According to data from the Spanish Society of Neurology (SEN), in Spain, 32% of the adult population suffers from some type of pain. And 11% suffer from chronic pain, that is, they suffer at least one pain condition that lasts more than six months.
Furthermore, 5% of the adult population manifests pain on a daily basis. And this has important implications, a serious physical and psychological affectation in the day-to-day life and a great impact on quality of life of those who suffer from it.
Every pain is different
As the doctor explains Alan Luis Juárez-Belaúnde, Coordinator of the Neuropathic Pain Study Group of the Spanish Society of Neurology (SEN), “there are different types of pain that we traditionally include in three large groups”:
- “Nociceptive pain, which is caused by the activation of pain receptors in response to a stimulus.” In other words, it is the pain we feel when we are injured, some part of our body becomes inflamed, we have some disease, etc.
- “Neuropathic pain, as a consequence of damage to the nervous system’s own communication system and which is considered pathological pain, since it has no use as an alert or defense mechanism,” explains the expert.
- A pain with mixed conditions of the previous two.
Various studies carried out in Spain also indicate that around 30% of the population reports having suffered pain in the last 48 hours, more than 40% in the last week and almost 80% in the last six months.
In addition, both its prevalence and its intensity are higher in women and increases with the age of the patients.
Headache, the most common
“We are thus facing a very common symptom, which accounts for 50% of visits to primary care and, since the neurological system is the starting and ending point of pain, also of neurology consultations”, adds Dr. Juárez- Belaúnde.
«In Neurology, the pain recognized as the first cause of visiting our outpatient clinics is headache, although it can also be expressed in almost all neurological pathologies: neuropathies, demyelinating disorders, Parkinson’s disease, dementias, in some epileptic syndromes, in cerebrovascular diseases, head injuries, tumor processes, encephalopathies, among others, “says the neurologist.
3 million Spaniards suffer from neuropathic pain
“But it is also estimated that 25% of consultations for pain in primary care may be related to patients suffering from neuropathic pain.”
As we have seen before, neuropathic pain is caused by a dysfunction of the nervous system that causes certain stimuli to be interpreted as painful that in reality are not.
The SEN estimates that up to 3 million Spaniards can suffer this type of pain. A pain that, due to its pathophysiological characteristics and the lack of response of more than 50% of patients to the initial treatment, tends to become chronic.
This means that up to 77% of patients can suffer it for more than 3 months and 65% present residual symptoms one year after the onset of pain.
«Neuropathic or mixed pain that also becomes chronic, is the one that usually involves a greater effort of care on the part of the specialist. Despite the fact that in recent years a great advance has been made in its treatment, on many occasions, these are not well tolerated by the patient, or therapeutic adherence is lost due to different factors, or even pain becomes refractory to any type of treatment, “says Dr. Alan Luis Juárez.
Both due to the difficulty of treatment, its enormous pathophysiological complexity and the intense way in which patients experience it, neuropathic pain is considered one of the worst pain.
Its influence is such that both the physical, psychological or functional spheres are affected in the daily life of 85% of patients.
In addition, it is described that around 70% of people affected by this condition may have some type of psychiatric disorder, especially the anxious-depressive type, sleep disturbances, and even chronic fatigue.
Chronic pain keeps increasing
On the other hand, due to the increase in life expectancy in the Spanish population, the prevalence of chronic pain, especially chronic neuropathic pain, is increasing.
The multimorbidity It is especially related to this type of pain and around 88% of the elderly population has these characteristics: with mood range disorders such as depression and anxiety, obesity, diabetes mellitus, cardiovascular and pulmonary disorders, and cancer, among the most common.
In addition, although in pain that is difficult to manage, the combination of two or more specific lines of treatment is needed, with relief in only 50% of cases, suffering from various comorbidities makes it difficult or prevents their adequate action by increasing adverse effects .
The pandemic has increased the pain
In addition, the pandemic has not helped at all to improve the panorama in terms of chronic pain. There are many patients with some type of special pain, at risk of becoming chronic, who have not been properly cared for.
Therefore, it is estimated that in future studies an increase in the chronification and prevalence of pain will be observed. The Spanish Society of Pain, a few months ago, pointed out that last year’s confinement situation has generated that 59.4% of people living with chronic pain in Spain they have presented a worsening of their condition.
“Although we are still learning about the consequences of the pandemic in this area, it seems that Covid-19 has generated, like other more well-known neurological sequelae, neuropathic pain involvement«, Emphasizes the doctor Alan Luis Juárez.
«We estimate a perhaps underdiagnosed presentation of this type of pain in 2.3% of subacute stages of the disease and a representative evidence of presentation of neuropathic pain, likewise, in states recognized as post-Covid and persistent Covid, at present . This is something that we are studying from our Study Group with the Neuropathic Pain Working Group of the Spanish Pain Society », highlights the neurologist.