WASHINGTON – Nearly a third of Americans experience long-lasting pain – the kind that lingers for weeks to months – and too often feel stigma rather than relief from a health care system poorly prepared to treat them, the Institute of Medicine said Wednesday.

The staggering tab: Chronic pain is costing the nation at least $558 billion a year in medical bills, sick days and lost productivity, the report found. That’s more than the cost of heart disease, the No. 1 killer.

All kinds of ailments can trigger lingering pain, from arthritis to cancer, spine problems to digestive disorders, injuries to surgery. Sometimes, chronic pain can be a disease all its own, the report stressed.

Whatever the cause, effective pain management is “a moral imperative,” the report concludes, urging the government, medical groups and insurers to take a series of steps to transform the field.

“We’re viewing this as a critical issue for the United States,” said Dr. Philip Pizzo, Stanford University’s dean of medicine, who chaired the months-long probe.

For too long, doctors and society alike have viewed pain “with some prejudice, a lot of judgment and unfortunately not a lot of informed fact,” he said.

The toll isn’t surprising, said Dr. Doris K. Cope, pain chief at the University of Pittsburgh Medical Center, who paused between patients Wednesday to read the report. The population’s getting older and less fit, and more survivors of diseases like cancer live for many years with side effects from treatments that saved them.

Too many patients think a pill’s the answer, she said, when there are multiple different ways to address pain, including physical therapy, stress reduction, weight loss, and teaching coping skills. Patients who take control of their pain do better, but too many have unrealistic expectations.

“Pain is not simple,” Cope said. “We as physicians need to be healers and educators as well as technicians. We certainly don’t want to be pill mills.”

Because pain can’t be seen like bleeding, or felt like a lump, or X-rayed like a broken bone, or heard like a skipped heartbeat, health workers who wrongly believe the intensity of pain should correlate to a specific medical finding may diminish or even dismiss a patient’s complaint, the report found.

Yet too few doctors are trained in its management, the report said. Also, insurance may not cover time-consuming counseling in pain-management techniques, consultations with specialists or even non-drug care. The report concluded at least 116 million adults suffer long-lasting pain.

The economic costs, however, are sure to attract attention in Congress, which mandated the report as part of the new health care law.

 

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