Chronic pain of one sort or another affects approximately 1 in 3-4 Canadians. In raw numbers this means 3-4 million people in Ontario alone and 9-12 million people across the nation. Chronis pain is no “small business”. The term “chronic” means pain that is present daily or very often, for weeks and years. It can be constant or comes in spells, can be there at rest or appear only with movement, weather changes, touch etc. Pain may be the result of damage or disease to the nervous system (neuropathic pain), the musculoskeletal system (muscles, bones, ligaments etc), the internal organs (heart, kidneys, urinary bladder, gut), in which case is called “visceral pain” or a mix of those types.
The estimated annual cost of pain from all causes in USA is approximately 61.2 billion per year and approximately 6 billion per year in Canada. What these figures do not include, is the immense cost of human suffering that cannot be expressed in dollar figures. Despite this, chronic pain seems to be unrecognized and is highly undertreated in most parts of our country. When it comes to research, less than 1% of all research funds spent in Canada is devoted to pain research (even though Canada is a true pioneer in many research fronts including children’s pain, imaging the brain, pain genetics etc). When it comes to waiting to be seen by doctors skilled in chronic pain, wait list across the country vary between many months to 5 years.
Family doctors are our “gate keepers” and manage 90% of chronic pain. But, our doctors have not been trained in medical schools to deal with pain (a veterinarian gets 5 times more training in dealing with our animals than your doctor). They need more time to deal with the complex physical and psychosocial issues that come with chronic pain, but the fee-for-service system does not allow proper remunerative time, nor do they have access to resources such as nurses, psychologists or social workers to assist them in getting the “whole person picture” of their patients with chronic pain. And of course, many Canadians do not have a family doctor to start with. Many chronic pain sufferers do not have access to doctors treating pain due to distance or just because such doctors and clinics do not exist in large parts of the country. Many treatments for chronic pain (outside interventions such as injections and surgery) are not funded by the fee-for-service system in our country unless you have a third party covering you such as workers compensation or extended health care. These treatments include not only medications but most importantly, physical and psychological treatments and “whole person treatments” in well organized pain clinics and setting.