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 stated.
Among 3575 individuals who responded to a mailed questionnaire,
2302 reported having chronic pain and 2221 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 health care 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.
