Chronic Pain Research

Goals

To obtain information about the onset of chronic pain, types of surgeries with a high rate of chronic pain, and types of accidents with associated chronic pain.

Early Findings

Surgeries

  • According to Dr. Buvanendran, professor of anesthesiology at the Rush University Medical Center in Chicago, IL, chronic post-surgical pain (CPSP) following thoracic surgery, has an incidence rate of 50 - 55%, with a larger portion being neuropathic.
  • Breast cancer surgery has a high rate of CPSP following the axillary node dissection procedure.
  • After having hernia surgery, patients have the risk of getting CPSP even if their "nerves during open inguinal herniorrhaphy" are identified.
  • "[S]tudies published from 2007 to 2012", found that 53% of patients in one study and 6% in another study, experienced chronic neuropathic pain following total knee arthroplasty (TKA).
  • Onset signals for chronic pain post surgeries include "severe pain during the first three days", as was reported in one study which saw 82% of patients reporting their experience of having more than 5 episodes of severe pain leading up to persistent pain at 6 months.
  • Darin Correll, in his study, found that "operations with the highest incidence of chronic postoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery".
  • Another study found that "[o]ut of 1,247 [cardiac surgery] patients, 18%, 13%, and 9% reported experiencing CPSP at 6, 12, and 24 months, respectively". It also found that the average cost associated with chronic pain on a monthly basis following cardiac surgery was CAN$207 at 6 months; however, this cost would later decrease significantly.
  • Cornell also found that "preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain" are risk factors that can affect the potential outcome of surgeries. He stated that millions of patients suffer from chronic pain which may range from a few months to years.

Injuries/Accidents

  • Gun violence-related injuries have "higher rates of chronic pain, post-traumatic stress disorder and other physical and mental health problems" in the U.S.
  • According to an Annals of Surgery article, 68% of firearm-related injury survivors had daily pain.
  • Chronic pain and PTSD following a firearm injury in the U.S. have "significantly higher than rates among the general population".
  • Traumatic events such as motor vehicle collision and stress can also be onset signals for chronic pain when there is no nerve or tissue injury present. The pain level that is felt is influenced by the individual's genes (e.g. FKBP5-TG or FKBP5-GG might cause more pain than FKBP5-TT).
  • Chronic pain might also follow injuries from "playing sport, car accidents, home accidents and work accidents".

Summary

  • In our background research, we found information on the onset signals for chronic pain following surgeries and injuries or accidents, examples of the types of surgeries with a high rate of chronic pain, and examples of the types of accidents that might be followed with chronic pain. We took a global approach since this was not specified.

Proposed next steps:

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