The annual cost of chronic pain in the United States, including health care expenses, lost income, and lost productivity, is estimated to be $100 billion.
• A 2006 study by the Centers for Disease Control and Prevention indicated that one in 10 American adults has experienced pain that lasted for at least a year.
• Adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain.
• Fifty-one percent of the 303 chronic pain sufferers who responded to the 2006 online survey "Voices of Chronic Pain" said they felt they had little or no control over their pain, and 77 percent reported feeling depressed because of their pain.
• Sixty-three percent of respondents to a 2005 ABC News/USA Today survey said they had talked about pain with their health care provider, but only 59 percent of these people said that these discussions led to "a great deal or a good amount" of pain relief.

GETTING HELP

Depending upon the nature and severity of the pain, and the experience and preferences of the attending physician, chronic pain may be treated with a wide range of practices and approaches, including acupuncture, behavior modification, electrical stimulation, prescription drugs and over-the-counter medications, physical therapy, psychotherapy, and surgery.

The Chronic Pain Management website provides details about these and other treatment options, and also lists a number of facilities that specialize in the treatment of chronic pain. By focusing on information and resources designed to empower pain patients to take an active role in their recovery, the CPM site can serve as a bridge between afflicted individuals and the healthy, active lives they are so eager to regain.