A patient with chronic pain may be anyone you see or know. They may be young or old, wealthy or homeless. Chronic pain does not respect age, race, financial status, or gender. It can affect anyone at any time, and the effects of the pain can be life changing. The pain can be the result of surgery, an injury, disease, or treatments such as chemotherapy, or it may just start for no apparent reason. Once the pain occurs, it will affect every aspect of the person's life. Every patient with chronic pain has a story to tell of how the pain has changed their lives and how they have learned to adapt and cope with it.
Chronic, persistent pain accounts for 40 million patient visits annually and is the most common reason that patients seek help from health care professionals. On average, chronic pain patient has:
■ Had three major surgeries
■ Incurred medical bills of $50,000 to $100,000
There are many different types of chronic pain. Responses to a survey by Research America indicate that the most common types of chronic pain include the following:
Low back pain, the most common type of chronic pain, has become a common complaint in the American health care system. The normal aging process causes the spinal discs to desiccate and flatten. By age 20, the vascularity of the spinal discs decreases and by age 30, the desiccation of the disc can cause fissures to develop in the endplates of the vertebral bodies (D'Arcy, 2009). Because of these spinal changes that occur as we age, it is estimated that 95% of the population will have the beginning of degenerative disc disease by age 50 (D'Arcy, 2009b). Patients who are at risk for low back pain, the most common type of chronic pain, include the following:
■ Those who are older than 55 years
■ Obese patients
■ Those with poor physical condition and who do not engage in regular exercise
■ Lower socioeconomic groups who have fewer opportunities to access health care
■ Workers who have engaged in heavy labor over time
■ Those with reduced spinal canal dimensions (spinal stenosis) (D'Arcy, 2009b)
Unfortunately, the picture of chronic pain for the older patients is even more grim. The American Geriatrics Society estimates that 80% of patients in long-term care facilities experience chronic daily pain. Assessing and treating pain in these patients is difficult because of the high incidence of dementia and nonverbal patients. The story for community-dwelling elders is a little better, with 25% to 50% of them reporting chronic pain that affects their ability to function. No matter what the age of the patient with chronic pain is, there is an impact on the way these patients lead their lives.
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