Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it.
Dr. Mark Borigini is a board-certified rheumatologist who has devoted his career to treating, and training others to treat, a wide variety of illnesses that cause chronic pain and disability. See full bio

A Whole Lotta Hurtin’ In Our Future

He ain't heavy, he's in a wheelchair.
In an issue last year in the Morbidity and Mortality Weekly Report, we are all reminded of one of the costs of living longer: having more arthritis in our midst.

Currently, rheumatic conditions, including arthritis, lupus, and fibromyalgia, affect approximately 46 million adults in the United States. As a society, the cost in treatment and time lost from work totals $128 billion each year. However, as the population ages-and lives longer-it is projected that the number of adults living in the United States with chronic illnesses such as arthritis will increase significantly. In particular, it is felt by many experts that adults in the United States with arthritis will number 67 million by the year 2030; 25 million of these will likely have physical limitations due to this arthritis.

It will be extremely important for the healthcare community to use current interventions, and develop new interventions, focused on decreasing the pain associated with rheumatic disease. Hopefully, healthcare professionals will simultaneously be able to improve function and delay disability associated with moderate to severe arthritis.

Interestingly, there may be even higher numbers of patients afflicted with arthritis if the United States does not better control what is increasingly becoming a major obesity epidemic.

Society must emphasize the importance of arthritis education, and what individuals can do in order to prevent arthritis, or at least the disability seen with arthritis. The Arthritis Foundation has been very proactive in this regard.

Those at high risk for disability, such as the obese or physically inactive, should be aggressively targeted for a multi-specialty intervention. The United States Centers for Disease Control is assisting in the development of an exercise program that focuses on joint protection to allow for the improvement of physical function.

If the population at large is successfully encouraged to participate in the preventive measures developed by the various agencies representing the interests of those engaged in the fight against arthritis, then we will hopefully see a reduction in the number of patients with chronic arthritis pain and disability.

But those at high risk for chronic pain and disability (for example, the obese) should perhaps be compelled to participate in such programs as dietary intervention and mandatory exercise programs.

The cost to self and society is too great for a continued acceptance of the status quo; because it is the status quo which will overwhelm us.



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