Where Pain Lives: Chronic Pain Tougher to Manage in Poor Neighborhoods
Living in a poor neighborhood was linked with worse chronic pain for young adults, according to a study by the University of Michigan Health System, but young black patients faced difficulties with pain management no matter where they lived.
With the study, the University of Michigan researchers have opened a new frontier in addressing chronic pain in America.
The results were published in a recent issue of The Journal of Pain and showed where a patient lives, its structural barriers, affluence, and access to resources such as pain medicines, play an important role in patient outcomes.
“Acknowledging the patient’s life circumstances and resources may facilitate physician-patient communication, increase adherence, improve health care effectiveness and efficiency and improve the patient’s health and well-being,” says lead study author Carmen R. Green, M.D., a pain medicine expert at the U-M Health System.
The study included 3,730 adults, all under age 50, and was designed to examine the association between race and neighborhood socioeconomic status in young black and white adults with chronic pain.
Living in a lower socioeconomic neighborhood was associated with increased sensory, affective and other pain, pain-related disability and mood disorders such as depression and anxiety, according to the study.
But blacks, especially young adults, had significantly more pain and disability whether in lower or higher socioeconomic neighborhoods, the study showed.
The Problem of Chronic Pain
Being a student is an exciting and challenging time in life. Young people face many changes, such as leaving home, demands of further education and starting work. Friendships and relationships change and often become more important. All young people have these pressures but for some life may be further complicated by chronic pain.
What is Chronic Pain?
Chronic pain is pain that persists for longer than three months. It can affect any part of the body e.g. headache, abdominal pain, back pain, muscle and joint pain. For most people chronic pain is associated with reduced energy, low mood and frequently feeling unwell.
What causes Chronic Pain?
No one knows for sure what causes chronic pain. We do know that breaking a bone hurts and as the fracture heals the pain reduces and then goes with no lasting problems. However, for some people an injury like a fracture can trigger chronic pain and that can remain long after the healing is complete. People can also develop chronic pain after an illness like flu or glandular fever, while others suffer it for no clear reason. Some people have chronic pain as part of an ongoing illness e.g. arthritis.
“Our results provide support for race as well as neighborhood socioeconomic status influencing the pain experience but further suggests that better socioeconomic status is not protective for young blacks in the same way it is for young whites,” says Green.
What Back Pain Is
Back pain is an easily recognizable problem that can bring on a number of sensations. It can present itself in any location along the spine, a stack of 26 bones connected by ligaments, muscles and shock-absorbing disks.
Back pain is one of the most common complaints brought to doctors in the United States. Over six million cases are seen annually, with the majority being in the lower back. It’s expensive, too, ranking 3rd after heart disease and cancer. Around 80 percent of people get back pain sometime in their lives. Although back pain can be categorized in a number of ways, the most obvious is by location. Many types of back problems can occur almost anywhere along the spine.
Green is a professor of anesthesiology, obstetrics and gynecology, and health management and policy at the U-M Medical School and the U-M School of Public Health.