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Chronic pain is also a disease

October 17 is the date on which the World Pain Day is commemorated, a disease that also affects the emotional, social and work life and that has more of a woman’s face than a man’s, especially if we talk about chronic pain.

According to the Spanish Pain Society (SED)the most frequent profile of a person with pain in Spain corresponds to a 46-year-old woman, and in the last edition of its annual event “Your pain matters” it has been shown that two out of three patients who suffer from it are women .

On this day, celebrated on the eve of World Day, the specialists detailed that the chronic pathologies that cause pain to a greater number of people are fibromyalgia (40%), headaches (24%), low back pain (24%) and osteoarthritis (23%), diseases that are all more prevalent in women.

Faced with these data, the doctor Carlos Goicoechea, professor in Pharmacology and vice-president of the SEDhe defended that doctors must “make visible the woman’s pain as a pain significantly different from that of the man”.

Chronic pain and gender bias

The speakers of #TuDolorImporta recognized that there is one gender bias in the care of people with chronic pain and assured that women “take an average of six years to be diagnosed, while men, three”.

A gender bias that has also existed in research until the current 21st century, when it has become almost mandatory to study pain in animals of both sexes.

However, things are changing and according to the doctor María Madariaga, anesthesiologist and president of the SED“the differences in biological, psychological and social aspects that are the gender and sex of each person are very current and are a growing object of study by science”.

According to the anesthesiologist, “women suffer from more diseases that are accompanied by pain and we suffer more intensely as we have a lower pain threshold”.

And the powerful painkillers available “are less effective in our gender/sex and culturally and socially we accept it without asking for help, so giving visibility to this gender difference is more than necessary”.

chronic pain disease
EPA/Facundo Arrizabalaga

Chronic pain: seven million Spaniards

The figures show that in Spain there are almost 7 million people over the age of 16 – 17% of the population – who suffer from chronic pain.

Of these, 11% have disabling chronic pain and 6% non-disabling.

A chronic pain that, according to the Platform of Patient Organizations (POP), affects emotional health (70% suffer from anxiety or depression) and autonomy (6 out of 10 have problems walking).

But also in the development of daily activities (4 out of 10 have limitations in tidying up and/or dressing), and in the work and training field (work or academic performance lower than usual, 22% of absences and an average of 47 days off per year).

Regarding pain in general, chronic or not, and according to the Spanish Society of Neurology (SEN)it is estimated that 32% of the adult Spanish population suffers from some type of pain, although only 27% have been diagnosed.

In addition, and in accordance with this last source, pain motivates 40% of the consultations of Spanish patients in Primary Care each year, of which approximately 20% of these patients experience pain for more than 6 months.

In any case, only experiencing pain for more than 3 months is already considered chronic pain.

The latest studies indicate that 20% of the European population suffers from chronic pain, and that in Spain it could reach at least 17% of the population.

WHO qualifies chronic pain as the greatest threat to the quality of life worldwide, and represents a social and health cost of more than 3% of the gross domestic product in Europe and, in Spain, represents the main cause of absenteeism from work.

According to Dr Alan Luis Juárez-Belaúnde, Coordinator of the Neuropathic Pain Study Group of the SENclose to one 25% of pain consultations in Primary Care may be related to patients suffering from neuropathic pain.

Neuropathic pain, one of the worst

This pain, says the neurologist, is considered one of the worst pains, “both because of the difficulty of treatment, and because of its enormous physiopathological complexity, and because of the intensity with which patients experience it”.

Neuropathic pain has an annual incidence of 1% of the population, which means that in Spain, every year, there are more than 400,000 new cases of people starting to suffer from neuropathic pain or pain with mixed conditions (as many nociceptive pain and neuropathic pain).

Although the triggering mechanisms of neuropathic pain are not fully understood, it is known that, very often, arises associated with diseases such as diabetes, herpes zoster, stroke, Parkinson’s or cancereither as a result of the disease itself or having had to undergo certain surgical or medical treatments.

Up to 3% of patients undergoing general or orthopedic surgery present with neuropathic pain, but these figures are even higher if there has been an amputation (85% of patients) or some type of traumatic injury to the peripheral nerve (50%).

It also has a very high prevalence in cancer patients (33%), especially in breast cancer; with lower back pain (37%); with spinal cord injury (67%); or with multiple sclerosis (28%).

But, in addition, it has also been seen that it can be caused by toxins, drugs, infections, metabolic and/or hereditary alterations, among others.

Furthermore, patients with neuropathic pain not only experience more severe pain than patients with other types of pain, but depression (34%), anxiety (25%), and sleep disorders (60%) are also significantly more prevalent, compared to other types of pain.

On the other hand, it is estimated that 41% of patients with neuropathic pain have suffered from pain for more than 5 years.

And despite the fact that in recent years great progress has been made in its treatment, many times it is either not well tolerated by the patient, or the therapeutic adherence is lost due to different factors, or even the pain becomes refractory to any type of treatment.

It is estimated that, with current treatments, only 40-60% of patients achieve adequate pain relief.

For all of this, the aforementioned SEN specialist defends the importance of improving knowledge about this pain and continuing research into new, more effective treatments.

He warns, finally, that with “the increase in the life expectancy of the Spanish population and, therefore, of many of the pathologies that can generate it, it is expected that its prevalence in our country will increase greatly considerable in the coming years”.

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