Pain common and increasing in prevalence in New Zealand

Pain is an extremely common condition and increasing in prevalence in New Zealand, University of Otago researchers say.

In the latest issue of the New Zealand Medical Journal out today, a team of researchers from the University have written an editorial about pain. Dr. Nicola Swain, Associate Professor in the Department of Psychological Medicine, says pain is the number one reason why people visit their GP.

"Pain is stealing people's lives. As we live longer and are more healthy, pain is an increasing issue," she explains.

"The World Health Organisation details the health conditions causing most loss of life and in the top eight, six are pain issues – including lower back pain, arthritis, migraine and various musculoskeletal pain."

Dr. Swain says pain is a big problem in New Zealand with little research on the condition and difficulties for patients accessing treatment. She hopes the editorial will raise awareness of pain as a societal problem.

Associate Professor Swain and her colleagues from the University of Otago, Dr. Louise Parr-Brownlie, Dr. Bronwyn Lennox Thompson, Ben Darlow, Dr. Ramakrishnan Mani and Professor David Baxter outline six key factors about pain in the editorial:

• Pain is always real. Despite this, patients continue to be characterised as "malingering" or "attention seeking" and judgments are made about drug seeking or illness behaviours. "To query whether a particular patient's pain is real is a nonsense," the editorial states.
• Persistent pain and acute pain need to be treated differently. There have been calls for persistent pain to be considered a disease in itself.
• Persistent pain is extremely common and increasing. Persistent pain, defined as pain that persists for at least six months, is extremely common and affects 20.2 per cent of the New Zealand population. The prevalence is rising both in New Zealand and globally, partly because of an aging population.
• Biomedical treatment has limited effectiveness.
• There are ethnicity and gender differences in perceptions and experience of pain. Pasifika and Asian populations are less likely to report pain than Europeans. There are also differences in the way men and women experience pain.
• Pain education is lacking.

Dr. Swain says it is sometimes difficult for patients suffering from pain to be heard by health practitioners. The editorial calls for an urgent need to investigate how pain is being taught in the New Zealand health professional curriculum.

"You can't see pain – two injuries that look the same on scans can cause completely different levels of pain," Dr. Swain explains.

"More research is needed in all of these areas to increase evidence-based ways of managing pain in the New Zealand population."