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Stanford’s Sean Mackey, MD, PhD on “What is Chronic Pain?”


[MUSIC PLAYING] Chronic pain is
that pain that lasts beyond the time you’d
expect for tissue healing after an injury or surgery. It can arbitrarily be defined as
pain after three months or six months. However, we like this
term after expected time of tissue healing. And chronic pain, as
opposed to acute pain, really serves no
physiologic basis for us. It serves no survival
or beneficial purpose. It’s persistent. It takes a toll on the person
who’s living with pain. But not only that person,
but their family, and then also society as a whole. How big is that burden of
chronic pain to society? Well what we’ve
learned is that there’s about 100 million Americans
who suffer from chronic pain. And that ranges from people
who are self-managing at home, but still very
functional, to those who have this catastrophic
chronic pain that may not even be able to get out of bed, or
may be at end of life care, and then everything in between. The economic burden
to our country is absolutely
astounding where we’re spending in excess of a half
a trillion dollars a year in the care and management
of people with chronic pain. Now that’s more than diabetes,
heart disease, and cancer combined. So it’s an incredible
societal problem. What we’ve also learned
about chronic pain is that while it can be a
symptom of another condition, when it becomes
persistent, it can be a disease in and
of its own right. One that fundamentally
alters our nervous system. This is much like what we see
with diabetes, where diabetes can start off being high blood
sugar leading to impaired glucose tolerance or an
impairment in the way that we respond to a sugar load,
say a donut or something else you eat, and then progress into
this frank disease of diabetes that affects multiple
organ systems. And we’re learning to think
of chronic pain in much the same way. And as that model has evolved,
what we’ve also learned is that chronic pain often
requires chronic disease management approaches. And that means bringing together
multiple groups of people all who are looking at the pain from
different perspectives, all who are lending their expertise
to help that person who is suffering from pain. The preceding program
is copyrighted by the Board of Trustees of
the Leland Stanford Junior University. Please visit us at
med.stanford.edu.

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