The first large-scale study of chronic pain concludes that 20 percent of Europeans live in agonizing pain, while some 15 million Europeans have contemplated suicide because of unbearable suffering. The study also estimates that chronic pain causes losses of $40 billion annually to the economies of the countries surveyed.
Prague, 16 October 2003 (RFE/RL) -- For more than a decade, a daily cocktail of pills has been the only barrier between 29-year-old Alice Peterson and excruciating pain.
Alice was a promising young hope of British tennis when she contracted rheumatoid arthritis 11 years ago. She has been in constant pain ever since. She is one of the 46,000 people who took part in the first in-depth European survey on chronic pain -- the "Pain in Europe" report.
This is how Alice describes her suffering at its peak: "I couldn't even be touched, actually. If anybody tried to comfort me, I'd shudder. I couldn't...the pressure of any touch was so...and...it was, it was like being a child again. That's the only way I can explain it. It was that awful pain, and you're totally dependent on other people. You're helpless. And it's agony even putting one foot in front of the other. It's like walking on daggers. I mean, it was really, really pain I can't describe."
Like Alice, some 75 million Europeans -- or one-in-five people in the 16 countries surveyed -- are categorized as chronic pain sufferers, meaning they have lived in pain for an average of seven years. Moreover, one-fifth of them have been suffering from chronic pain for 20 years or more.
The survey was released as part of the European Week Against Pain (12-19 October), an initiative of EFIC, or the European Federation of National IASP Chapters, or (International Association for the Study of Pain). It was undertaken by the research organization NFO World Group and was funded by private British medical company Mundipharma International.
The report focuses on chronic pain, which is defined as long-term pain that persists after its underlying cause has been treated. It differs from acute pain, also known as warning pain, which acts as an alarm signal that something is wrong in the human body. Acute pain subsides once the illness or injury has been healed.
Norwegian doctor Harald Breivik, who is also president of EFIC, told RFE/RL that the report identifies chronic pain as an issue that should be treated as an illness itself:
"It really is a major health-care problem. And we like to call it a disease in its own right because, even if most of them have an underlying cause for the pain, the chronic, persistent, recurring pain has so many negative consequences that the pain becomes a disease in its own right, in addition to the underlying disease or injury. And this disease or chronic pain clearly is not taken seriously enough. Forty percent [of those surveyed] report they are not satisfied at all with the result of the treatment they are receiving."
The report studies pain in 16 countries. They include European Union members Austria, Belgium, Finland, France, Germany, Ireland, Italy, Netherlands, Spain, Sweden, and the United Kingdom. Non-EU members in the survey are Israel, Norway, Poland, and Switzerland.
The report shows the highest number of chronic pain sufferers live in Norway, Poland, and Italy, where more than one-quarter of the adult population is thought to be affected by chronic pain.
While Spain has been found to be the country with the lowest prevalence, 10 percent of adults there still say they suffer from chronic pain.
Breivik told RFE/RL that, even though aging remains the most obvious cause for chronic pain, specialists have yet to come up with a thorough explanation for the geographical distribution of pain.
"It's very clear that the older you are, the more frequent chronic pain occurs. For a 60- or 70-year-old person, the risk of having chronic pain is four times higher than if you are 20 or 30. The population in Norway is a bit older than in the other countries. It may be one explanation that there are more people with joint pain, muscle pain in Norway, maybe related to the climate. But I don't know why this is so in Italy. We don't understand really."
The study finds that the most common source of chronic pain is back pain, which affects almost one-quarter of all sufferers, while arthritis and osteoarthritis were found to be the most common illnesses that cause pain -- some 35 percent of the cases.
The intensity and frequency of pain is also high. One-third of sufferers say they experience severe pain, while one-third suffer chronic pain permanently.
The study says pain affects the social and economic life of the continent. It estimates that pain accounts for some 500 million working days lost every year, costing the European economy some $40 billion. An estimated 20 percent of pain sufferers has lost a job as a result of pain.
The report says some 34 percent of sufferers have had their family and sex lives affected, while 76 percent have lost sleep.
Dr. Beverly Collett, president of the British Pain Society, says pain is "stealing people's lives": "[Pain] is a huge problem across Europe today. It shows that it impacts significantly on the individual. Pain steals people's lives. They become depressed. They can't have sex. They can't work. They lose their role in the family and also in society. And then, lastly, there is an economic and financial perspective on this, in that these are people probably not working or probably not working to their full capacity."
As a result of the pain, many sufferers become severely depressed. The report says an average of 20 percent of those affected suffer from depression, with the highest rate in Spain -- one-third -- and Norway, at 28 percent. Some 15 million people in the countries surveyed have contemplated suicide because of unbearable pain.
One of them is 53-year-old Norwegian Inger Fladseth, who has been suffering from chronic pain caused by reflex dystrophy in her right leg for more than 25 years.
"I was there," Fladseth said. "I tried, almost, to take my own life. Yes, I was there. It was...I thought that I...Yes, it was nothing to live for. It was pain, pain, pain. I didn't see...no future. I see no future."
Fladseth has managed to brave the pain. She now works as a vocational rehabilitation consultant in Horton, Norway.
The report does not cover Central or Eastern European countries, with the exception of Poland. Professor Breivik says there still is insufficient data from this region. Next year, however, he notes the survey will cover the Czech Republic.
However, Breivik says the study represents a first step in the right direction: "What this study is doing now [is] creating much more awareness over how big a health-care problem this is. [It] is the first step. You can't do anything about the problem until you know it's there. So I think this study is very important because it has documented in a very clear way that chronic pain is a major health-care problem, and it is not managed well enough. There are so many patients who suffer unnecessarily because their pain is not taken seriously enough. They are not managed the way they should be."
Meanwhile, Collett of the British Pain Society says the report highlights the need to educate doctors and other health-care professionals to provide better pain management. She also says politicians must pay more attention to the plight of chronic pain sufferers.