Treating chronic pain as a disease in its own right

A conference being held in Dublin this week will focus on chronic pain as ‘a disease in its own right’

Most people and even most doctors have trouble understanding pain as being anything other than a symptom of an illness. It was always understood that pain was a manifestation of an underlying condition and not a condition in itself.

That notion is slowly changing as doctors come to realise that chronic pain, mostly located in the lower back, is a medical condition itself. Other forms of chronic pain can be headaches lapsing into migraine, pains in the bones and pains in the stomach. It is a function of a poorly designed nervous system.

The classification of chronic pain as a disease in its own right is the theme of a conference taking place Thursday-Saturday in the Convention Centre Dublin. Entitled Chronic Pain – A disease in its own right and a major healthcare problem, it amounts to an attempt by specialists to raise awareness among the public about the status of chronic pain as a condition.

Traditional approaches to medicine do not categorise persistent pain as a disease. It was believed that chronic pain was an unavoidable consequence of trauma and various illnesses.

An organisation called the International Association for the Study of Pain has defined pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage or described of in terms of such damage”. Even then there are 500 types of chronic pain and no two patients suffer in a similar fashion.

Calls to action

Pain is not currently recognised as a disease in Ireland, changing this will be one of the main calls to action.

Among the speakers at the conference is world-renowned Australian pain specialist Prof Michael Cousins. He will give the keynote Francis Rynd lecture on Thursday named after the Irish doctor who invented the intravenous needle.

He played the key role in the recognition by the Australian government of pain medicine as an independent medical specialty in 2005. Australia is regarded as a world leader in pain management. He has pioneered the use of an electronic stimulator close to the spine which disrupts damaged nerves sending signals to the brain. In a recent interview, Cousins said chronic pain was “a disease in its own right and the basis of it is the sensitisation of the nervous system by fairly complex mechanisms”.

When he started out in the late 1960s, he maintained that only 10 per cent of people with chronic pain could be treated effectively; that ratio is now up to 80 per cent, but the 20 per cent are still relatively helpless.