Pain Patients Suffer Silently
by Will Boggs, MD
NEW
YORK (Reuters Health) More than 20 percent of patients with chronic
pain do not seek physician care for their pain, according to a report. “We
need to get over what for many people appeared to be the ‘don’t
ask, don’t tell’ mentality about chronic pain,” Dr.
Barbara P. Yawn from Olmsted Medical Center, Rochester, Minnesota
told Reuters Health.
Among 3,575 individuals who responded to a mailed questionnaire,
2,302 reported having chronic pain and 2,221 answered relevant questions.
The investigators found that 497 of these patients (22.4 percent)
said that they had not informed their doctors about their pain. Of
these silent pain sufferers, 70.6 percent had moderate or severe
pain, 48.9 percent had pain for eight days or more per month, and
40.6 percent met both of these criteria.
About one quarter of them reported at least moderate interference
with general activity and sleep, the results indicate. Vocal pain
sufferers were more likely to report interference with general activity
and sleep.
The survey showed that 78.9 percent of the silent sufferers used
over-the-counter pain medications (compared with 56.3 percent of
vocal sufferers), but only 5 percent used prescribed pain medications
(compared with 35.2 percent of vocal sufferers).
Silent sufferers made fewer healthcare visits per year than their
vocal counterparts (5.2 vs 8.6), the report indicates. Educational
and employment status had little impact on whether patients were
silent or vocal about their pain. Men were more likely to be silent
than women, the investigators say, and younger patients were more
likely to be silent than older patients.
“I think we need to
reassure our patients (probably by example) that we will listen to
concerns about chronic pain and take those concerns seriously,” Yawn
said, and “that we do have
alternatives to the ‘stronger’ pain medications that
can cause side effects and have the potential for addiction. I think
it is important to determine if the chronic pain is interfering with
work, play, or sleep and if it is, try to help,” Yawn commented. “We
also need to know when patients are able to deal with the pain on
their own and don’t need us—but I would prefer they have
the confidence to ask us when it is interfering with activities they
want to do.”
Source: Mayo Clinic Proceedings,
February 2006.
