This quality standard uses the commonly accepted definition of “chronic pain” as pain that typically lasts longer than 3 months or that continues past the time of normal tissue healing. Some common examples of chronic pain include musculoskeletal, neuropathic, and postsurgical pain, but chronic pain is also associated with many other underlying conditions. Chronic pain can also be considered a disease in itself when the underlying cause is unknown but the pain has a significant impact on a person’s physical, emotional, and psychological well-being, with detrimental effects on the person’s functional, social, and economic status, and quality of life. People with chronic pain may also experience mood disorders, sleep disturbances, and impaired social interactions.
Chronic pain is common and can significantly affect quality of life, including the ability to work or attend school. Some estimates suggest that as many as one in five Canadians live with chronic pain. About one-half of people with chronic pain report experiencing the condition for more than 10 years.
Studies show that people with chronic pain have a health-related quality of life similar to individuals with heart disease or chronic obstructive pulmonary disease. In Ontario, the average annual extra cost of chronic pain to the health care system is estimated to be 51% more than for a matched person with similar morbidity and demographic characteristics but without chronic pain.
Chronic pain can be challenging to assess and manage because of the variety of underlying conditions, the relative lack of effective treatments, and the different ways people are affected. A treatment that works well for one person may not work well for another. Effective treatment requires a personalized and equitable approach to care. The challenge is to determine when and where to use different treatments for the best long-term outcomes. Even in cases where pain cannot be eliminated, evidence-based interventions can significantly improve a person’s quality of life, mood, and function.
People with chronic pain achieve the best outcomes when they are treated through a multimodal and interprofessional approach designed to improve function and quality of life. Health care professionals should work together and closely with the person with chronic pain and their family to promote their health and well-being and provide support for their self-management.
While most people with chronic pain are able to receive their care from their primary care provider, some will also require periodic access to an interprofessional pain program or to specialist care. Access to specialized pain care varies across Ontario. In some places, there are no pain specialists, and some pain management interventions might not be available or affordable for everyone.