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Chronic Pain in Primary Care: Practice Update

Chronic Pain in Primary Care: Practice Update

©Sebastian Kaulitzki/©Sebastian Kaulitzki/
Experiencing pain is as close to a universal human encounter as exists, with the exception of birth and death. Acute pain is often reflexive and serves to prevent immediate injury; somatic pain can be a sign of pathology that needs to be addressed before it progresses, doing irreparable harm, or leads to death. In most cases of acute pain, but in far from all, the etiology is identifiable.

Chronic pain conditions are often a mystery. Unlike acute pain, chronic pain is rarely protective and often has the opposite effect, impairing overall health by limiting a person’s ability to lead an active, engaged life.

Pain is one of the most common reasons for patients to seek care from primary care physicians. For acute pain—from a sore throat, a recent injury, or a disease that can be diagnosed, there is usually a clear treatment path to follow. For chronic pain that may have been present for months, even years, however, the way forward is often much less clear.

A study that examined the impact of disease around the world1 found that of the most common chronic conditions, seven are primary pain conditions where pain is the chief problem, such as tension-type and migraine headaches, low back and neck pain, and other musculoskeletal conditions. The study also found that chronic low back pain is responsible, by far, for the greatest number of years spent living with a disability. There are many widespread diseases, too, such as diabetes and HIV/AIDS that can cause chronic pain that is difficult to manage.

In the United States, an estimated 126 million have experienced pain during the previous three months with 25 million suffering chronic pain and over 23 million reporting a lot of pain.2

Why do so many people suffer from pain for which health care providers often can offer only limited relief?

There are so many reasons (next)>>


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