Is Pain a Disease?
It seems like there is a lot of discussion about pain – specifically chronic pain – these days. My BFF and fellow contributor Wren wrote of her personal experience recently in her article, Weasel Words. There was an excellent article entitled Primary Pain Disorders discussing the work that the International Association for the Study of Pain (IASP) and the World Health Organization (WHO) have been doing classifying pain disorders and raising the question of whether pain is a disease unto itself. An additional article in RheumatologyNetwork.com asks the same question.
Classifying the many kinds of pain
There are many kinds of pain. Probably the most common is the immediate pain that alerts us when something is wrong – a bump, a burn, or something more serious like appendicitis. There is another kind of pain – long-lasting, chronic pain that may not have an apparent cause. The IASP website estimates that approximately 20 percent of people worldwide suffer from chronic pain.
Treating pain more than a symptom, as a disease?
Elevating pain beyond a symptom to disease status has far-reaching effects, but one of the first steps is to formally define and classify types of pain. The IASP has worked with the WHO to include classifications of pain in the current draft of the International Classification of Disease (ICD-11). The ICD is the standard used worldwide by healthcare providers, insurance companies, the government and other entities to classify and code all health diagnoses, symptoms, and treatments. Formalizing these pain classifications in the ICD means that they can be recognized and, hopefully, open the door for research and funding.
This is a huge development for people who are suffering from chronic pain. Could it be that they will be treated as patients with a disease rather than hypochondriacs?
The problem with any new development, including one with such great potential as this, is that it can also be a Pandora’s Box with unexpected consequences. The Primary Pain Disorders article points out that classifying pain as a disease and having it listed on a patient’s medical record may result in it becoming a pre-existing condition. As in not-covered-by-insurance because it’s pre-existing. Or having a disability or other compensation claim denied because the person had pain before the accident/illness/injury.
For patients, it’s simple. It hurts. We need treatment – for the cause and/or the pain itself. But pain is complex and it becomes even more complex when you involve insurance companies, governing bodies, and international organizations. All that being said, getting everyone to agree that pain does need to be recognized and classified is a huge step in the right direction.
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?