Pain sufferers seek answers
Fewer than 10 per cent of people experiencing severe discomfort receive effective treatment. Lynnette Hoffman reports
THE pain in Yasmene Salhia’s hands and feet was once so debilitating that she couldn’t open a tube of toothpaste or squeeze a bottle of shampoo in the morning. Diagnosed with rheumatoid arthritis at the age of 25, Salhia would lie in bed for more than an hour after waking up, so sore, stiff and swollen that she would lose her balance and fall when she tried to walk.
After an hour or two, the pain would subside to tolerable levels, only to return again each evening.
‘‘ I was losing three or four hours each day,’’ she says.
‘‘ I was uncomfortable all the time. I didn’t sleep well, and I didn’t feel well. I was too tired and stiff to enjoy anything.’’
The pain sent Salhia on a wild goose chase from specialist to specialist.
At one point, her employer even paid for her to see a world renowned expert.
But the medication she was prescribed didn’t help and she found herself frequently nauseous and dizzy. Other treatments she received were useful only as a temporary ‘‘ quick fix’’.
Sahlia’s story is far from unique. A series of studies and research by the Pain Management Research Institute in Sydney has found that it’s not just older Australians who experience ongoing pain.
One in five working age Australians are suffering from ‘‘ persistent’’ or chronic pain, defined as pain that lasts for more than three months, after the healing phase is over.
That figure rises to one in two Australians over the age of 65.
Professor Michael Cousins, director of research at the PMRI, says preliminary research estimates persistent pain is to blame for some 36 million lost work days every year and costs the economy $5.2 billion in terms of the lost work alone, and somewhere in the realm of $10 billion a year when health care and social welfare support costs are considered.
In August, MBF Foundation announced it would provide $115,000 for a much more comprehensive and detailed study into the economic costs of persistent pain, which will be carried out by Cousins and his colleagues at the PMRI.
They say the problem of persistent pain is both ‘‘ under-recognised and underreported,’’ and consequently patients aren’t getting the best treatment available.
In Sahlia’s case, after three years of frustration she made several lifestyle changes that helped her manage the pain.
The pain is still there, but she can cope. But many patients aren’t so lucky.
In theory persistent pain can be effectively managed in more than 70 per cent of cases, but the reality is that less than 10 per cent of patients get adequate pain relief, Cousins
in says. The reasons for that are complex. Even among health professionals, persistent pain isn’t taken as seriously as it should be, experts say. Often it’s viewed as if it’s the same as acute pain that occurs in the short term, as if it’s just a symptom.
‘‘ But when pain goes on after three months, after proper investigations are carried out and appropriate treatments are given, it becomes a disease in its own right,’’ Cousins says.
‘‘ There are physical changes in the nerves, the spinal cord and brain and those changes are semi-permanent.
‘‘ They are very long-lasting and difficult to reverse. There are also psychological and behavioral changes that occur and there are changes in the patient’s environment, for example in terms of their relationships and their work.’’
People with persistent pain often develop other health problems as a result of their condition, putting them at risk of premature death. Up to 50 per cent may have some degree of depression, for example, and may be at risk of suicide.
Pain: Michael Cousins, left, says preliminary research estimates persistent pain is to blame for some 36 million lost work days every year and costs the economy billions