by Maria Giovanna Faiella
Epidemiological monitoring could facilitate access to treatment in the pain therapy centers of the National Health Service. The right not to suffer enshrined in Law 38/2010
Whether it is due to headache or back pain, trauma, a tumor or other diseases such as fibromyalgia, arthrosis, neuralgia or herpes zoster, chronic pain – that which lasts for months or even years – afflicts in our country over 10 million adults, especially women. the estimate – the first validated at national level – by the Istituto Superiore di Sanit published in Istisan report Chronic pain in Italy and its psychosocial correlates from the European Health Interview Survey 2019.
The study involved over 44 thousand people, of which approximately 38,800 responded to a short questionnaire on chronic pain, included in the European Health Survey conducted by Istat.
The investigation
The results of the survey show that approximately 4 million men and almost 6 and a half million women suffer from chronic pain, persisting for at least 3 months (prior to the interview), in one or more parts of the body.
This condition of suffering that persists over time affects 8 percent of the population between 18 and 44 years of age, 21.3% of adults between 45 and 54 years of age, 35 percent of people aged between 65 and 74 year olds, up to 50 percent of those aged over eighty-five.
And, the Report underlines, gender inequalities are confirmed, and not only that.
The gap in prevalence estimates between males and females in fact begins already at the age of 35, and gradually widens to the detriment of females, with percentages more than 15 points higher among the elderly (65 years and older).
Overall, 60% of adults with chronic pain in Italy are female.
The distribution of this condition, the survey reveals, varies across the national territory, with a more evident disadvantage for southern people aged 65 and over; in particular, the elderly in the South represent the highest share of people with chronic pain in Italy: among those over 84 in the South 67.1% are affected, compared to 58.5% in the Center and 52.5% of the North.
Causes of chronic pain
The causes that may be at the origin, or underlying the onset of chronic pain, include: a primary disease, already diagnosed, usually related to a state of pain (in 52 percent of cases); a trauma (21%), a surgery (7%), a tumor (3%). There is a percentage of individuals with chronic pain – 13 percent – who does not yet have a clear diagnosis of the disease, and who report high or very high intensities of pain in 23 percent of cases.
Furthermore, the survey shows that less well-off people are generally more affected by chronic pain, with social inequalities that become more marked as age increases.
Also implications for mental health
Chronic suffering also has implications for mental health. The survey finds that as many as 13 percent of people suffering from chronic pain have moderate to severe depressive symptoms compared to less than 2 percent in the population who do not suffer from it. There is a co-morbid condition between chronic pain and depression to the detriment of female people and people with a lower level of education.
Centers dedicated to pain therapy (paid by the NHS)
The right not to suffer unnecessarily – or at least alleviate pain – enshrined in law no. 38 of 2010 Provisions to guarantee access to palliative care and pain therapy.
With the Prime Ministerial Decree defining and updating the LEAs in 2017, pain therapy was included in the essential levels of assistance, the services that the National Health Service must guarantee to every person throughout the national territory, regardless of their place of residence.
Chronic pain is a real pathology and can also be treated in centers dedicated to pain therapy, within the National Health Service. Anyone who suffers from it must talk to the doctor (family doctor or paediatrician, or in hospital), who will be able to “measure” the level of intensity through suitable instruments, and prescribe the appropriate therapies or (always on the prescription of the National Health Service) a specialist visit at one of the pain therapy centers spread throughout the area, where advanced therapies for the treatment of pain are also available.
Promote access to diagnosis and treatment
The study fills a knowledge gap in our country compared to other European countries, as the authors underline: The high prevalence of chronic pain in the adult population and the other estimates presented in the Report, referring, for example, to comorbidities, mental health, role of sociodemographic factors or the impact of chronic pain on work activity and disability, offer a valuable epidemiological framework for identifying diagnosis, treatment and rehabilitation needs, for the definition of prevention models and, last but not least, the definition of plans of social welfare support.
With the Report, the Istituto Superiore di Sanit inaugurates the epidemiological monitoring of chronic pain in Italy, with the contribution and collaboration of Istat and the ISAL Foundation (Institute for Research and Study of Pain).
The information impact that this monitoring produces – the Institute hopes – will be able to encourage the full application of what Italian law has already established since 2010 regarding access to the pain therapy network for all.
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February 9, 2024 (modified February 9, 2024 | 12:52)
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