All this week ideastream is examining the "Body in Pain.” Yesterday health reporter Anne Glausser looked at how we feel pain; today she looks at why it often lingers.
Chronic pain costs the US billions of dollars each year. It's a major cause of work disability, and for many it can be excruciating.
Pill bottles line the counters of Bill Schuffert's home in Avon Lake.
Sometimes they work.
Sometimes the pain cuts through.
SCHUFFERT: The biggest knife you could find in your kitchen…just jabbing into my leg.
Schuffert is 59. He worked in the steel plant in Lorain for almost 40 years and had an active life.
SCHUFFERT: I worked 70-80-90 hours a week. I was kickboxing, doing crunches, and then this happened.
Stabbing pain started shooting up and down Schuffert's legs.
It was out of the blue, about a year and half ago, and it hasn't gone away.
After seeing multiple doctors, he was diagnosed with severe neuropathy, or damage to the nerves.
SCHUFFERT: But the pain, I don't know, just it's, you know you like massage your legs and you think it's going to go away. And it doesn't… It dictates. The pain in both of my legs dictate my life now.
Chronic pain affects 116 million Americans.
It costs the nation upwards $630 billion dollars a year in medical costs and lost productivity.
Some experts believe we should be paying more attention to chronic pain as a public health issue.
LANDIS: Chronic pain has not been either recognized or treated particularly effectively by physicians. It appears to be on the rise.
That's Dr. Story Landis.
She heads the National Institute of Neurological Disorders and Stroke in Bethesda, Maryland.
Pain research has kind of fallen on her lap.
Let me give some background: The Affordable Care Act passed in 2010 mandated that the nation take a closer look at chronic pain. Landis’s institute was tapped to take the lead. So the NIH commissioned a report. This report found major problems in America’s approach to chronic pain.
It calls for a complete overhaul, a transformation in how we perceive, judge, and treat people in pain.
Dr. Landis says this'll take work:
LANDIS: It's a public health challenge for a number of reasons. We don't have a very good understanding of what causes chronic pain.
Trauma, injuries and diseases cause pain, but sometimes pain seems to come out of nowhere.
There are a lot of questions about why it lingers but we’re clear on its impact.
LANDIS: It interferes with your ability to interact socially, it interferes with your ability to work, it interferes with your ability to have a family and manage a family, so chronic pain can be very devastating.
Government surveys show there's been a steady increase in the reporting of pain.
Some say this is due to an aging population and conditions that contribute to pain, like obesity and cancer.
Some say it's simply because people are more aware of pain.
Experts agree on this point though:
BROWN: Pain is under talked about at medical school.
David Brown is an anesthesiologist and pain management physician at the Cleveland Clinic.
BROWN: Classic medical school education doesn't have a block on pain.
Med students typically spend five hours or less learning about pain.
If chronic pain sufferers find their way to a pain specialist…someone like Brown, they’ll likely encounter a much broader range of treatments.
Brown uses everything from exercise to OxyContin to techniques like nerve blocks, depending on the patient.
Pain can be managed.
Many find long-term relief by making changes to their diet and lifestyle in addition to medical therapies.
But the pain often doesn't go away.
That's a fact Bill Schuffert lives with every day.
His wife left; his sisters don't call.
SCHUFFERT: No family understands.
SCHUFFERT: And then it gets dark and you're up all night again with that pain. It's stabbing pain. Nobody understands.
His biggest fear is that he'll lose his ability to drive.
SCHUFFERT: And then I'll be stuck. What am I going to do? I can't drive. I'll be stuck. Like a rat. Like a rat in a box.
That new federal study on pain is a step toward re-thinking how best to treat chronic pain but no new federal money has been set aside for pain research or training.
There’s a lot of possible help out there though.
And people in pain often share a characteristic: perseverance.
SCHUFFERT: I’m gonna try some more things. I got some other things to try.