Chronic pain-related disability and use of analgesia and health services in a Sydney community

Objectives: To describe the clinical features, antecedents and impact of chronic pain. Design: Telephone survey of randomly selected household respondents. Setting: Northern Sydney Health Area, metropolitan Sydney, July to September 1998. Participants: 2092 English-speaking residents aged 18 years or over. Main outcome measures: Age- and sex-adjusted prevalence of chronic pain (pain experienced every day for 3 months in the previous 6 months), pain-related disability, and use of health services and analgesic medications. Results: Chronic pain affected 474/2092 respondents (22.1%; 95% CI, 20.2%-24.0%), with high levels of pain-related disability in 129/439 (27%). Nominated causes of chronic pain were injury in 173 (38%), most commonly sports injury (54; 13%), and a health problem in 132 (29%). Pain was work-related in 62 (14%). A musculoskeletal condition was the leading diagnosis (127; 26%). Of the 474 with chronic pain, 374 (78%) had consulted at least one health practitioner for pain in the previous 6 months, comprising medical practitioners (consulted by 292.[60%] and including general practitioners [55%]), allied health professionals (245; 50%), and alternative practitioners (99; 21%). Current or recent use of oral analgesic medications (often over-the-counter preparations) was common (339; 70%). Higher levels of pain-related disability were associated with greater use of medications and health services. Conclusions: Our study shows that chronic pain is common and often results from injury. It highlights the importance of timely interventions to prevent progression from acute to chronic pain and the need for a coordinated approach to managing pain-related disability.