ArticlesThe epidemiology of chronic pain in the community
Introduction
Chronic pain is recognised as a common problem within the community, and is known to affect general health,1 psychological health,2, 3, 4 and social and economic well-being.5, 6 Chronic pain is one of the most common reasons why people seek medical care; patients with chronic pain use health services up to five times more frequently than the rest of the population.7, 8 Chronic pain also results in many days lost from work.9 Nevertheless, our understanding of the epidemiology of chronic pain remains limited. Several previous studies of the prevalence of chronic pain have been based on patients attending pain clinics,10, 11 but these patients represent one extreme of the population with chronic pain and are not likely to be representative of the general population.12, 13
Good community-based epidemiological studies have been difficult to do. Many approaches used to estimate the prevalence of chronic pain have had limitations, such as the use of non-specific measurement instruments.9, 14 Some studies have concentrated on patients with specific pain-related diagnoses, such as back pain, fibromyalgia, and chronic musculoskeletal pain,2, 15, 16 and others have been small.14 Previous estimates of the prevalence of chronic pain in the general population have ranged from 2% to 45%.2, 3, 9, 14, 16, 17, 18
We present results from an epidemiological study of chronic pain, designed to quantify and describe the prevalence of chronic pain in the community, according to age, sex, and sociodemographic status.
Section snippets
Participants and procedures
The International Association for the Study of Pain defines chronic pain as “pain that persists beyond normal tissue healing time, which is assumed to be 3 months”.19 This definition does not allow for intermittent pain, so for the purposes of this study we defined chronic pain, after pilot testing, as “pain or discomfort, that persisted continuously or intermittently for longer than 3 months”.
The study was done in the Grampian region of northeast Scotland. All practices that used the General
Results
Of the 5036 individuals randomly selected, 425 were excluded from the survey by general practitioners (figure). The reason for exclusion was not always given. 267 exclusions were explained: 72 patients had died; 99 were no longer registered with the practice; 18 had terminal illness; 43 were demented, frail, or very elderly; nine had mental illness; 12 were in hospital; and 14 were excluded for other reasons. Of 4611 questionnaires mailed, 176 questionnaires were not delivered because the
Discussion
This study shows that chronic pain is a major problem in the community, with about half of the sample reporting chronic pain; after standardisation we estimate that 46·5% of the general population have chronic pain. This figure is higher than previous estimates of chronic-pain prevalence in general population studies.2, 3, 9, 14, 16, 17, 18 This discrepancy is likely to reflect differences in the research methods and case definitions used; differences that previously accounted for the majority
References (25)
- et al.
Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multi-disciplinary pain center
Pain
(1997) - et al.
Chronic musculoskeletal pain and depressive symptoms in the National Health and Nutrition Examination—I: epidemiological follow-up stidy
Pain
(1993) - et al.
An epidemiological follow-up survey of persistent pain sufferers in group family practice and speciality pain clinic
Pain
(1989) - et al.
The prevalence of pain complaints in a general populaton
Pain
(1984) - et al.
The prevalence of pain in a gneneral population: the results of a postal survey in a county of Sweden
Pain
(1989) - et al.
Prevalence of chronic benign pain disorder among adults: a review of the literature
Pain
(1998) - et al.
Grading the severity of chronic pain
Pain
(1992) - et al.
The Chronic Pain Grade Questionnaire: validation and reliability in postal research
Pain
(1997) - et al.
Persistent pain and well-being: a WHO study in primary care
JAMA
(1998) - et al.
Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data
J Consult Clin Psychol
(1988)
The socioeconomic impact of chronic pain
Disabil Rehabil
Disability and disadvantage
Cited by (987)
Clemastine-induced enhancement of hippocampal myelination alleviates memory impairment in mice with chronic pain
2024, Neurobiology of DiseasePrevalence of Chronic Pain Among People with Dementia: A Nationwide Study Using French Administrative Data
2023, American Journal of Geriatric PsychiatryPain-motor integration in chronic pain: A neurophysiological study
2023, Clinical NeurophysiologyA randomized, placebo-controlled, double-blinded mechanistic clinical trial using endotoxin to evaluate the relationship between insomnia, inflammation, and affective disturbance on pain in older adults: A protocol for the sleep and Healthy Aging Research for pain (SHARE-P) study
2023, Brain, Behavior, and Immunity - HealthThe impact of threats to belonging on health, peripheral physiology, and social behavior
2023, Advances in Experimental Social Psychology