The findings from Versus Arthritis’s latest report – Unseen, Unequal and Unfair: Chronic Pain in England – have recently been published, providing valuable data on the sheer scale of people living with a musculoskeletal condition. The report follows on from the updated publication of the NICE guidelines earlier in 2021 which moved away from recommending an opiate and invasive approach for the treatment of pain conditions in favour of proactive holistic options.
This Versus Arthritis report comes at a time when socioeconomic factors have affected COVID rates in certain areas of the country, leading to concerns of inequality and a need to tackle poverty and deprivation. This report has overwhelmingly concluded that those same factors increase the prevalence of chronic pain.
The report in detail
The report provides valuable data. 18.8 million people live with a musculosketal condition in the UK. This is 1 in 4 people, with half of that 18.8 million in pain every day. This doesn’t just affect the elderly.
In 2017 a third of people over 16 reported living with chronic pain, according to Health Survey for England. A large proportion is arthritis but other health conditions play a part. As with other health emergencies, pain is more likely to be found in deprived areas (30%) and affect people from minority ethnic backgrounds. Young adults are an increasing source of the condition. The suffering can then lead to more poverty and exclusion.
Versus Arthritis, together with Public Health England, have explored the epidemiology to address how to break the cycle. The NHS wants to provide more personalised care and address pain holistically.
The report is detailed in its analysis but the key findings are:
- 42% of chronic pain conditions involve back pain.
- The percentage in pain rises as individuals age with 53% of those over 75 suffering - 5 in every 10 people. 2 in 10 in the age range 16 – 34 have chronic pain.
- Individuals with high impact pain are half as likely to be in paid work and 20 times more likely to say they are unable to work. Work can be a positive focus and flexibility and supportive employers can help.
- In the 45 – 64 age range those in the deprived areas of England are almost twice as likely to report back pain -17.7% compared to those in wealthy areas – 9.1%.
- Women are more affected than men in every age range.
- Ethnic minorities are more likely to suffer from chronic pain conditions
- Obesity and lack of exercise increase chronic pain conditions.
If there is expertise on personal and holistic treatment, training on treatment and self-management this should lead to some of the huge numbers suffering being able to function and participate in society. It is a public health problem requiring public health solutions.
The recommendations include:
- Local NHS and social services to identify those with chronic pain. Data is everything!
- NHS to standardise the recording of chronic pain
- Everyone to be offered a holistic assessment and impact on their life with review of underlying causes
- If suffering from high impact chronic pain creation of personalised care and support.
- The unequal burden of chronic pain on the most deprived, certain ethnic groups and women must be given priority
- Promote health – physical, mental, obesity
- Statutory and employer support
- Chronic pain coordinators for every integrated care system in England.
- Data on prevalence and impact of chronic pain to be routinely collected and published.
How can we use the data?
The recommendations are encouraging but in a time of intense pressure on our health and social care system a positive response isn’t likely any time soon. In the meantime we can act on the findings in dealing with the cases before us in promoting a holistic approach through rehabilitation and self-management. We should be encouraged by both the NICE guidelines and the Versus Arthritis report that improvement in condition and recovery is possible IF a sufferer is assisted and supported in many aspects, including in addressing lifestyle choices. In the long term the impact of deprivation is something to which there is no easy solution.