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Jax Spine & Pain Centers: Just How Prevalent is Chronic Pain in the U.S.

Approximately 20 percent of U.S. adults live with chronic pain and 8 percent had high-impact chronic pain—meaning pain that limited at least one major life activity—according to reports in 2016. These are the findings of a recent study that analyzed National Health Interview Survey data to establish the burden of pain in the United States and aid in the development and implementation of population-wide pain interventions. Researchers from the Centers for Disease Control and Prevention (CDC), National Institutes of Health, Stanford Division of Pain Medicine, Kaiser Permanente, and Yale University analyzed pain data for the overall U.S. adult population and by various sociodemographic characteristics. The findings of the study were published in Morbidity and Mortality Weekly Report (MMWR), a CDC publication.  We summarized the findings here coupled with the take on things from the Providers at Jax Spine & Pain Centers.

Notable findings included the following:

  • Higher prevalence of chronic pain and high-impact chronic pain were observed among women, older adults, previously but not currently employed adults, adults living in poverty, adults with public health insurance, and rural residents.
  • Higher prevalence was associated with advancing age.
  • The age-adjusted prevalence of chronic pain and high-impact chronic pain was significantly lower among adults with a bachelor’s degree or higher compared to all other education levels.
  • Although non-Hispanic white adults had a significantly higher age-adjusted prevalence of chronic pain compared to all other racial and ethnic subgroups, no significant differences in high-impact chronic pain prevalence by race and ethnicity were observed.
  • Although veterans had a significantly higher age-adjusted prevalence of chronic pain compared to nonveterans, no significant difference was observed for the prevalence of high-impact chronic pain.
  • For adults less than 65 years of age, the age-adjusted prevalence of chronic pain and high-impact chronic pain was higher among those with Medicaid and other public coverage or other insurance compared with adults with private insurance or those who were uninsured.
  • Among adults 65 years of age and older, those with Medicare and Medicaid had a higher age-adjusted prevalence of chronic pain and high-impact chronic pain than adults with all other types of coverage

Chronic pain has been linked to restricted mobility, opioid dependency, anxiety, depression, and reduced quality of life, and it contributes to an estimated $560 billion annually in direct medical costs, lost productivity, and disability programs in the United States. The 2016 National Pain Strategy called for more precise prevalence estimates of chronic pain and high-impact chronic pain to reliably establish the burden of chronic pain and aid in the development and implementation of population-wide pain interventions. This study helps fulfill that objective, providing data to inform pain-focused policymakers, clinicians, and researchers.

The Centers for Disease Control and Prevention and other federal agencies have faced a fair amount of criticism over the years for adopting insensitive policies and guidelines that are often harmful to the pain community. But there are growing signs the CDC and other agencies are starting to listen to or at least better understand pain patients.

Today the CDC says in a new report that they estimate 50 million Americans – just over 20 percent of the adult population – have chronic pain. About 20 million of them have “high-impact chronic pain” — pain severe enough that it frequently limits life or work activities. The estimates are based on the 2016 National Health Interview Survey of over 33,000 adults.

“Pain is a component of many chronic conditions, and chronic pain is emerging as a health concern on its own, with negative consequences to individual persons, their families, and society as a whole,” reported James Dahlhamer, PhD, of the CDC’s Division of Health Interview Statistics.

Dahlhamer and his colleagues found that women, unemployed older adults, adults living in poverty, rural residents and people without public health insurance are significantly more likely to have chronic pain, while the risk of pain is lower for people with a bachelor’s degree.

“Socioeconomic status appears to be a common factor in many of the subgroup differences in high-impact chronic pain prevalence,” they found. “Education, poverty, and health insurance coverage have been determined to be associated with both general health status and the presence of specific health conditions as well as with patients’ success in navigating the health care system. Identifying populations at risk is necessary to inform efforts for developing and targeting quality pain services.”

Chronic pain is a major public health challenge. That’s not just because it is estimated to cost over half a trillion dollars annually in medical costs, disability programs, and lost productivity. Instead, the reason is because the treatment of chronic pain has become, in part, a hot-button political issue.

Pain patients often rely on powerful drugs such as opioids to cope. But the ongoing drug crisis, which claimed the lives of more than 72,000 Americans last year alone, has complicated the sacred doctor-patient relationship. Now, Uncle Sam wants to know what and how much the doctor is prescribing, lest opioids fall into the wrong hands. Even worse, politicians and the media have oversimplified and distorted the issue, placing blame on careless doctors and greedy pharmaceutical companies, when the lion’s share of the blame lies with recreational drug users.

Caught in the crossfire are the millions of innocent people who are suffering from chronic pain who simply need some relief. Just how many of these people are there?

A lot. A new study by the CDC revealed that 50 million Americans (just under 20% of the age-adjusted adult population) suffered from chronic pain, which was defined as “pain on most days or every day in the past 6 months.” Nearly 20 million (about 7.5%) experienced high-impact chronic pain, defined as “limiting life or work activities on most days or every day in the past 6 months.”

The stratified data revealed some important insights. Obviously, as people get older, they are more likely to experience chronic pain. However, what may be less obvious is that more women (20.8%) than men (17.8%) suffer from chronic pain. The same gender gap exists for high-impact chronic pain (8.2% vs. 6.7%). There was also a noticeable divide between rural (9.8%) and urban (7.0%) dwellers for high-impact chronic pain. Additionally, poorer or less educated people were far likelier to suffer chronic pain than richer or more educated people.

Who Are We Hurting?

This data should make us pause and consider the unintended consequences of our policies. While something needs to be done to rein in the opioid crisis, we must beware of overreach. The Seattle Times told a heart-rending story of a severely injured man who committed suicide after he could no longer acquire the opioids he needed to survive.

By making it more difficult for chronic pain patients to get life-saving drugs, the data show that we are disproportionately harming women and poor people. Surely, that’s an important part of the opioid story.

To find out how we can help, schedule an appointment today with one of our double board certified providers. Call 904.223.3321

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