Chronic Pain: The Price and Quality of Life Burden at Just One Hospital

About 15% of complex postoperative pain patients end up developing moderate to severe chronic pain, becoming disabled, and using opioids long-term, according to a new study in the journal Pain Management.

About 15% of complex postoperative pain patients end up developing moderate to severe chronic pain, becoming disabled, and using opioids long-term, according to a new study in the journal Pain Management.

Led by researchers from the University Health Network (UHN) in Toronto, the analysis found that costs for patients with chronic post-surgical pain can reach $2.5 million to $4.1 million in one year at just one hospital in Ontario.

“Pain is an epidemic, and the costs to the healthcare system, as well as to patients, are staggering,” Hance Clarke, MD, PhD, FRCPC, medical director of the Pain Research Unit at Toronto General Hospital (TGH), UHN, said in a news release.

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Although only about 15% of surgical patients develop chronic pain, they consume 90% of available pain-related resources. This includes repeated physician visits and extended hospital days — and the average person with chronic pain stays at the hospital an extra five to seven days when compared to patients who are in the hospital for the same condition but without chronic pain. In addition, those with chronic pain are more likely to be readmitted to a hospital.

Clarke explained that 5% of all surgeries performed at TGH result in new chronic post-surgical pain patients. “Identifying at-risk patients, typically those who have pre-existing pain, mental health issues, or chronic use of opioids before surgery, is critical, so that we can develop follow-up plans, and educate patients and other healthcare providers,” he said.

One part of the study looked at 200 patients who had major surgery at TGH, such as thoracic cardiac, gynecological, and head and neck, in 2013 or 2014. A total of 51 patients were experiencing pain three months post-op, and 12 of them (27%) were using opioids. Previous estimates thought this would only be the case for 1% to 10% of patients. Those taking opioids reported worse overall health than non-opioid patients, including pain-related disability due to loss of mobility, altered mood, and diminished ability to work.

Not only is chronic pain a heavy burden on patients’ quality of life, but it also costs a pretty penny.

“We need to break the cycle of pain before it becomes chronic,” Clarke concluded.

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