Michigan: Pain and Its ManagementPage 2 of 11

1. The Prevalence of Pain

First, treat the person. Second, treat the pain.

MI LARA, 2013c
A Pain Toolkit for Health Care Professionals

Pain is an unpleasant fact of daily life for many people, affecting every aspect of their lives. In its 2011 landmark report Relieving Pain in America, the Institute of Medicine (IOM) (now the Health and Medicine Division of the National Academies) estimated that in the United States treatment and management of pain costs about $635 billion annually in direct medical costs and lost productivity (IOM, 2011).

Although vast amounts of money are spent each year on the treatment and management of pain, it is still inadequately treated in vulnerable populations. This includes women, children, older adults, ethnic minorities, patients with cognitive impairment, cancer patients, nursing home residents, and those with active addiction or a history of substance abuse. Untreated pain has a profound impact on quality of life and can have physical, psychological, social, and economic consequences (King & Fraser, 2013).

Among African Americans, lower rates of clinician assessment and higher rates of undertreatment have been found in all settings and across all types of pain (IOM, 2011). Similar results have been found among Hispanics, Asian Americans, and Native Americans. These disparities among racial and ethnic minorities are related to lack of provider education, system-level lack of access to pain medications, and cultural beliefs about pain (Makris et al., 2015).

In Michigan, as in other states, pain is widespread. In a 2013 public telephone survey of Michigan residents, about 25% had sought treatment from a healthcare professional for a chronic pain condition in the previous year, and 28% had sought treatment for an acute pain condition (LARA, 2013a). The Michigan Advisory Committee on Pain and Symptom Management (ACPSM) noted in 2014 that up to 3 million Michigan citizens live with daily chronic pain, and that both in the state and nationally, pain affects more people than does diabetes, heart disease, and cancer combined (LARA, 2014).

In the Centers for Disease Control and Prevention’s (CDC) most recent look at long-term health trends, Health, United States, 2016, data spanning the years from 1997 through 2015, indicate the percentage of adults over 18 reporting some of the most common kinds of pain—severe headache or migraine, low back pain, and neck pain—has remained at constant or slightly increasing levels across all age brackets, genders, races, and socioeconomic levels (CDC, 2017).