I consider myself very lucky. I am not one of the more than 110 million Americans who experience chronic pain every year. In the past, when I have had neck pain from daily lap swimming, it consumed me. It was all I could think of 24/7. I remember how generally bad I felt both physically and emotionally. I was completely drained and not easy to live with.
So it is astounding to consider that more than a third of the nation’s population walks around feeling lousy all of the time from pain. I think one of the main obstacles that prohibits treating pain effectively is that we’ve been taught from an early age to just suck it up. From that perspective pain is just the price of being alive. That’s just plain nonsense.
A new report from the Institute of Medicine doesn’t quite see it that way either. The study concludes that pain costs the economy a boatload of money -$635 billion annually. The IOM reported back in record time – their work began after Thanksgiving in 2010 - and concluded that pain is a major public health problem in America.
I spoke to Philip Pizzo, MD, dean of Stanford's medical school and chair of the IOM panel, about the work of the committee and why pain is undertreated in the United States. Pizzo has seen pain from two perspectives, professionally and personally. He tells me in my latest 1:2:1 podcast:
Pain does takes a toll, and I've witnessed it in the patients I've cared for, in my own personal life, and particularly in the lives of members of my family who every day have a new reckoning in terms of how to accommodate the insults of pain and make the best of one's life accordingly.
Something this significant and far reaching won’t be easy to solve. Culture change may be the biggest obstacle to recognizing and effectively treating pain. The report calls on Medicare, Medicaid, worker’s compensation programs, and private health plans to find ways to cover interdisciplinary pain care. Because of the size of the problem and the “significant toll on individuals and society,” the report concludes, “pain warrants a higher level of attention and resources within the National Institutes of Health.”
I know there’s a lot on the federal government’s table right now. Yet pain shouldn’t be dismissed as insignificant or peripheral to overhauling health care. It’s part of the puzzle. And it’s clear that it’s time to deal with this major public health problem.