‘I can’t imagine my life if I hadn’t gotten multidisciplinary care when I did. I still have bad days, but now have the skills and support to manage. Pain is part of my life, but it is not my life.’
These are the words of Sarah Fowler, one of the youngest members of Painaustralia’s Consumer Advisory Group. Sarah shared her experiences on her lifelong journey of managing her chronic pain. Before Sarah found the right care, she and her family had spent many years in the search for answers. She is one of the lucky few in Australia who do find them.
Which brings us to the more important question of those who don’t. We know the prevalence of chronic pain is high. We know the impacts are larger. But just how high and how large?
A new report from the Australian Institute of Health and Welfare Chronic Pain in Australia has highlighted the issue again - and again raised serious questions. The scale of the issue is frightening, with one in five people over the age of 45 now living with chronic pain. The data finds that chronic pain has resulted in a 67% increase in GP visits in a decade and those living with these conditions are five times as likely to be limited in daily activities.
How are GP’s managing chronic pain? Despite well-established evidence around the harms, the AIHW report found that people with chronic pain continue to be primarily sent down the pharmacological intervention path, with more than half (57%) dispensed analgesics, compared with one in five (21%) people without chronic pain. Concerningly, people with chronic pain are almost three times as likely to be dispensed opioids, other analgesics and migraine medication as those without pain.
We have been wrestling with the problem of appropriate pain management for a while now. In primary care, over the past few years we have seen multiple attempts to reduce opioid related harm, but more needs to be done. We need better awareness among consumers and doctors about pain management treatment options – and we need to ensure those options exist.
Perhaps most concerning is the report’s findings that in 2017-18, there were nearly 105,000 hospitalisations involving chronic pain. Hospitalisations involving chronic pain involved more procedures: 22% had five or more procedures, compared with 8.9% for other non-pain hospitalisations. More than half of these additional hospital procedures are for allied health, services that could be provided in a community-based setting.
There are significant barriers for most people to access best practice, multidisciplinary care. We hear time and time again from consumers that cost is a significant barrier in accessing this care. Many consumers have also shared the barriers that their geographical locations pose, with very limited access to allied health in regional areas.
Through the public health crisis of the COVID-19 pandemic, we have seen how important and urgent it is to build accessible primary care, so that our acute care services can be available for the high intervention care that they are designed to deliver. As we emerge from isolation, we must not forget these lessons.
People living with chronic pain are already some of the most vulnerable and isolated in our communities. We must build the services that we know are needed to support their unique healthcare needs. Now more than ever, we need to ensure that people living with chronic pain do not continue to fall through the cracks of our systems.