American Pain Foundation

Incidence of Pain, as Compared to Major Conditions

A hallmark of many chronic conditions, pain affects more Americans than diabetes, heart disease and cancer combined.

*Sources:

Pain – 76.2 million people, National Centers for Health Statistics

Diabetes – 20.8 million people (diagnosed and estimated undiagnosed), American Diabetes Association

Coronary Heart Disease (including heart attack and chest pain) and Stroke – 18.7 million people, American Heart Association

Cancer – 1.4 million people, American Cancer Society

Highlights from the National Center for Health Statistics Report: Health, United States, 2006, Special Feature on Pain1

Pain Statistics

• More than one-quarter of Americans (26%) age 20 years and over - or, an estimated 76.5 million Americans - report that they have had a problem with pain of any sort that persisted for more than 24 hours in duration.
  [ NOTE: this number does not account for acute pain].

• Adults’ age 45-64 years were the most likely to report pain lasting more than 24 hours (30%). Twenty-five percent (25%) of young adults age 20-44 reported pain, and adults age 65 and over were the least likely to report pain (21%).

• More women (27.1%) than men (24.4%) reported that they were in pain.

• Non-Hispanic white adults reported pain more often than adults of other races and ethnicities (27.8% vs. 22.1% Black only or 15.3% Mexican).

• Adults living in families with income less than twice the poverty level reported pain more often than higher income adult.

Pain Duration

Adults 20 years of age and over whom report pain said that it lasted:

• Less than one month – 32%

• One to three months – 12%

• Three months to one year – 14%

• Longer than one year – 42%

The Burden of Pain on Every Day Life

• The annual cost of chronic pain in the United States, including healthcare expenses, lost income, and lost productivity, is estimated to be $100 billion.

• More than half of all hospitalized patients experienced pain in the last days of their lives and although therapies are present to alleviate most pain for those dying of cancer, research shows that 50-75% of patients die in moderate to severe pain.

• An estimated 20% of American adults (42 million people) report that pain or physical discomfort disrupts their sleep a few nights a week or more.

Commonly-Reported Pain Conditions

• When asked about four common types of pain, respondents of a National Institute of Health Statistics survey indicated that low back pain was the most common (27%), followed by severe headache or migraine pain (15%), neck pain (15%) and facial ache or pain (4%).



• Back pain is the leading cause of disability in Americans under 45 years old. More than 26 million Americans between the ages of 20-64 experience frequent back pain.7

• Adults with low back pain are often in worse physical and mental health than people who do not have low back pain: 28% of adults with low back pain report limited activity due to a chronic condition, as compared to 10% of adults who do not have low back pain. Also, adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain.



• An estimated 70% of those with cancer experience significant pain during their illness, yet fewer than half receive adequate treatment for their pain.

• An estimated 46 million adults in the United States reported being told by a doctor that they have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. By 2030, an estimated 67 million of Americans aged 18 years or older will have doctor-diagnosed arthritis.11

• Painful knees and hips are common symptoms among older adults, with about 30% of adults 65 years of age and over reporting knee pain or stiffness in the past 30 days and 15% reporting hip pain or stiffness. In 2003, knee replacement surgery was estimated to cost the nation $11.9 billion and hip replacement $12.2 billion.13

• Osteoarthritis is the most common diagnosis associated with knee and nonfracture hip replacement procedures – 97% of knee replacements and almost 70% of nonfracture hip replacements in 2003-2004 were for patients with a diagnosis of osteoarthritis.

• As many as 6% of all men and up to 18% of all women (about 12% of the population as a whole) have experienced a migraine headache.15

• Migraine, jaw and lower facial pain (TMD/TMJ) account for over 25 million pain suffers, many of who treat themselves with over-the-counter medications. Many pain sufferers take over-the-counter pain relievers for 5-10 years despite label warnings.

Disparities in Pain Care

• African Americans and Hispanics are affected by racial profiling for diversion and under-treatment by some physicians. This is compounded by a lack of research on pain across racial and ethnic differences, as well as cultural attitudes toward pain care. In one study, more than 80% of African American patients and 80% of Hispanic patients waited until their pain severity was a 10 on a 10-point scale before calling their health care provider or oncology clinic for assistance with pain management.18

• Elders are among the most under treated for pain. Of the community-dwelling elder population, 25-50% can expect to suffer pain. Among institutionalized elders, 71-83% report at least one pain problem.

• Unfortunately, under-treatment of pain in the pediatric population is worse than that for adults, including elders. Only recently has the FDA required new medications be evaluated for efficacy and safety in the pediatric population. In one study, 65% of children younger than 2 years old went without pain medications compared to 48% of older children up to 10 years.

• Gender is also a bias in pain assessment and treatment. Women seek help for pain more frequently than men, but are less likely to receive treatment. Physicians often assume either that women can handle more pain or that they are exaggerating the level of pain they experience. Women are more likely to be given sedatives for their pain while men are more likely to be given analgesics.

• Historically, the medical literature has portrayed women as hysterical and oversensitive. By extension, physicians often view women’s statements as emotional, rather than objective. In one study of patients with chronic pain, female patients were more likely than their male counterparts to be diagnosed with histrionic disorder, excessive emotionality, and attention-seeking behavior.

• Studies of VA patients show that the pain of veterans is significantly worse than that of the general public. A higher incidence of pain in veterans was anticipated compared with the general public because of the greater exposure to trauma and psychological stress, both of which increase pain and compound therapy.