The disease pain

Jan 21, 2009 by admin

Pain is an “epidemic” that hinders the full expression of life to millions of people, both in European countries and, even more, in the Mediterranean countries with lesser health-power. The World Health Organization indicates that pain is one of the main causes for which medical attention is requested, and represents a serious public health problem (1-3).

Defeating pain therefore allows people to recover from the disability caused by illnesses, guaranteeing them the possibility of reintegration into a society of normal working relationship and productivity, thus, avoiding the establishment of disability from chronic pain.

The heightened sensitivity to quality of life that developed in recent decades has highlighted the tragedy of unnecessary suffering and the serious limitations of the models of care implemented in health systems because of institutional lack of knowledge about painful conditions and their treatment(4).

There is thus great potential for the development of skills that require the deployment of a strong economic investment to support research for new therapeutic strategies.

Comprehensive epidemiological pan-European data, capable of defining the scope of the problem PAIN, are not currently available. However, a number of researches, although limited, are sufficient to prove beyond reasonable doubt that in Europe, pain is a major health problem.

As a matter of fact, all international epidemiological surveys show that painful pathologic processes, particularly if characterized by chronic pain, affect the peoples’ quality of life and the cost of health care systems.

Population studies in Europe and in some regions of Italy, and benchmarking data provided by national scientific societies point out that the problem of pain, even undervalued and undertreated, has enormous and growing devastating impact on the daily lives of patients and their families . Chronic and cancer pain affects about 30% of the Western population and sometimes does not even find a solution in specialized centers of excellence, creating a state of severe suffering and disability.

The “disease pain” costs to the national and European Union economy a loss exceeding 3 / 5 million working hours, and an estimated cost in the range of 2,000 million euros in benefits and medication.

The epidemiological magnitude of the disease pain and the peoples’ request of “not to feel pain” that was voiced in many events (in Italy the day of relief), have prompted several European health systems to develop programs for the treatment of pain.

Future prospects

Chronic pain from cancer, secondary to neuro-metabolic pathologies, is an area that still requires huge efforts of both, research and operational interventions, to enable the advancement of science and welfare, and respond to the demand for total quality of health systems.

The pharmaceutical companies have perceived that the treatment of pain is, and will be in the coming years the sector promising the highest index of development, are preparing major investments for the creation of new medicines and tools; in the field of pain, however, the skills acquired by professionals and researchers are still not uniform in different international realities, in contrast with other research and studies environments.

No gap has been created in knowledge or in laboratory tools that may circumvent competition from nations with lesser-scientific and biotechnological impact.

All countries in this area start at a condition of equal competence and opportunity to create a high concentration of expertise and equipment, to ensure the development of planning and designing of bio-techniques for the diagnosis and treatment of pain (5).

This condition is likely to change over the next 5 years, as forces linked to non-profit and profit foundations, including pharmaceutical companies and the world of institutional research in both the USA and in England, are beginning to design programs dedicated to the study of pain for obtaining new molecules for the treatment, and new complex diagnostic tools.

We are all on the starting line, so we need to make an effort to speed up our identity as holders of a space for an autonomous territory of competence.

Bibliography

1) Melzack R:”The tragedy of needless pain: a call for social action”.Proceedings of the Vth World Congress on Pain, Elsevier Science

Publisher BV,1998.pp.1-11

2) Loeser JD: “President’s address to the 8th World Congress on Pain”.

Proceding of the 8th World Congress on Pain (ed. Jensen TS,Turner JA, Wiensenfeld_Hallin Z) IASP Press, Seattle 1997, pp.3-11

3) Helme RD, Gibson SJ: Paijn in the elderly, Proceedings of the 8t World Congress on Pain (ed. Jensen TS,Turner JA, Wiensenfeld_Hallin Z) IASP Press, Seattle 1997pp.919-944

4) Sweet P, Hanna M , Helliot K: The prevalence of pain in Hospitalized medical patients.Abstract Book of 9th World Congress of pain, IASP Press,Seattle,1999 pp.101-102

5) Besner G, Rapin CH:The hospital. Creating pain-free environment: a program to improve pain control in hospitalized patients, Journal of Palliative Care 1993, 9:51-52.

Francesco Amato
Specialist in pain therapy,