Health & Medicine

Inadequate pain care 'a travesty'

WASHINGTON — Medical science has learned a great deal about the causes of pain and ways to relieve it, pain experts say, but for a host of reasons, the treatment of pain and suffering has improved hardly at all in recent years.

John Seffrin, the president of the American Cancer Society, calls this "a national health-care crisis of undertreated pain."

"Nearly all cancer pain can be relieved, but fewer than half of our patients report adequate pain relief," Rebecca Kirch, the society's associate director of policy, said at a pain seminar in Washington last week.

Hospitals do a little better than that in managing pain for patients with all kinds of illnesses, according to a survey to be published Thursday in the New England Journal of Medicine.

The survey of hospitals in 40 metropolitan areas by the Harvard School of Public Health found that one-third of patients felt that their pain wasn't well controlled. The percentage of those who were satisfied by their pain care ranged from 72 percent in Birmingham, Ala., to 57 percent in New York City hospitals.

The figure for the Lexington metropolitan area was 68.7 percent.

At least 76 million Americans suffer chronic pain, including as many as three-quarters of people older than 65, said Dr. Ann Berger, the chief of pain and palliative care at the National Institutes of Health in Bethesda, Md.

"Pain is the most common complaint for which individuals seek medical attention," said Dr. Howard Heit, a chronic-pain specialist at Georgetown University in Washington, D.C.

Said Kathryn Walker, the president of the Maryland Pain Initiative, a volunteer organization of state pain experts in Baltimore: "Considering the available research and medical technology we have today, it's a travesty that in 2008 so many pain sufferers are untreated or undertreated because of lack of awareness, education and misconceptions about pain and pain treatment."

One problem is that medical schools give only a "paltry" one hour of training in how to understand and treat pain, said Will Rowe, the executive director of the American Pain Foundation, a national advocacy group that's also based in Baltimore.

As a result, Rowe said, "few physicians are equipped to adequately assess and treat pain."

Pain experts distinguish between acute pain, as when you break an arm or hit your thumb with a hammer, and chronic pain, long-lasting suffering from injury or disease.

Acute pain can be beneficial, prodding the victim to avoid painful situations in the future, Georgetown's Heit said. Chronic pain, however, is "pain that has outlived its usefulness."

"If we don't treat acute pain, it moves to chronic pain (by) rewiring the nervous system," Berger warned.

The Pain Foundation says that the most common complaints are back pain, 55 million cases; arthritis pain, 43 million; and chronic headaches, 40 million.