Persistent Pain: One in five New Zealanders suffer and many can not get effective help

According to one researcher, one in five New Zealanders suffers from persistent pain and the health system is struggling to effectively manage this problem.

Write in the world of today Medical Journal of New ZealandNicola Swain and her colleagues, psychology experts at the University of Otago, said: "The pain is extremely common and its prevalence is increasing in New Zealand … and the current biomedical treatment is often ineffective" .

"Pain steals people's lives.While we live longer and are healthier, pain is a growing problem," said Swain.

She said that little research had been done on pain in New Zealand and that patients had difficulty getting treatment.

Back problems, arthritis and migraines are major causes of persistent pain. According to the Ministry of Health, musculoskeletal disorders account for almost 13% of "health losses" in New Zealand, with lower back and neck pain being the main factor.

In their editorial, the authors say that the prevalence of persistent pain is higher among women than men and higher among Asians, Pacific and Maori than among Europeans. Our aging population is leading to an increase in prevalence as pain is more common among seniors.

People suffering from persistent pain often also have other problems, such as depression, anxiety, sleep disorders, movement difficulties, concentration, social limitations and relationship difficulties.

Ted Shipton, chairman of the New Zealand National Committee of the Faculty of Pain Medicine, said that there was a real problem in New Zealand that will only worsen.

"In New Zealand, the four causes of disability were chronic pain: lumbar pain, knee pain, neck pain and other musculoskeletal pain," he said. Herald.

"What's worrying us right now is that the burden of pain related to the disease costs between $ 13 billion and $ 15 billion a year from the 2016 global burden of disease study.

"With the aging of the population, this will only skyrocket, we need more resources to fight the lingering pain in this country."

Poverty is also a risk factor for persistent pain and the poorer a person is, the more likely they will be to have a negative treatment outcome.

The authors stress that "pain is always real", although its causes are "elusive or illusory". Doctors often do not understand it.

"Patients continue to be referred to as" simulation "or" attention seeking, "and pejorative statements are made about drug or disease-seeking behaviors.

"To ask if a patient's pain is real is nonsense. There is no objective test of pain; it is a subjective experience and its complexity can make evaluation difficult, even with accepted measures.

"In the end, the pain is about what we live …"

"A biomedical approach that treats persistent pain through physical interventions has not reduced the burden of pain."

The authors stress that "pain is always real", although its causes are "elusive or illusory". Doctors often do not understand it.

"Patients continue to be referred to as" simulation "or" attention seeking ", and pejorative statements are made about behaviors related to drug seeking or illness.

"To ask if a patient's pain is real is nonsense. There is no objective test of pain; it is a subjective experience and its complexity can make evaluation difficult, even with accepted measures.

"In the end, the pain is about what we live …"

"A biomedical approach that treats persistent pain through physical interventions has not reduced the burden of pain."

Surgery can be a valuable treatment, for example for osteoarthritis of the hip, but often brings no benefits corresponding to the high cost and risk, explain the authors.

Good care for people with persistent pain includes "building autonomy and optimizing physical activity, sleep, nutrition, stress, and social participation."

The pain education in major health worker training programs is poor, although a good postgraduate program is available.

"Research shows that clinicians generally demonstrate insufficient knowledge and inappropriate beliefs about pain, and poor pain-related skills can limit the effectiveness of health professionals in delivering effective treatments."

Shipton said that the burden of pain is often swept away by curtains in New Zealand and that it is something that needs to change.

"Because the pain is not sexy, that it's not close to the heart or brain, it goes almost underneath, it floats underneath and so it's a problem ", did he declare.

"We need the government to create more training positions in health boards and we need more pain specialists to deal with this problem."

Dr. Bronwyn Lennox Thompson, co-author of the editorial, said that although VAC clients considered needing help to relieve their pain could get good care, Many District Health Board patients were not doing as well.

There were only two specialized pain treatment services, run by the DHBs of Auckland and Christchurch. Patients not accepted by these were usually followed by a GP, some of whom had little experience in treating pain, said Lennox Thompson.

People then often resorted to Google, which was rich in discussions about cannabinoids, stretching exercises and "exaggerated claims of efficiency and scary language".

A woman fights pain

Deb Thompson, 56, a part-time media teacher at Western Springs College in Auckland, has been living in pain for more than five years.

It took six months to diagnose a pelvic fracture. Later, she had two operations: one to treat a torn cartilage from the hip and the other to replace a hip joint.

But the operation did not end the pain and Thompson continued to seek help.

Around 2015, she was referred to the Regional Pain Department of the Auckland District Health Board and her life changed dramatically.

She has worked with various health practitioners and learned how pain can persist despite the repair of flesh and bones.

She attended an acceptance and commitment therapy and participates in a weekly session of mindfulness and meditation at the service. Separately, she sees a physiotherapist.

Thompson took tramadol and later gabapentin to relieve his pain, but found them uncomfortable and stopped using them.

She still suffers, but manages to manage her life – doing things she likes and keeping her busy while staying calm.

"Instead of trying to find answers, I try to live with what I have … it's a constant balancing act for me: do not let my pain dominate my life and shoot me down. "

"When the pain is at its peak, I close the door and go to bed and look at Netflix."