Feature Archive

The Cost of Pain

Loss of productive work time? $61.2 billion. Personal suffering? Enormous.

By R. Morgan Griffin
WebMD Feature

Reviewed By Charlotte Grayson

How much does a bad back cost?

Maybe it's just $10 a month for a new bottle of Advil? But what about your chiropractor bills? What about the housekeeper you had to hire to do the housework that you can't do? What about that pricey ergonomic chair? Or what if you need to cut down on the hours you work, or quit your job altogether? What if you lose your insurance as a result?

The costs of pain can be enormous, and they spill out well beyond what you spend at the drugstore. "If you have pain all the time, it gets into every nook and cranny of your life," says Sean Sullivan, CEO of Institute for Health Productivity Management. "It's about as pervasive as something can get."

Big and small, those costs -- financial and emotional, obvious and hidden -- can add up. And you're not the only one footing the bill: your spouse, your family, and your employer are all affected. That's all from one achy back. Now imagine a nation's worth of achy backs -- and arthritis pain, and migraines, and other types of pain. How much does all that pain cost us as a society?

It's a tough question to answer. But because pain is emerging as a serious health problem in the U.S., it's one that more and more researchers are trying to answer.

Pricing Pain

Here's one estimate for the cost of pain: $61.2 billion per year. That's from a recent article by Walter "Buzz" Stewart, PhD, MPH, in the Journal of the American Medical Association. But Stewart points out that it's still only part of the picture. That staggering sum is only the money drained from U.S. businesses because of productivity lost from employees in pain. Stewart's study also only included arthritis, back pain, headache, and other musculoskeletal pain.

As pain researchers know, putting a number on the cost of pain is tricky. Pain is a subjective experience -- no one can ever know what someone else's pain feels like.

But even though pain won't show up in blood tests or on X-rays, its effect is undeniable. Experts in pain management argue that pain needs to be studied so that we can come to grips with its costs. It's also crucial that people see pain not just as a symptom, but as a widespread, debilitating condition in itself.

How common is pain?

In 2003, Research!America released the results of a survey of 1,000 people in the U.S. The survey showed:

  • 57% of all adults have had chronic or recurrent pain in the last year.
  • 75% of people currently in pain had to make adjustments to their lifestyle because of their pain, including 33% who had to make major adjustments.

Moreover, many people in pain are undertreated, according to surveys. In 2004, the American Chronic Pain Association released the results of its Americans Living with Pain survey. Of the 800 adults with chronic pain interviewed, almost half say that their pain isn't being controlled by their treatment.

Next: Who's in Pain and Why?

Who's in Pain and Why?

So who makes up the bulk of pain sufferers? One might expect that pain tends to worsen with age; as you get older -- and you've accumulated a few decades of wear and tear -- you're more likely to have pain. Right?

Not really. The Research!America survey found that people under 35 are about as likely to have chronic pain as people over 35.

Stewart, from the Center for Health Research & Rural Advocacy at Geisinger Health System in Danville, Pa., came to a similar conclusion: the percentage of people in pain is roughly the same across different age groups. What varies is the cause of the pain, he says. For instance, as you'd expect, older people are more likely to have arthritis pain. But migraine pain is most common in young and middle-aged adults, especially women. So no matter what the age, the risks of serious pain are similar.

The long-term dangers of pain are significant.

"People in pain are at risk of going into a downward spiral," says Stewart. "The pain can make them depressed, and the depression can exacerbate their perception of pain. That leads to even more disability. It can become a serious condition, and it needs the most aggressive treatment we have."

Depression appears to have a strong link with pain. In one recent study of 573 people with depression, two-thirds reported that they were in physical pain. Many had headaches, back pain, and joint pain. The study indicated that the severity of pain might even be an indicator for the severity of depression.