Responding to the global burden of pain

Professor Lars Arendt-Nielsen, Dr. Med, Phd

President, International Association For The Study Of Pain (IASP)
Director, Center For Pain And Neuroplasticity, Smi, Department Of Health Science And Technology, School Of Medicine, Aalborg University, Denmark

Pain is having a huge impact on patients and their families’ lives across the world, but better recognition, treatments and management outcomes can improve life for those living with chronic pain.  IASP is committed to leading this effort.

Chronic pain is a leading factor in contributing to the global burden of disease, primarily through the burden of disability.

The Global Burden of Disease study¹ ranks health loss resulting in premature death and disability from a wide range of diseases and injuries.

The burden of pain to societies and its associated costs are enormous to our citizens, institutions, and communities globally.

Pain is prominent in chronic musculoskeletal conditions (e.g. neck, lower back, and joint pain), as a consequence of acute events (e.g. trauma and/or accidents), which may lead to chronic pain, and as a lingering side effect of disease (e.g. cancer) and its treatment (e.g. chemotherapy).

The burden of disease from chronic pain

“The data from the Global Burden of Disease Study have given us a remarkably clear understanding of the huge burden of disease and disability that is driven by chronic pain,” said Andrew SC Rice, Professor of Pain Research at Imperial College London and IASP Councillor.

“What is striking is that this observation is reproduced across all countries, healthcare systems, and economies.

“As such, these findings have major global health and societal implications and should place chronic pain firmly at the centre of debates regarding healthcare, welfare, and research allocation priorities.”

The impact of pain on patients and families

In trying to cope with chronic pain, patients and their families face mental health challenges (such as depression), financial challenges (unemployment), and social pressures (isolation, social stigma).

These cause a tremendous burden on the fabric of our society and the lives of individuals.

Furthermore, chronic pain shortens life span and has significant impact on quality of life.

Fiona Blyth, Professor of Public Health and Pain Medicine at the University of Sydney and an IASP member and collaborator of the Global Burden study notes the relationship between age and pain.

“Globally, the huge disability burden related to chronic pain is being driven by ageing human populations around the world,” she said.

“In developing countries, population ageing is happening very rapidly in societies with fewer resources available to address the pain burden.”   

Better recognition for pain conditions and treatments globally

In order to improve the way that pain conditions and treatments are recognised by national healthcare systems around the world, IASP has been working with the World Health Organization (WHO) to support research and data necessary to introduce new pain classification codes in the 11^th version of the International Classification of Disease (ICD-11) system.

IASP-WHO Liaison, Professor Rolf-Detlef Treede, Chair of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Heidelberg University considers the use of data to be extremely important to treatment.

“If pain is better recognised as a disease state among healthcare systems, our members will have better data to advance research to better understand the true magnitude of the problem and consequently to improve the provision of advanced treatment options,” he said.

Cross-sector collaboration is needed in order to adopt a multi-disciplinary approach to better understand the complex nature of pain.

Along with additional research, pain education is critical to improved treatments and outcomes. 

Patients living with pain and their families are important partners in education efforts, awareness campaigns, and working groups focused on solutions to ease the burden of pain globally.

Collaborative engagement between patients and their families, along with patient advocacy organisations, ensures that the patient’s perspective is represented in framing the burden of pain and in developing a global strategy to address this problem globally.

Now, more than ever, we need to work together to implement new solutions and address the burden of pain on our society.

^{1 Vos et al. Lancet 2015;386:743-800}