People are developing new cases of chronic pain at higher rates than new diagnoses of diabetes, depression or high blood pressure, according to a study published Tuesday.

The research, which appears in the journal JAMA Network Open, was based on data from an annual survey conducted by the National Institutes of Health, which asked adults how often they experienced pain in the past three months. Chronic pain was defined as pain on most days or every day during that window.

The researchers compared the responses of more than 10,000 people in 2019 and 2020. To determine the rate of new cases that developed during that period, they used a metric called person-years, which represents the number of people in the study and the number of people in the study. of time between people’s survey responses, since not everyone responded at the same intervals.

The researchers identified about 52 new cases of chronic pain per 1,000 person-years. That was higher than the rate for high blood pressure (45 new cases per 1,000 person-years) and much higher than the rates for new cases of depression and diabetes.

Of those who did not have any pain in 2019, 6.3% reported new chronic pain in 2020, according to the study.

«What we’re finding is that, to no one’s surprise, we have a staggering problem of pre-existing chronic pain in this country and a large number of people develop chronic pain every year,» said Dr. Sean Mackey, chief of pain medicine. from Stanford University School of Medicine, who was not involved in the research.

In 2019, about 21% of the more than 10,000 adults who participated in the NIH study reported chronic pain. By contrast, nearly 19% of American adults had depression, while rates of diabetes, heart disease and asthma were below 10%, according to the Centers for Disease Control and Prevention.

High blood pressure was more common than chronic pain: About 48% of adults had high blood pressure, on average, between 2017 and 2020.

«Chronic pain can be a disease in its own right,» Mackey said.

He added that people often experience chronic pain in various parts of the body, but low back pain is the most common, followed by headache and neck pain.

The new study found that people 50 and older were at higher risk of chronic pain than younger adults. However, not all cases persist: About 10% of adults who reported chronic pain in 2019 said they were pain-free in 2020.

To treat chronic pain, many doctors start by prescribing mild pain relievers like ibuprofen or acetaminophen, then move on to stronger drugs like opioids, according to Gregory Scherrer, whose lab at the University of North Carolina School of Medicine studies the underlying mechanisms behind from pain.

But Scherrer, who was not part of the NIH research, said «it’s not clear that opioids are always helpful,» especially since they are addictive and have side effects such as drowsiness and sedation.

Mackey estimated that, in all, there are a couple hundred medications available for people with chronic pain. But almost all of them are prescribed off-label, she said, which means they may not have been studied as chronic pain treatments in large trials and may not always be covered by insurance.

Doctors sometimes repurpose antidepressants, anti-seizure drugs or drugs for abnormal heart rhythms in patients with chronic pain, he said.

«One of the biggest problems we have in society is the accessibility and affordability of access to these treatments,» Mackey added.

In A study last year, about 20% of people with severe chronic back pain said they were not receiving treatment (although the study did not account for the use of over-the-counter medications).

Other options for managing chronic pain include physical therapy, talk therapy, and nerve blocks—injecting an anesthetic or anti-inflammatory drug into the site of pain.

There is no one-size-fits-all approach, Mackey said, and research is underway to give patients better options.

Scherrer’s lab, for example, is investigating ways to develop new, non-addictive pain relievers. In particular, wait identify nerve cells They are responsible for the physical sensation of pain.

«The goal would be to be able to turn off those cells or decrease their activity,» he said.

Scherrer and Mackey said that methods that stimulate nerve cells with electrodes or magnets have also shown promise.

One such technique, called peripheral nerve stimulation, involves a procedure that implants electrodes along nerves outside the brain and spinal cord. The electrodes send pulses to the nerves that trick the brain into turning off or weakening the pain signals.

Another approach, transcranial magnetic stimulation, involves holding an electromagnetic coil against the scalp, which sends pulses to the brain that similarly mask pain signals.

Richard Nahin, an epidemiologist at the National Center for Complementary and Integrative Health who led the NIH study, said doctors have also become more interested in integrative therapies for chronic pain such as acupuncture, massage therapy and yoga.

«Certainly in our clinical trials, which are published in major journals, we are finding benefits for these non-drug approaches,» he said.

Scherrer also emphasized the benefits of cognitive behavioral therapy, which focuses on changing thoughts, beliefs and attitudes to help with pain management.

«Sometimes the brain can repair itself,» Scherrer said. «If you promote a positive attitude and try to encourage the patient to believe that the treatment is going to work, you’re more likely to be successful.»

TO rehearsal of 850 participants found that cognitive behavioral therapy led to a modest reduction in pain but did not reduce opioid medication use.

The ideal strategy for pain management likely involves a combination of different treatments and interventions, the experts said.

In general, Mackey added, it’s best to get treatment early, before a person’s pain begins to diminish their quality of life.

«If it interferes with your ability to work, play, be with family and friends, then don’t suffer in silence. Find a good doctor,» he said.