Arthritis pain and you

Pain is no stranger to people with arthritis. For those newly diagnosed it arrives like a thief in the night and steals their drive to fully participate in society. For others who have a history of arthritis, pain can be chronic, a condition they accept and live with. All pain ranges from mild to severe. But what does arthritis pain look like in Canada and what should we do about it?

Arthritis and its pain affect over 4.5 million Canadians and their families

It's estimated that, by 2016, over 6 million Canadians will be living with arthritis, the leading cause of deformity and long-term disability in Canada. One in 6 live with moderate to severe chronic pain. (Canadian Pain Coalition – CPC- news release, November 3, 2008)

The economic burden of arthritis accounted for 10.3% ($17.8 billion annually) of the total economic burden of illness, but only 1.3% of health science research (ICES 2004).

Long-term disability accounted for almost 80% of the economic costs of arthritis in 1998, at nearly $3.4 billion.

The 35-64 year age group incurred 70% of these costs, proving that arthritis is not just an older person’s disease.

Arthritis is the cause of 80-90% of wait lists for total joint replacement (TJR). Wait times related to joint replacement exceed all other waiting times.

The CPC says, “It is unacceptable that so many of us are living in pain that could have been prevented, cured or reduced with timely and proper care.“

Arthritis tends to be an invisible disease that forces many to become housebound and non-functional members of society.

Our current health care system is unable to address the serious needs of arthritis patients, particularly those living with pain.

A new edition of Arthritis in Canada will soon be published with fresh and up-to-date statistics and information. CAPA will keep you informed.

What do we know about arthritis pain?

Pain is not cool! It's for whiners.

Recognizing arthritis pain is a major health, social, economic and emotional issue.

Arthritis can kill you. Dr. Ted Pincus claims that half the arthritis patients unable to walk for a period of five years will die, the same levels of morbidity for patients with diabetes and severe coronary disease if unable to walk. Pain is the most common reason for inactivity.

According to Dr. Gillian Hawker, epidemiologist and rheumatologist, arthritis and resulting pain together are the underlying cause of more deaths than melanoma, asthma, or HIV/AIDS.

Why arthritis causes pain

Once arthritis affects a joint, the biophysical and chemical changes have repercussions for the body’s overall metabolism spreading the disease – and pain - to other joints. Disability and decreased mobility are by-products of pain. Unfortunately, many family physicians are not trained to recognize, acknowledge and treat arthritis and resulting pain.

The Honourable Ed Broadbent suggested that pain relief is a human right.

When we're in pain....

Being in pain is waiting to be heard, waiting for a diagnosis and the right care. The delay can mean increasing disability with ever decreasing options. Finding the right diagnosis and support frequently is a challenge. It's easy to become disheartened and hard to know where to turn. These tips may help:

Getting a care team that supports and surrounds you is critical. Never be afraid to ask for advice.

A physiotherapist can help. So can exercise and ongoing activity. Check your community to see what is available.

A knowledgeable GP can assist you in accessing the best pain management. In fact, he/she is your gatekeeper to such things as a pain clinic.

If pain can best be managed with surgery, then accessing surgery is important. It can also be time consuming and frustrating. An early diagnosis is important and ideally you will find an orthopedic specialist who will follow you until and after surgery. Surgery can mean the difference between walking and not walking, especially if you have knee, hip and back arthritis.

Managing pain is also an issue: Pain medication prescribed by your doctor that's appropriate for you and your situation is imperative but sometimes not easy to obtain. Be diligent and make sure you get the right ‘prescribed’ medication, and be wary of accepting a generic that was not prescribed.

Pain often has a ripple effect throughout all aspects of your life. You need to learn how to manage how you live with your family, friends and your colleagues at work. Don't hesitate to see a psychologist or psychiatrist for advice.

Knowing that you’re not alone is very helpful. Perhaps the best advice is to find other people with arthritis, perhaps a support group, and consider enrolling in The Arthritis Society Self Management Program (ASMP).

Finding your voice and choices

Accepting a life of chronic pain and disability is accepting a life of misery. We have the choice of helping ourselves by accepting appropriate treatments such as medication and surgery, and learning to deal with our disease in a positive and problem solving fashion. But to properly manage these choices, we must understand our disease, the health system and have a good working relationship with our physicians.

What do we need NOW?

We need to recognize the invisibility of pain, the denial and fear of pain, and the diseases that involve pain. We need to remove the veil of fear, the denial and shame about having pain.
We must remove the phobia, stigma and criminalization of opiates. We need an informed public who are active participants in the decisions about health care and pain management. We need to get rid of systemic barriers in relation to access to care and, medication, and recognize arthritis as the serious chronic disease that it is.