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How Big of a Problem is Chronic Pain, and What Are the Main Obstacles to Healing it?

A staggering number of people suffer from chronic pain. In the United States, chronic pain affects more people than cancer, diabetes and cardiovascular disease combined—more than 100 million—with similar statistics being reported throughout the world. This represents an immense cost, both to individuals and to society as a whole.

Given the economic burden chronic pain imposes at all levels, it’s almost impossible to calculate the exact cost. Nonetheless, it is safe to say that the direct cost of care in treating chronic pain pales in comparison to the real costs—in terms of quality of life—imposed on individuals, families, employers, healthcare providers, governments, and society at large.

According to the American Academy of Pain Medicine and others, the financial impact of chronic pain in the United States, as measured by the direct cost of care and the loss of productivity, comes in at approximately $600 billion. From visiting with many hundreds of chronic pain sufferers and talking to them about how chronic pain has impacted their lives, however, it is clear that there is no amount that adequately expresses the loss of mobility, vitality, and self-respect caused by chronic pain.

A Failing System, Despite Many Dedicated Practitioners

Given the scale of chronic pain, you might imagine that we would be pouring resources into developing a solution. The truth is far stranger than that.

I have been blessed with a career that has exposed me to and taken me through the range of healthcare approaches from allopathic “Western medicine” to the gamut of “complementary” and “alternative” providers. I grew up in healthcare. My dad was a hospital administrator. I also grew up exposed to alternative care, with an uncle who was a chiropractor. My career has placed me in the operating room with surgeons, in the C-suite of hospitals, and in the private consultation rooms and back offices of private practices owned by MDs, DOs, PhDs, DCs, NDs, PAs, NPs, LAcs, and LMTs, in addition to healers without recognized credentials. Perhaps you, too, in an effort to resolve chronic pain disrupting your life, have been exposed to a broad swath of clinical disciplines.

These career experiences have been eye-opening and profound. I have met many brilliant, caring, and talented clinicians and practitioners, who I am honored to know. I’ve been impressed with their dedication, compassion, and contribution. Despite these outstanding individuals, however, it’s clear that we’re seeing a systematic failure to resolve our complicated health challenges, such as chronic pain. Why is this?

Recently, a leak from a Goldman Sachs biotech research report came under fire for asking whether “curing patients is a sustainable business model” (April 10, 2018, report entitled “The Genome Revolution”). Exercise, movement, sleep, nutrition, mindfulness, service to others, laughter, joy, etc., all have healing properties. Generally speaking, however, they are not institutionally supported or scalable in the way that a pharmaceutical solution is, for example. Nor are they lucrative to healthcare institutions that make a lot of money from the research, development, and marketing of healthcare solutions via the mainstream medical establishment.

There is a huge industry based on caring for people with chronic conditions, but sometimes it seems as though we have become too focused on the problems themselves, instead of pursuing solutions.

As a society we love discussing problems. Just turn on the radio or TV news, and you’ll be bombarded with problems. Lucrative careers, billion-dollar companies, and global brands are built on problems. Many seemingly altruistic organizations and feel-good campaigns are designed to bring awareness to problems. At some point, one might wonder, have we lost sight of the goal or misdirected those resources?

What would happen if a cure for a significant disease, like cancer, was discovered? How would that impact the perceived contribution of these groups? No doubt “doing good” is the intention, but we should follow the money and ask ourselves if we have allowed the financial incentive of discussing and “researching” solutions to outweigh the value of identifying and building solutions?

The scientific understanding of pain has changed significantly in recent years, yet the therapies have not. This is due to the latency in disseminating new knowledge into the massive medical system, as well as the economics that encouraged continued use of various therapies because they get paid for or covered by insurance, even if those therapies are not consistently effective or even safe.

The Situation for Most Chronic Pain Sufferers

In recent years, as my focus has shifted toward chronic pain, I have attended various conferences on chronic pain and listened to “experts” speak. I have met individually with countless pain management professionals and pain sufferers. From these conversations and experiences, a few other nuances have come to light. The first is that, generally speaking, people don’t die from pain—at least not directly. Although people in chronic pain may also suffer from terminal diseases, pain itself is not usually a killer.

Consequently, chronic pain does not receive the same levels of funding, research, attention, or discussion as do other diseases. Institutionally, the formal education most physicians and care providers receive about chronic pain is very limited, perhaps even grossly inadequate, and generally related to acute pain or symptomatic pain. New science takes years to filter down through the literature and find its way into medical school textbooks. Practicing physicians typically have to go out of their way to find and really learn the most current changes in any science, especially pain, and then must decide what to do with that information.

This fragmentation in pain treatment has only compounded the problem because it has created a scenario in which no one fully “owns” pain management. Allopathic or osteopathic pain specialists may be dismissive of chiropractic care, instead recommending drugs, injections, or surgeries. Alternative care providers often promote their approaches of alignment, movement, nutrition, sleep, and mindfulness over the quick fix of a pill or injection. And yet, all of these professionals would probably admit that their solution or approach to chronic pain is, in truth, inadequate.

What Next for the Treatment of Chronic Pain?

If we acknowledge the scale of chronic pain in the United States and many other countries, and if we also recognize that the popular approaches to chronic pain usually don’t represent a sustainable solution, we’re left with the question of what will work?

We don’t want to be satisfied with merely alleviating the experience of chronic pain, through drugs, surgery, or any therapy that is just masking the problem. Instead, we want to develop a solution that allows chronic pain sufferers to become empowered, find relief, and live fulfilling, vibrant lives. My experience with both my own chronic pain condition and the hundreds of people treated through my company, Radiant Pain Relief Centres leads me to believe that this is a realistic and achievable goal for the vast majority of people struggling with chronic pain. But it begins first with education and expanding our collective understanding of pain and pain science.

My book, Radiant Relief, A Case For A Better Solution discusses these complicated and sometime competing realities that prevent the growth and adoption of safer, more effective approaches to chronic pain. And it paints the picture of what I see as the bright future for innovation and disruption in how we understand and treat chronic pain.

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