The Prevalence of Chronic Pain in Developing Countries

Abstract

83 ISSN 1758-1869 10.2217/PMT.12.83 © 2013 Future Medicine Ltd Pain Manage. (2013) 3(2), 83–86 It is often reported that the prevalence of self-reported chronic pain in the adult general population is approximately 20% in developed countries. All ages are affected, with women and the elderly being overrepresented [1]. However, there have been few population-based surveys conducted in developing countries, defined by the World Bank as “a country that has a relatively low standard of living, an undeveloped industrial base and a moderate-to-low Human Development Index (HDI) score and per capita income” [101]. It could be argued that the prevalence of chronic pain would be higher in the developed world since individuals live longer and women have more access to health services. Alternatively, the prevalence of chronic pain may be higher in developing countries owing to a higher incidence of pain-related trauma from road traffic and industrial accidents, and a higher prevalence of pain-related diseases, such as diabetes, HIV/AIDS and cancer. Evidence suggests that common barriers to effective pain management in developing countries include the low priority given to pain management by government agencies, a lack of education in pain management, restriction of drug availability as a result of cost implications, poor patient compliance and a fear of addiction in relation to opioids [102]. Furthermore, the tendency for healthcare professionals in developing countries to focus on treating diseases causing pain, rather than relieving pain itself, may contribute to inadequate pain management [2]. Whether inadequate pain management affects prevalence is not known. Interestingly, there is a lack of reliable statistics on the magnitude of chronic pain in developed and developing countries, making economic planning diff icult. The majority of population-based surveys estimating the prevalence of chronic pain have been conducted by nongovernmental research programs, suggesting that governments do not consider epidemiological data on pain as a public health priority. An analysis of information provided by 19 member countries of the International Association for the Study of Pain found that only three countries (USA, UK and Portugal) used governmental epidemiological research on pain when developing national law, regulations or statutes, with epidemiological research by