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Understanding the Complex Issue of Pain

Experts share how new research is shaping the medical understanding of chronic pain

Mature man suffering from wrist pain at home while sitting on sofa during the day. Clenched painful hands

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En español | Pain is not just a symptom: Experts now believe that it is a disease in its own right, a complex condition that involves a combination of biological, psychological and social factors. Only 58 percent of patients say prescription painkillers effectively treat their pain, according to the American Academy of Pain Medicine. About 100 million Americans experience serious pain at some time in their lives, whether from an aching back, recovery from surgery or the aftermath of a car accident. 

About 1 in 5 American adults, roughly 50 million, have chronic pain, and up to half of adults over 65 suffer from it.

Physical pain can lead to other misery. Xavier Jimenez, a physician with the Center for Neuro-Restoration at the Cleveland Clinic, calls pain symptoms a big bucket of related psychological problems: social isolation, insomnia, depression and trauma. Acute pain typically is the body’s method of helping it heal; for example, by training you to avoid movements that may exacerbate an injury. Chronic pain doesn’t serve any purpose for survival, says Jeannie Sperry, a psychologist who cochairs the division of addictions, pain and transplant at the Mayo Clinic in Rochester, Minn.

Worry, sadness, stress and anger can worsen pain. So can obesity, which is a growing issue in the United States. And advances in medicine mean that Americans may live longer but not always better. A confluence of circumstances have created what seems like a perfect storm of pain, says Sean Mackey, chief of the division of pain medicine at Stanford University and a past president of the American Academy of Pain Medicine.

Treatment beyond painkillers 

The Cleveland Clinic's pain-management protocol has entailed intense sessions that can last for weeks, weaning patients off opiates by using exercise and emotional tools to deal with pain. Sessions include occupational and physical therapy, psychotherapy and meditation. "The program felt like boot camp, but it changed my life,” says Lisa Carter, 54, who has suffered chronic pain from multiple illnesses as well as a 1999 traffic accident. “I’ll always be in pain, and some days are better than others. But now I can manage it." 

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